Workflow and the Competitive Edge: Improving Policyholder Services with BPM

For most of the last century, insurance agencies were cornerstones of their communities. Agents met with customers face to face, and transactions were sealed with a handshake. Policyholders often were on a first name basis with their agents, and organizations were motivated by a sincere desire to provide the best customer service possible.

While the electronic age has changed many insurance processes, it has not altered insurers’ fundamental motivation of service to their customers. Insurers are recognizing that processes that are dependent on paper tend to impede this objective. Policy issue, agency support, loan processing, billing, claims processing, underwriting support, and other operations can be so paper-intensive that insurers’ abilities to serve their customers in a time-sensitive and efficient manner can be hindered. This trend is universal; however, organizations have recognized that when they are successful in tackling their paper challenges, they are able to realize better customer service and retention, as well as increased revenues.

To counteract some of the obvious complications brought about by paper processes, insurers initially focus on electronic document management (EDM). By making information available electronically, EDM addresses challenges such as document storage and retrieval that is efficient and cost-effective. It also helps organizations recoup costs that are associated with wasted consumables, such as paper, toner, and printing. To these ends, implementing EDM can provide dramatic outcomes for insurers. However, when organizations are able to look beyond an EDM system’s initial capabilities by supplementing their systems with electronic workflow, they are able to realize astonishing results that can accomplish in hours or days processing that formerly took weeks.

Workflow allows organizations to route information electronically, and is configurable and customizable to achieve diverse business goals. A robust workflow solution has the ability to drive business processes throughout an enterprise, and to integrate easily with varied applications such as CRM, A/P, policy administration, and claims. Organizations are reaping vast rewards by implementing automated workflow in claims, underwriting, customer service, mailrooms, customer support, and other operations.

Automated workflow also provides insurers with the ability to automate complex multi-level tasks. The software enables organizations to standardize processes, expedite processing, monitor system activity and employee productivity, and improve processes, sometimes in excess of twenty times their previous abilities. Read on to learn more about innovative workflow implementations that are helping insurers of all sizes to maintain a competitive edge.

Workflow and the paperless mailroom

Often, the constant movement of papers throughout an organization makes it difficult to operate efficiently and to respond quickly to internal and external requests for information. Bins are often scattered throughout organizations for mail that needs to be forwarded to different departments for processing. Copies of faxes might be printed and distributed manually. For these reasons, the mailroom is often a logical starting point for the implementation of automated workflow.

One of the largest Medicare and TRICARE claims processors in the United States uses workflow as the key component to its paperless mailroom. The mailroom handles incoming funds to cover benefit payments, outgoing checks to beneficiaries, and previous outbound checks (including military recipients’ checks) that have been returned for a variety of reasons.

Workflow helps facilitate the handling of increasing volumes of incoming medical benefit and disability checks, as well as related documents and correspondence. Workflow also initiates timely deposits, and removes some of the slowdowns and inconsistencies that can be experienced on a daily basis with traditional processing methods. It provides significant increases in efficiency, and enables this organization to meet mandated service level agreements that are difficult to address using a paper-based process.

To initiate the process, envelope contents are scanned into the EDM system. The account number, check amount, check date, related correspondence, and other information that might be pertinent are gathered and automatically launched through the workflow to the correct recipient in seconds. Workflow provides the organization with ability to route multiple reports and prepare deposits simultaneously, and it eliminates the incidence of lost, misplaced, or delayed information. Workflow integrates with OD390, an On Demand mainframe system, where all of the company’s documents (including scanned images, e-mails, faxes, correspondence, and other media) are sent.

Another insurer has successfully implemented a workflow process to expedite the processing of returned mail. This organization places bar codes on all of its outgoing mail so that when mail is returned, the customer number is readily accessible and the entire process can be automated without the need for human intervention. The type of response that is required is easily determined, and returned mail is routed either to an automated customer calling system or directly to agents for prioritized follow-up. Workflow integrates seamlessly with applications for both systems, facilitating a process that is less prone to error and provides efficient customer follow-up.

Improving underwriting processes with workflow

One underwriting department is able to shorten turnaround time by integrating electronic signatures into workflow, routing updated electronic documents or forms directly to the appropriate personnel for processing. After policyholders electronically sign and submit policy information, the electronic forms are imported into that organization’s EDM system. A workflow process automatically updates customer files to indicate what was submitted, and when. Policy information that is incomplete automatically enters another workflow to ensure that the form is routed to an underwriter for immediate follow-up.

Other underwriting departments use workflow to delegate work. Robust workflow software has the capability to eliminate bottlenecks by allowing your organization to distribute work according to your specific needs. Organizations can distribute work to the first available user in a group, or to the person with the least amount of jobs to perform. Distributions can also be configured to flow to the next person of responsibility within the assigned workgroup. Tasks can even be distributed round robin style, or they can be designated for a specific person. A robust workflow solution will even take into account employee vacation schedules, unanticipated absences, and other real-life occurrences that can cause interruption.

Work distribution is configured by an administrator to ensure that processing takes place in the most efficient manner possible. Underwriters who process information from different states can also use automated workflow to capture a state’s index value on a form so that it is automatically forwarded to the correct state for processing. Workflow software can be configured according to organizations’ specific needs; it ensures that information is routed seamlessly behind the scenes, eliminating the potential for lost documents due to human error.

Workflow throughout the insurance enterprise

Other insurers are realizing dramatic results by integrating workflow throughout their entire enterprise. Some workflow software has the ability to integrate with fax systems so that faxed messages can be automatically routed to an intended recipient’s email inbox. Further integration with an email management tool allows these messages to be indexed automatically, with little to no involvement from staff. In addition to saving paper, toner, and other consumables, this practice ensures that information can be stored and located quickly and efficiently.

Workflow can also be used to automate the insurance cancellation and rewriting process. Under a paper-based system, when a policy number changes due to merging policies or other reasons, it is sometimes common for all of the related policy materials (which could number up to 400-500 documents) to be corrected or updated and manually re-indexed. The implementation of a global workflow system for cancellations and rewriting can automate this process, saving a significant number of hours per month while at the same time providing a sophisticated automated audit trail.

One often-overlooked application of an enterprise-wide implementation of automated workflow is its role in productivity analysis, as well as in external and internal audits. Workflow’s ability to integrate with external and internal applications allows businesses to download audit and inspection reports. Workflow can work behind the scenes to send reports to the appropriate staff daily, so that they are ready for review upon staff arrival. Its reporting ability makes it easier for organizations to meet service level agreements and to comply with increasingly stiff government regulations.

Increasing your capabilities exponentially

Whether you configure it to generate follow-up documents such as thank-you letters or invoices, or to notice new customer numbers and automatically initiate policies, loans, or further reviews of information, automated workflow can improve virtually any insurance process. With workflow, organizations have significantly increased their processing abilities without adding more staff. Smaller insurers are able to compete with organizations that have vastly greater numbers of staff and resources, and larger organizations are able to dramatically increase their efficiency. In describing the flexibility of workflow software, one insurer noted, “There was nothing that we couldn’t do.”

As you look for ways to transform your processes and to connect disparate silos of information, consider that there may be one tool that can address a multitude of inefficiencies. Consider that this tool can be used to optimize customer service. Consider that, at the same time, this one tool can improve operations throughout and within every department in your enterprise. Consider workflow.

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