TRANSFORMED TO A NEXT-GEN CLAIMS MANAGEMENT SYSTEM THROUGH AUTOMATION

A leading Excess and Surplus insurance company providing insurance and risk management solutions to the energy and utilities industry

THE CHALLENGE / REQUIREMENT

The client's legacy system for claims administration with inconsistent and workflow processes were manually handled and had the following limitations

• The line of authority escalation and approval for claims was cumbersome and time-consuming
• There was an inability to enforce SLAs and handle foreign claims
• Implementing minor changes experienced huge turnaround times
• Most of the data were being entered manually by referring to details outside the system, with minimal business rule validation
• Integration with other downstream system was not seamless and required manual handoffs in some cases
• Transaction data reports were manually prepared by CDA (claims divisional administrator) on accessing claims database
• The settlement was completely handled in spreadsheets and was offline with the claims system

The client was looking to achieve an end-to-end core claims system that would integrate with various lines of business - such as property, workers compensation, DAO etc.

THE OUTCOME / BENEFITS

We achieved a seamless transformation from legacy systems to a next-generation platform using BPM-Pega. Our end-to-end claims solution achieved the following outcomes: