Modernizing Claims Content Processing – Next Generation Digitization Tools

Alfresco hosted Digital end to end claims management: an attainable goal? Or an insurer pipe dream for the foreseeable future? for our European and UK based customers. In digitizing claims content, our experience is that most of our clients are indeed digitized but with first generation tools.  This post will describe those early digitization efforts for claim content and what new content and modernization efforts customers are adding to improve speed, efficiency, and security through the claims content management process.

First Generation Claims Digitization Efforts – Dumping Documents Into a Repository

First Generation efforts focused on the removal of paper with image scanning and viewing of scanned images.  While “going paperless” was an important first step in the early 90’s, the evolution of the internet, email, and desktop applications further added capabilities to digitize the experience. While the addition of email removed many of the paper and scanning components, many times resourceful claims processors would leverage desktop tools to “dump” their documents into loosely managed areas of the repository.  Consider the following process of a first generation claims digitization system leveraging desktop tools, using the repository as more of a dumping ground.  

1. Claimant emails to claims@ABC.com that they have had an accident with their car but the car is still drivable.
2. Indexer opens claims in Outlook – looks up customer – creates claim in Claims Data Management System and Content repository – drags Outlook email into repository.
3. Claims Adjuster that is assigned the claim, reviews emails and emails claimant back via Outlook to take pictures of the car as well as contact one of multiple service facilities in the area.  Claims adjuster drops the email to the claimant from their Sent folder into the repository.
4. Claimant takes pictures and emails back to the Claims Adjuster.
5. Claims Adjuster navigates to the right claim and dumps the Outlook email with attachments into the claims folder.
6. Claims Adjuster writes a letter to the claimant about a Request For Repair Estimate in MS Word and emails the document to the claimant.  The Adjuster dumps from the Sent folder into the repository.
7. Claims Adjuster needs to create a package to send to the 3rd party’s insurance company to request payment. Claims Adjuster spends 20 minutes downloading X,Y,Z from repository, converting all documents to PDF, then opening Adobe Acrobat to build the document with selective pages and emails the document to the lawyer.  Hopefully the Adjuster remembers to drag email from Sent folder into the repository.

While the above process is digitized, it is not very efficient and is highly manual as the claims adjuster needs to remember to move items from their Outlook client throughout the process as well as work outside the claim in Word and Acrobat.

Next Generation Claims Digitization Efforts – Claims Content Efficiency

Next Generation focuses on the removal of the desktop components to let the claims adjuster work more efficiently within the claims folder, removing the need to jump to different applications.  The Next Generation approach allows for increased efficiency as well as consistency.  The scenario above can be modernized as demonstrated below:

1. Claimant accesses web or mobile application to alert insurer of accident.  From cell phone number or other data supplied, the claim is automatically created and claim adjuster is assigned.  Initial contact and description is automatically populated in the repository with index from the Claimant. 
2. Indexer – not required 
3. Claims Adjuster reviews the claim and communication directly in the claims folder, then accesses a feature in the claim content system to send an email to the client requesting more pictures.  Communication is constructed from a template and includes claim number and other indexing in the email itself.
4. Claimant receives email along with link to upload pictures directly to the claim folder.  
5. Claims Adjuster – navigate to claim to upload pictures is not required.
6. Claims Adjuster creates communication to the claimant about a Request For Repair Estimate from a template in the claim folder, with the claim number and other indexed data automatically populated.
7. Claims Adjuster needs to create a package to send to the 3rd party’s insurance company to request payment. Claims adjuster combines documents with no downloads or PDF conversions (3 minutes) and emails to lawyer.  The email and document created are automatically stored and indexed in repository. 

You can view an example of the next generation tools in action in the below video.

Summary

Now that most companies have digitized their documents, they can take advantage of next generation tools to make their processes more efficient, consistent, and cost effective.

Let us know your thoughts below.