Manage Automate and Optimize Business Processes:
Automating Insurance
Processes with BPM
A Whitepaper submitted by Adeptia
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Table of Contents |
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Overview |
4 |
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Challenges and
Opportunities |
4 |
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Adeptia BPM for
Insurance Solution |
5 |
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Book of Business
Transfer |
6 |
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Solution Highlights |
6 |
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Process Flow
Template |
7 |
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Agency - Carrier
Interface |
8 |
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Solution Highlights |
8 |
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Claims Management |
9 |
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Solution Highlights |
9 |
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Process Flow
Template |
10 |
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Benefits to the
Insurance Industry |
11 |
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Adeptia BPM for
Insurance Architecture Illustration |
12 |
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Adeptia Features
and Functionality |
13 |
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Summary |
14 |
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About Adeptia,
Inc. |
15 |
Overview
Before change could
come completely to this heavily regulated and most paper-and process-bound
industry, there are challenges to be addressed and opportunities to be
availed. 9/11 has posed the biggest challenge to the core business of
insurance industry therefore existing strategies, offerings and processes
are being reviewed carefully. As a result of terrorism and fraudulent
activities, industry has been imposed with many federal regulations. Irrespective
of the fact that these regulations would benefit both insurers and customers,
industry is going through tough time in implementing them. Commoditization
of insurance is another disguised opportunity for insurers; however it
challenges their efficiency and agility to think innovatively and take
proactive actions to provide customers with need based and easy to buy
solutions.
On one hand is a need
to minimize exposure to risk, save claims, underwriting and other administrative
costs. On the other hand is the constant push to provide better service
and customized offerings. (Although claims recovery is the ultimate truth
that validates the dependability of insurers, claims are yet far away
from being the single point of judgment.)
The industry needs
tools that could help save cost yet improve quality of offerings and service.
Insurers need to strike a balance while implementing the cost saving and
quality service strategies to make best use of the dual faced situation.
Challenges and Opportunities
The following are most
dreaded factors for the insurance industry.
State and federal
regulations
Some state and federal regulations present a competitive disadvantage
for insurance carriers competing with other financial service institutions.
For example, compliance with regulations like Financial Modernization
Act of 1999 (Gramm-Leach-Bliley) and Health Insurance Portability and
Accountability Act of 1996 (HIPAA), USA Patriot Act of 2001, Terrorism
Risk Insurance Act of 2002 and Sarbanes-Oxley Act of2002 have all added
to the costs of doing business.
Commoditization
of insurance
Policies are becoming
more packagable, particularly in the low value,high volume sector. As
a consequence of this commoditization, reducing costs of managing policies
and claims has risen as a key issue. Keeping expense ratios in control
is all important for maintaining profitability.
Compete with non-insurance
verticals
The industry is experiencing
increased competition from other industry verticals like banking and manufacturing.
Now many banks leverage their client base to sell packages of various
financial products, including insurance products.
The insurance
Mergers and acquisitions
As a result of mergers
and acquisitions in 1990’s many companies have more than one system for
any given function such as claims processing systems, multiple billing
systems, and multiple user interfaces. These systems are not compatible;
therefore require dedicated human staff to manage information exchange,
data consistency and integrity.
Expanded scope of
risk management
Risk management after
9/11 has increased its scope. Now it also includes operational risk in
addition to investment risk. It is important that companies balance their
risk portfolio to withstand political mishaps, terrorism etc.
Downfall in equity
market
Volatility in the equity
market has risked insurers’ reliance on there turns from their investment
portfolios, because the low interest earning is no more sufficient to
balance underwriting losses.
For the complete article go to:
http://adeptia.com/products/whitepapers.html
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