Business Challenge

When things go wrong, you count on your insurance company to help pick up the pieces. This insurer wanted to speed up claims processing so that it could deliver better service to agents and customers.

Transformation

The insurer is digitizing and automating document capture and management with IBM Enterprise Content Management software, empowering teams in claims and other divisions to work more effectively.

Results

Over 500%

increase in amount of claims captured and classified automatically

648 work weeks

saved quarterly through greater automation, supercharging productivity

Efficiency gains

help teams handle higher claims workload and sustain responsive service

Business challenge story

Moving towards more efficient content management

As the insurance marketplace grows increasingly commoditized, providers must find more effective ways to connect with customers in order to stand out from the pack and maintain a competitive edge. Perhaps nowhere is this more important than in claims, where the speed and quality of an insurer’s response have a huge impact on the customer experience.

This mutual insurance company knows that effective claims management is one of the most important ways to boost retention—both with customers and agents. The firm’s Enterprise Content Management (ECM) Solutions Manager explains: “We offer insurance products exclusively through independent agents. Just as our policyholders have a choice when it comes to picking an insurance provider, our agents choose to work with us, which makes it doubly important for us to deliver a very high quality of service. The faster our teams can work behind the scenes to process claims, the faster we can respond to our customers and agents. This increases their satisfaction and loyalty, and the likelihood that they will continue to do business with us.”

However, the insurer found that inefficient content management processes were making it difficult for teams to keep up with rising workloads, and to deliver top-notch service to customers and agents.

“We work with huge volumes of content, processing over two million documents a quarter in our claims division alone,” notes the ECM Solutions Manager. “Previously, we relied on mainly manual processes to manage this content. For instance, when we received a new claim, teams would have to review the document, enter relevant information like the claim number and document type into our systems manually, then route the electronic claim to the appropriate agent for processing. As it took so long just to get documents into our systems, it was really slowing the pace at which we were able to settle claims, delaying our response to customers and agents.”

He continues: “What’s more, at times of very high demand, such as in the aftermath of a natural disaster, it was simply not feasible for our in-house team to handle all the claims we received. This meant that we had to contract independent adjusters to help with the extra work, which involved sending numerous emails and documents back and forth between our teams—creating more work for employees who were already stretched to their limits. We knew there had to be a better way, and set out to find a solution that could help us manage our enterprise content more efficiently.”

IBM Datacap allows us to settle claims faster and deliver the important financial support that helps customers to weather life’s unexpected events.

—ECM Solutions Manager, Mutual insurance company

Transformation story

Automating document capture

The insurance company decided to tackle its content management challenges at the source—automating the capture and classification of inbound claims documents.

To underpin the new approach, the insurer selected IBM® Datacap. The ECM Solutions Manager says: “We evaluated a number of offerings and IBM Datacap had the edge in terms of solution maturity and capabilities. We really like the direction that IBM is taking with the platform, especially with the development of cognitive capture and mobile capabilities, and we feel that the roadmap for Datacap aligns nicely with how we want to evolve our document capture landscape in the next few years.”

He adds: “IBM also offered the most attractive pricing out of all the vendors we considered. Many other providers used an image-based pricing model, which was just prohibitively expensive for a company with as large imaging volumes as ourselves. By contrast, IBM gave us much more flexible licensing options, where we didn’t have to pay by image.”

Today, some 3,600 users across more than 100 claim branch offices use Datacap to capture over two million documents every quarter. Since introducing Datacap, the insurer has increased the number of claims captured automatically from seven percent to 48 percent; it plans to increase this figure to 75-85 percent in the future.

“We’ve found it very easy to work with Datacap, and the solution has enabled us to automate a number of document capture tasks that previously required manual intervention,” remarks the ECM Solutions Manager. “In the future, we’d like to harness Datacap Insight Edition to take our document capture to the next level. We’re particularly interested in using the platform’s natural language processing and machine-learning technologies to help capture more unstructured content and enable straight-through processing for more documents.”

The insurance company has integrated Datacap with a number of other IBM enterprise content management solutions. It has deployed IBM FileNet® Content Manager as a centralized repository for all the electronic content captured using Datacap. The insurer also makes use of IBM Content Navigator and IBM Case Manager software to provide users with a quick and easy way to access and work with digital information.

The ECM Solutions Manager confirms: “We see clear value in the integration between IBM Datacap, FileNet Content Manager, Case Manager, and Content Navigator. We are able to select the right product mix for a business need and implement solutions quickly.”

Additionally, the company has used Datacap and Case Manager to streamline the way it manages communications from independent adjusters. Today, when one of these adjusters sends an email, the insurer can automatically index the message and any attachments to the relevant claim file. If action needs to be taken in response to the adjuster’s communication, the system can also start a new activity for the insurer’s staff to complete in Case Manager.

Results story

Shaping a better claims experience

Thanks to the increased automation delivered by Datacap, the insurance company is freeing up teams from tedious and time-consuming data entry and validation work, and helping them manage rising claims volumes in a more controlled and efficient way.

The ECM Solutions Manager comments: “Now that we’re capturing and classifying close to half of claims documents without any manual intervention from staff, it has really lifted a burden from our operations team. In fact, we are saving teams the equivalent of 648 work weeks a quarter thanks to the newfound efficiency that Datacap has brought to operations.

“People are no longer struggling to keep up with content, even when we are at our busiest. With Datacap, we’ve been able to smooth the spikes in workload that occur during periods of high demand. Whereas before, people would often have to work overtime to handle the extra volumes, we can now manage it all in a very controlled and efficient way. Not only does this save the business money, it makes for a better working environment for our staff.”

In addition, faster, more accurate document capture is helping the insurer to speed up claims processing and respond to customers and agents much more quickly.

“Datacap helps us get content into our systems much more rapidly, so teams can start working with the information they need right away and make timelier decisions around settling claims,” states the ECM Solutions Manager.

“When we relied on manual processing in the past, it could sometimes take up to a few hours for teams to enter electronic claims into our system and route them to the relevant adjuster for settlement. Today, with Datacap, we can typically have electronic claims ready for adjusters in minutes, so they can complete settlements more quickly. The result is that, in certain cases, we can process claims up to a day faster. By speeding our response to customers and agents, we strengthen their satisfaction and loyalty, which in turn helps our business maintain its competitive edge.”

He concludes: “As an insurer, we help people to put their lives back together when things go wrong, and the quicker we can do so, the better it is for everyone. By enabling us to deliver key content to adjusters more quickly, IBM Datacap allows us to settle claims faster and deliver the important financial support that helps customers to weather life’s unexpected events.”

About Mutual insurance company

This mutual insurance company is one of the largest providers of life, home, car and business insurance in the United States. The company markets its products in more than 25 states through a network of independent agents.

Solution Components

  • Case Manager
  • Datacap Capture
  • FSS: Insurance - Core Insurance - Claims
  • FileNet Content Manager

Take the Next Step

To learn more about IBM ECM solutions, please read our eBook: Outthink Content Chaos