Enterprise Technology Integration Key to Claims

Insurers face an uphill battle when it comes to claims management, according to James Swayze, president and CEO of Symbility Solutions, Toronto. Swayze, who presented on the topic at the 2010 PLRB Claims Conference last week in San Antonio, presented results of a JD Power & Associates study that revealed 46% decline in client satisfaction scores for property claims between 2004 and 2008, and a rising claims process cycle time that averages 18.6 days to close.

“Insurers using the latest satellite roof measurement device, property damage estimating tools or content replacement plans may believe they are up to date,” noted Swayze, “but if these tools aren’t integrated with the claims department’s file, it could just be creating a techno-stew that makes the claims process even more difficult to swallow.”

Gene Roberts, AVP and director of claims at State Auto Insurance, agreed that the using an auto claims model, keeping pace with technology is key. Roberts pointed to the same survey, which revealed auto claims satisfaction scores rising 12% during the same time period. Property managers must grapple with a more difficult equation: integrating technology while providing good quality and service on a more challenging emotional level for the customer. “The auto goes to the shop and comes back, but with a person’s home, you’re really touching a very personal space,” he said.

So how can property claims managers bring their claims to a faster conclusion and increase satisfaction levels? “It’s all about integration,” said Swayze. “Integrate technology so that information can move from vendor to vendor,” he advised. To advance the claim faster and more efficiently, the claims department must control the “supply chain” of information instead of allowing vendors to keep their own parts of it and simply provide reports. This integration would allow claims managers to “understand and measure every piece of the process,” he said.

Swayze pointed to these efforts being conducted in many other insurance arenas. On the auto side, he suggested a program called SceneGenesis, (www. www.scenegenesis.com/) and in healthcare, Eclipsys, he said. Independent agencies, too, are streamlining their efforts using integration tools such as offered by AgencyPort and FirstBest.

Swayze outlined major barriers to integration, such as integrating “data capturing tools” into the claims management system, the IT or legal department might be wary of other parties getting access to claims data, and that would certainly be a concern for claims executives. “Everything today is configurable,” he said, suggesting insurers consider systems using an application program interface to accomplish the integration faster and more efficiently.

Swazye also pointed to cloud computing as a way to simplify the integration process and add even more efficiency. Because the software exists in “the cloud,” it’s accessed by staff through a Web browser. That freedom of access means many more parties could work on the claim, in multiple offices and in the field, Swayze said. Many carriers will probably be considering SaaS in the near future, said Swayze, citing a recent Towers Watson survey showed that 92% of insurance executives said they expect to do a major claims technology investment in the next year.

So, fueled by efficiency needs and claims satisfaction rates, and enabled by tablet computing and cloud computing, claims integration seems to be seeing a convergence of factors that will make a major technology leap more likely in the near future.