5 Must Haves To Consider When Implementing a New Claims System

Technology is About the People Both Before and After Implementation

I have just returned from the Americas Claims Event held this year in New Orleans. This was a really great conferences that was well run and provided some great learning opportunities.  This year was an interesting mix of speakers and vendors discussing the latest trends.  It was a great place to hear some of the challenges facing the industry and how are those challenges being solved.

One of the most interesting speeches I heard was given by Paul Tuhy, Global Head of Claims for XL Insurance.  Paul spoke about building effective claims systems and processes and gave some valuable suggestions on how to implement claims projects successfully.  Paul began his speech by going through a bit of history surrounding claims technology from the punch card days to the paperless office. It was a great way to set up how to develop a platform that “flows” with the claims staff.

I believe strongly that claims systems should assist claim handlers in making better decisions and not necessarily be expected to make those decisions for them. In the end, the claims technology must serve claims professionals. This is what Paul Tuhy and XL have been trying to achieve with their technology offerings. Developing a new claims system can be fraught with many challenges, regardless, there are some great ways to make that process better (see Putting Puzzle Pieces Together and the Challenge of Creating a New Claims System and The Legacy Claims System Facelift – 5 Issues To Consider When Looking At New Systems).

5 Ways For a Successful Implementation

Paul Tuhy made the following suggestions to manage development:

  1. Use the best and the brightest on the project: A new IT project for claims cannot be a dumping ground to stick poor performers.  Paul suggests the process should hurt a little and that means taking some of your best claim handlers off their desks to act as the subject matter experts. These experts must be able to think strategically and have a broad perspective in order to assist in what will be a major change for much of the organization.
  2. Consult the business: Don’t build a claims system in a silo. This is a business system and not just a claims system.  Involving the underwriters and actuaries in the process will help to implement an enterprise wide solution to improve the overall business outcome and not just make claims handling easier.
  3. Dedicated executive sponsorship: A project this large and this important needs an executive champion. There must be the ability to help move the project forward and ensure deadlines are met at an executive level or the development may stall.  This will require a large time commitment, however, this commitment will be rewarded with a streamlined approach and the ability for decisions to be made effectively.
  4. Project management: The project team must have passion to move the project forward with a tireless dedication. The team must have the same vision as the leadership to maintain the focus through a long implementation.
  5. Scope creep: The system and suggested changes must have value. It is very easy to sit back and add a piece here and another there.  Prior to making a change to the project a cost benefit analysis must be done.  It is a difficult thing to measure, however, and sometimes system enhancements will begin slow and don’t show their value for several months or years.  Measure those changes after the fact and see if the perceived value actually came to be.

As companies continue to invest money in new technology it is important that those investments do not end up creating more problems.  Claims technology can be a great way to improve efficiencies and lower costs when done correctly.  Too many times projects fail because the up-front time and investments were not made.

How do you help your IT projects succeed?

Shakespeare & Claims: Looking Inward

Looking In From The Outside

Ariana Huffington recently wrote about taking responsibility for ones own action in her article On Dominique Strauss-Kahn, Shakespeare, and the Enemy in the Mirror.  As she reflected on some of the recent news of the week and reminded us that

in the game of life, as Cassius said in Julius Caesar, “The fault, dear Brutus, is not in our stars — but in ourselves…” This was a frequent theme of Shakespeare’s, who put it another way in All’s Well That Ends Well, when Helena says: “Our remedies oft in ourselves do lie, which we ascribe to Heaven.”

So what the heck doe this have to do with claims? More than might appear at first glance.

Insurance companies and claims departments are quick to blame all sorts of issues when problems arise. The loss was unexpected, we didn’t know the information was available, or my favorite, it was the other guy’s fault. As Ms. Huffington went on to write

In the end, if we spent even a small percentage of the time we devote to obsessing about those we consider our rivals, competitors, and enemies on examining where our own fault lines are, it’s hard to believe we wouldn’t be more successful

For companies to be successful they must look inward and then act on what they learn.

Don’t Let History Repeat Itself

Recently I was part of a claim review that found significant issues in not only how claims were being managed, but in how policies were being issued. I provided my report and commentary about what was found. Regardless, the client chose to move forward to renew the account.  It reminded me again of the time when we in claims had recommended the company get out of a particular class of business only to be told “it’s OK we doubled the premium.” Then reality sank in two years later when the loss ratios went over 220%.

Now I am not against writing business. I agree with the principal I learned from the CEO of one of my former companies that it’s not about not writing business it’s about writing the right business at the right prices and terms. Regardless, reviews done in both those cases provided valuable information that could help to improve the operation.

Claims auditing is a way to look inward and learn the faults within our ourselves.  A good claims review can identify weaknesses and provide a road map to improve an operation.  Regular reviews can help prevent surprise and insure the department continues to improve. Of course, the information needs to be used to improve decision making and not ignored.  As has been said “those who ignore history are bound (or doomed) to repeat it.”

Learn From What You Already Know And Review Your Claims Regularly