Improving The ROI On Claims Processing

Although computer technologies have been applied to improve productivity in vast arenas of the American economy, the insurance industry had-until now-limited access to technologies designed to improve the productivity of its highly mobile claims adjusters.Legacy systems in this market are costly and require intense IT support. Even then, they do not address the unique needs of this mobile workforce. Adjusters are rarely stationary: They are in the field moving from site to site and do not have the leisure to write their reports comfortably.

The advent of laptop PCs and PDAs with WiFi and/or landline secure connectivity to corporate Web sites-along with new software technologies-enables insurers to improve the productivity of this workforce.

But the benefits associated with a mobile solution must first be identified as hard (direct) benefits or soft (indirect) ones. Hard benefits contribute to an insurer's cash position, while soft benefits are usually measured by productivity gains.

Traditionally, return on investment focuses on hard benefits, but the soft benefits associated with productivity gains are significant too, especially in insurance where many people in the field have heavy workloads and may be loosely managed.

Labor-intensive business

Processing claims is a labor-intensive business. For example, State Farm states that nearly 34,000 people (almost one-half of the company's workforce) are involved in processing claims. As the number of errors and discrepancies occur, claims processing costs rise.

How can new technologies help? In the simplest terms, claims histories can be accessed faster, accurate claims information can be updated on the fly, and errors on new claims can be eliminated. Electronic forms and checklists can be entered directly on a laptop PC and then sent to the field office via the Web. More importantly, paperwork and redundant data entry is eliminated, which saves both paper and time.

One ROI study conducted by iGillott Research Inc., Austin, Texas, examined 3,000 adjusters in the field using these new technologies and assumed a 5% reduction in costs to process a claim.

Assuming claims processing costs average $750 million per year, and each claims adjuster's expenses are $250,000, a 5% decrease in claims processing costs equates to a savings of $12,500 per adjuster. With 3,000 adjusters, the savings total $37.5 million in one year.

How can this be accomplished? Several software solutions are designed to enable insurance companies to control the secure distribution, management and tracking of vital information to their mobile workforce.

Using laptop PCs and/or PDAs, these technologies enable the secure distribution of documents and provide an audit trail of all electronic forms sent to and from the field or head office to adjusters.

In a nutshell, errors are reduced, redundant work is eliminated, and costs are lowered.

Right now, your adjusters may connect to your network to access information only when they are stationary.

The downside to this approach is: Adjusters, who are on the road most of the time, cannot always be connected to a corporate server. In addition, these workers are likely only occasionally connected to the Web, either on land-line or wireless connections.

But, what if they could automatically receive vital information directly onto their laptops, whenever they logged on? And, what if these documents resided locally on their laptops? What if they could complete all forms electronically? And what if they could retain, review and send back to headquarters information stored on their laptops once they are connected?

All these capabilities are available for your claims adjusters who are now only occasionally connected.

Audit trails for compliance

With new software technologies, not only can adjusters access, store and submit vital information, but your field and head office can confirm who received which documents, what time they were accessed, and for how long. What's more, an audit trail can be made available for compliance purposes.

Consequently, automating information processing not only expedites the deployment of information to and from the field, it also substantiates the exact nature of efforts to meet mandated compliance requirements.

Based on the iGillott Research study, the $37.5 million annual savings more than offsets the total cost of ownership for these technology investments--which is $21.5 million over three years, including the purchase of new laptops and ongoing support and maintenance.

This provides a 231% annual ROI if 3,000 adjusters are provided the hardware and software to perform their work with these new technologies.

The growth of mobile work across a myriad of industries has spurred the development of both hardware and software solutions that work in concert with the Web.

The insurance industry can now reap the benefits of technologies that have eluded them for the past decade.

David Koehn is vice president of marketing for TailWind Solutions Inc., San Mateo, Calif.

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