Soaring sales increased the workload at Control€xpert’s claims processing service—but just increasing headcount did not solve the problem long term. How could C€ stay lean and meet the new demands?
C€ built an innovative platform with IBM that automatically reviews claims sent to insurers, compares them to expected costs, and flags up any unusual figures for verification by experts.
Millionsof euros saved for insurance companies per year
20%more claims can be processed, enabling a more responsive service
Boostsemployee productivity by saving time with automation
Business challenge story
Today, customers expect rapid responses to insurance claims. To address the insurance industry’s need to speed up processes and minimize overheads, Control€xpert (C€) launched an innovative offering that enables insurers to reduce the cost of claims management by outsourcing processing to C€.
Philipp Haac, Head of Operations at C€, begins: “Insurers are jumping at the chance to become faster and make cost savings, and the popularity of our claims processing services is booming—we have grown from processing 10,000 claims per year to 4 million cases per year in Germany alone.
“In the past, we manually reviewed each claim to determine whether the requested payouts were reasonable, but we realized that our team of experts would soon be overwhelmed by the growing workload. To cope with the increasing number of claims, we needed to hire more specialists and make sure we would use their expertise as efficiently as possible.”
In keeping up with growth, C€ had developed a large and unwieldy IT estate, which was becoming increasingly difficult to manage.
Marco Delmes, Head of IT at C€, adds: “To minimize our operational costs and protect our profitability, we decided to standardize our technology platform to streamline and automate our workflows further.”
Making the right decisions, faster
Joining forces with IBM Business Partner S&D Software nach Maß and IBM Software Services, C€ deployed IBM Business Automation Workflow, a platform that enables the firm to define automated claims management processes for each of its insurance clients.
In parallel, the company implemented IBM Operational Decision Manager to identify patterns by detecting potential discrepancies of claims against repair guidelines and determine how to optimize outcomes. Using business rules, C€ can apply expert knowledge to claims in an automated process in order to verify whether the requested payouts are acceptable.
Marco Delmes explains: “Using IBM solutions, we have developed a big data application that interrogates a 2 TB live database and analyzes 120 GB of new data each day, increasing day by day, all supported by a 120 TB IBM Storage SAN. We compare claims against the relevant guidelines, such as manufacturer specifications on the spare parts and amount of labor required to complete various types of repairs.”
Protecting profitabilityToday, the solution processes many items on bills automatically, so that claims experts at C€ can focus their efforts on higher-value activities, such as dealing with complex claims and on-boarding new clients.
Philipp Haac comments: “The new platform is an enabler for our digitization and automation strategy. For example, we are now able to extract more information from incoming documents, helping us to increase the number of rules we apply and thereby the quality of our checking results.”
The company is now able to accommodate growing volumes of work while keeping costs firmly under control. Philipp Haac summarizes: “IBM solutions are saving our insurance clients millions of euros each year in payouts. This capability will help us to maintain excellent profitability, compete more effectively, and expand faster into new markets in the future.
“Better still, increasing our team’s productivity means we can process 20 percent more claims each day and on-board new clients in hours rather than days, helping us provide a more responsive service to our clients in the insurance industry and their end customers.”
The solution also eases compliance efforts by automatically recording each claim processed, payouts and the justification for decisions.
“We can now automatically spot potential errors in bills, such as charges for duplicate spare parts,” elaborates Marco Delmes. “The IBM solution helps us to pinpoint irregularities and cost variations, and feed the information back to insurers, helping them to reduce unjustified payouts. This is yet another way that the solution enables us to sharpen our competitive advantage.”
Control€xpert(C€) is a service provider for the insurance, automotive and car leasing industries. Headquartered in Langenfeld, Germany, the company employs approximately 600 people, processing more than 6 million claims in 2015 and serving clients all over the world.
- Decisions - Legacy
- FSS: Insurance - Core Insurance - Claims
- FSS: Insurance - Front Office - Sales & Customer Service
- System i: System i5 570
- Workflow - Legacy
Take the next step
To learn more about S&D Software nach Maß visit: www.software-nach-mass.com
To learn more about intelligent business process management, please contact your IBM representative or IBM Business Partner, or visit the following website: ibm.com/software/products/en/business-process-manager-family