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Alfresco Content Accelerator for Claims Management

Enhance your existing Claims Management System with powerful Content Management

Historically, Claim Operating Systems have been powerful solutions used by insurance companies to manage all aspects of a claim. Systems like Guidewire, Salesforce, Duck Creek and more often custom systems, are instrumental in making an enterprise run. Over the years, as technology has improved (mobile phone usage, drastic increase in rich media and internet bandwidth), a gap in functionality has emerged. These systems excel in managing data associated with the claims process, they lack the robust content management features that modern claims require.

Industry leaders are taking the approach of segmenting these desperate systems and instead of forcing a Claims Operating System to fill a role it was never intended to fill, they are looking to bring in best of breed systems that not only meet, but exceed their document management needs.

Modern Content Management for Claims Operating Systems

Modern

Enhanced Content Management capabilities allowing your Claims Management System to focus on what it does best.

Fast

Content Enable your existing claims systems with a no code configurable solution.

Efficient

Increase efficiency, reduce training and streamline processing times with an interface built specifically working with modern content.

The Alfresco Content Accelerator for Claims Management enables a company to extend their current data-driven policy and claim systems with electronic file capabilities with seamless integration.

Increase Claims Processing Efficiency

One of the goals of most claims processing/member service departments for Auto, Health or any type of insurance is how to improve the efficiency of the claim document access and processing for a better customer experience, satisfaction and retention.

Providing users with quick access to content and modern content functionality decreases processing times and reduces internal claims related costs:

Legacy Correspondence Methodology

The Adjuster was forced to use thick email clients like Outlook and was required to manually download the documents to be emailed. The Adjuster would attach these documents in an Outlook email and send. The Adjuster would then go into their Sent Email and drag and drop the email (with attachments) back into the claim folder to record the correspondence.

Modern Correspondence Directly from Claims Folder

correspondance-in-claimThe Adjuster can select documents in the claim folder, click send email and send the email directly from the claim folder.  Audit activity of the sent email is automatically captured in the system and the documents are linked to the email without being duplicated again in the claim folder.  An address book for the claim folder is maintained recording any outbound email allowing any users that comes into the claim folder to continue the conversation.

Legacy Folder Browsing Methodology

Folders – Service representatives typically would have a glorified file system where they would create folders and sub-folders for specific types of content (Legal, Contract, Communication, etc) and place the file within the folder often naming the document something to indicate the type of folder. Finding new documents required navigating through folders and looking at the names of the documents and hoping that everybody used similar patterns for naming of documents.  Thumbnails and preview were not available and selecting a document required launching the document (and supporting desktop application).

Modern Searching, Tagging & Filtering from the Claims Folder

search-filter within claim folder

Adjusters are not allowed to create folders.  Instead of creating folders, folder tags are created as part of the content ingestion process.  Adjusters can still navigate folders but most (especially large health and workers comp claims) rely on quick viewing of all documents and the ability to search, filter and preview content.

Legacy Content Ingestion Methodology

Documents are added to the system one at a time.  Too often adding attributes would mean guessing the content and retyping claim content from one document to another.  Accuracy is an issue as content typically isn’t viewable until it is in the new system.

Modern Bulk Indexing & Heads-up Display During Ingestion

Heads-up Indexing and Bulk UploadDocuments are added to a claim in bulk from automated processes or directly by the user. Documents are shown during the indexing processing with “Heads Up” Indexing. Documents are indexed or re-indexed while looking at the document and even copying text from the document itself.

Legacy Document Composition Methodology

Documents would be downloaded to the desktop and a combination of Word, Acrobat and other tools would be used to manually create a new document. These new documents would require the user to spend additional time to create and would often never find their way back into the system.

Modern Document Composition from the Claims Folder

Combine PDF within a ClaimThe Combine Documents capability allows users to select multiple documents, choose pages within those documents, reorder those pages, rotate pages and create one high-end piece with a dynamic table of contents. The user and document never need to leave the system or the claim folder.

Legacy Document Annotation Methodology

Documents would be downloaded to the desktop and a combination of Word, Acrobat and other tools would be used to manually create a new document. These new documents would require the user to spend additional time to create and would often never find their way back into the system.

Modern Digital Annotations & Redactions

annotations-redactionsAn Adjuster can preview and annotate or redact directly within the browser without any download.  Annotations are stored with the system as a separate layer with security.  Redactions are typically stored as a new version or a new document depending on the scenario.

Legacy Document Viewing Methodology

Documents would be downloaded to the desktop and a combination of Word, Acrobat and other tools would be used to manually create a new document. These new documents would require the user to spend additional time to create and would often never find their way back into the system.

Modern Document Viewing, Annotations and Bookmarks

high-speed-viewingAn Adjuster can preview and annotate or redact directly within the browser without any download.  Annotations are stored with the system as a separate layer with security.  Redactions are typically stored as a new version or a new document depending on the scenario.

Legacy Document Comparison Methodology

In legacy interfaces, adjusters would be forced to view documents one at a time. If the document was an email or a MS Word doc, the native application (Outlook or Word) would need to be re-launched for each document to be viewed (slow). Users can quickly be overwhelmed by all of the applications being opened when hunting for the document that they are trying to find.

Modern Multi-Document Viewing

side-by-side viewingRendition everything to PDF and view the document in the browser using AEV. By allowing documents to be viewed natively in the browser, documents can be viewed in less than a second, and users don’t loose their place in the document list by viewing the document list and the document content in a side by side viewer.  Once the user finds the particular documents they are looking for, they can choose to launch these documents in separate tabs, or choose two documents to view side by side for comparison.

For a deeper dive into Claim Document Efficiency, read our post here.

Integrate with Existing Claim Operating Systems

As an integrated solution, ACA does not require the replacement of existing systems, only a slight modification to “electronically file enable” the existing claim systems.  Data such as insured name, policy number and claim number is passed to the solution when electronic file system is first accessed, saving critical data entry time and effort and reducing errors.

Claims Management Solution Overview

Case Studies

See how TSG has helped New York Property Insurance Underwriting Association (NYPIUA) replace their legacy mainframe ECM solution with a modern claims processing solution.




Download Insurance Requirements Template

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