Pegasystems conducted a survey of insurance industry leaders and asked them to share their views on the “Top Ten Issues in Insurance” for 2009. The goal of the survey is to provide insight into the business challenges these leaders forecast and are working to address in 2009.
Survey participants were asked to rank how important these issues were to their 2009 business objectives. The survey respondents covered a broad range business and technical professionals from all lines of business within the insurance industry.
The Top 10 Issues in Insurance
- Being competitive in a price driven market
- Maintaining compliance with changing statutory, federal and international regulations
- Creating a consistent customer experience that promotes customer acquisition and retention
- Promoting “ease of use” across varied lines of business and distribution channels
- Effectively mitigating and managing regulatory reviews, fines and penalties
- Managing product development and life cycle components effectively
- Increasing growth with decreasing levels of support resources
- Increasing work automation, process efficiency and continuous improvement opportunities
- Building consistent processes that can be extended across products or lines of business
- Optimizing legacy and mainframe system environments
The original document can be found at the Pegasystems site
Typical insurance process challenges
All insurance companies, regardless of the market segment they serve, share common processes, including business and market development, product development and maintenance, product promotion, and distribution. The processes that would most benefit from BPM, however, vary by segment and according to product types offered by the company.
Accordingly, each market segment has different processes that they would like to improve. The priority assigned to improvement efforts may be based on transaction volume, complexity of work, error rates or overall client pain. Examples of business processes that are prime candidates for business process improvement, by market segment, include:
Application submission, underwriting, policy issuance (new business), inquiry management, call center services, internet services (customer services), contract maintenance, policy loans (maintain contracts), billing, payment processing (collect premium), agent commission management (create/maintain distribution system) – prioritized by individual and group products (respectively)
Manual receipt processing, claims data entry, claims manual adjudication, payment or denial, auto-adjudication, pend management (claim management), recovery of overpayment, claim adjustments/refunds/voids, subrogation (claim adjustment), group processing, membership processing, premium billings, billing/payment reconciliation (membership), claim status, verification of coverage, verification of benefits (customer services) – prioritized by group, managed care (HMO), individual, indemnity and dental products (respectively)
- Property & Casualty.
First notice of loss, analyze coverage, conclude claims (adjudicate claims), submit application, underwriting, policy issuance (issue contracts), endorse policies
The key takeaway is that in a mature market like insurance, no process is off limits when evaluating the improvements that can be introduced by a BPM suite. Improvements that increase the efficiency, effectiveness and agility of existing processes enable insurance providers to outperform their competitors in both the cost to provide products and services and by offering outstanding service to both agents and end consumers.
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