Commercial P&C carrier speeds FNOL to achieve SLAs

Industry : Insurance Function : Operations

Company Profile

Leading engineering and technical risk insurer providing equipment breakdown and other specialty coverages as well as inspection services and engineering consulting. Their risk solutions are tailored to client needs and strategies to optimize the reliability, lifespan and efficiency of equipment and operations.

Scope Highlights

  • Guidewire ClaimCenter
  • MS Outlook email
  • PDF form
  • Carriers existing claim vetting solution
  • Address verification and standardization
  • Rules-based data cleansing

Challenge

Commercial insurer has tight SLA commitments for handling policyholder first notice of loss (FNOL) claim. Also to give great service, they accept claims in many ways, including through a web form, emailed PDF/Word document, fax a form, or call to service center. The existing process was entirely manual and prone to SLA misses. Management sought to ingest items to the queue more efficiently, immediately register claims in good order and identify claims not-in-good-order sooner for SLA-preserving intervention.

Solution

The automation monitors Guidewire’s work queue for newly ingested FNOL claims and takes ownership of them. It reviews and validates submitted claims, confirms that it is not a duplicate claim, and determines whether or not the policy is verified. Thereafter, it registers each claim in the right Guidewire workflow and re-assigns the new claim to the right triage team. For claims not-in-good-order, it attempts to correct it through data validation and cleansing rules before redirecting the NIGO claim to the team for manual intervention.

Results

30% of FNOL claims registered without people

75% reduction in FNOL receipt-to-registration unit cost

Improved throughput time for improved adherence to SLAs