As a claims management professional, you have to deal daily with formidable - and sometimes competing - challenges: provide superior customer experience; achieve operational excellence and cost containment; and effectively manage risk. Predictive analytics can help you improve each of these three outcomes, but more importantly, it helps strike the right balance among these three objectives for each new claim received. Read this white paper from IBM to learn about applying predictive analytics to claims management, including the typical ROI achieved, how embedded analytics improves decision making, and technology components of a predictive analytics solution.
IBM Software InsuranceBusiness Analytics
Improving claims
management outcomes
with predictive analytics
Executive SummaryContents: This executive report makes the case for applying predictive analytics to achieve the objectives of insurance claims management professionals. 1 Executive Summary A predictive analytics-based solution for claims management:2 Introduction . Improves the three key claims management objectives to provide a 3 Predictive Analytics Defined superior customer experience, to achieve operational excellence and to 3 Proven ROI from Predictive Analytics manage risk. Helps strike the appropriate balance between these three objectives4 Improving Decisions in the Claims Management Process . Enables a "predict and act" approach that is the basis for the highest quality of business decision making6 Technology Components . Delivers measurable and proven ROI7 Making Your Existing Systems Smarter . Is applicable to a wide range of decisions in claims management. Applies analytics at the point of decision making7 Further Reading . Leverages the data you already have7 About IBM Business Analytics . Makes your existing systems smarter. Uses a pragmatic "journey" approachIBM Software InsuranceBusiness Analytics
Introduction . It applies advanced algorithms to help insurers identify as Claims management professionals have to deal daily with early as possible if a claim will require specific resources such formidable, and sometimes competing, challenges: as senior handling teams, litigation support or third party services such as external assessors or a rental car agency. . How to deliver a superior customer experience - filing a Based on this assessment, insurers can assign exactly the right claim is perhaps the single most important of all "Moments resources at exactly the right time.of Truth" in the relationship between insurer and insured and . It applies advanced algorithms to help insurers identify as lays the foundation for customer retention, growth of early as possible where the company can minimize fraud customer value and positive word-of-mouth. Insurers that do and unnecessary payments and maximize recovery from not accurately understand the relationship between key third parties.customer actions (such as policy renewals, buying additional products and services and referrals) and how their customers But, more importantly, it can help strike the right balance experience interacting with them, risk investing between these three objectives. Imagine that for each new claim, inappropriately in initiatives for improving operational you could make the following assessments:processes, customer relationships or risk management.. How to achieve operational excellence and cost . How likely is it that this policy holder will cancel their policy containment - claim payouts and Loss Adjustment at the next renewal?Expenses represent a significant portion of all insurance . How likely is it that this claim will require our senior expenses so any improvements have a very visible effect handlers to get involved?on the insurerīs bottom line. Insurers that fail to make . How likely is it that we will be able to avoid full or partial accurate decisions in, for example, the "right-tracking" of payment because of fraud?claims, suffer unnecessary costs and worsened combined ratios in comparison to peers that do. If you had that information available, how would you change . How to manage the risks inherent to the insurance the way you deal with each claim compared to how you business - Insurers that fail to detect and avoid unnecessary currently work?payments from fraud or fail to recover paid claims from third party liability represent an "easy target" which, in addition to The following figure shows some examples of ways to damage to the corporate reputation, also leads to unnecessary differentiate your claim treatment based on the combination costs and worsened combined ratio of these three factors:
Predictive analytics can help improve each of these three outcomes individually:
. It helps insurers gather information about each customer's attitudes and preferences, apply a range of analytical techniques to deeply analyze both structured and unstructured data, and apply advanced algorithms to determine the best course of action for every individual customer to optimize investments in customer retention, cross-selling and o... [download for more]
