The insurance industry was an early adopter of information technology, and computer systems are still the backbone of core insurance processes. However, in many organizations, technology is no longer an enabler of business process improvement; it has become a constraint that insurance professionals grapple with every day.

The limitations of existing technology are clearly evident in today's claims organizations. In the last decade, visionary claims leaders have conceived of many new claim-handling processes that promise to lower costs while improving outcomes and customer service. Just a few of these new ideas include:

Beginning the adjusting process during the first contact, including referrals across a network of partners to deliver service faster;
Sophisticated segmentation and assignment models that deliver work immediately to the appropriate resources;
Real-time collaboration among a team of professionals both inside and outside the claim organization, including adjusters, attorneys, investigators, case managers, and others.

However, instead of making these ideas a reality, most claims systems serve instead as an impediment to change. Too often, legacy mainframe and client/server systems cannot be modified to support new processes at a reasonable cost. At the same time, adjusters struggle with a plethora of everyday annoyances and obstacles, such as:

The need to constantly switch between multiple screens or multiple systems to access even routine information;
The inability for more than one person at a time to work on (or even look at) the same claim;
The failure to capture required data elements — generally those ignored by the system's original developers.

Guidewire Software is dedicated to enabling innovation in the insurance industry and unlocking the power of technology to improve core insurance processes. Guidewire's flagship solution, Guidewire ClaimCenter, applies this basic principle to claims organizations.

ClaimCenter is entirely built with state-of-the-art software technology; it is written in Java to the J2EE standard, with a pure web client and web services interfaces. More importantly, the system provides claims leaders the freedom to translate innovative ideas into reality. This freedom allows them to tune their claim processes to the specific and evolving needs of their business, rather than struggling with the artificial limitations imposed by legacy systems.

At the core of the system, an extensible data model allows each organization to define the exact data elements they need both to adjust claims and to analyze the claim process. Configurable screen layouts capture the critical information necessary to make accurate decisions at key points in the claim lifecycle. Streamlined communication mechanisms, from system-generated emails to automated flagging and handling of “exceptions,” notify the appropriate claim handler at the moment that intervention is needed–not a week later, when the claim has already escalated out of control.

Behind the scenes, a powerful rules engine gives claims leaders the power to mold the claim process or processes, since a different workflow can be defined for each line of business, state, coverage, severity, or other factor. Based on any of these attributes, claim handling activities can be specified, with varying priorities and due dates, and can be assigned to the most appropriate person inside or outside the company. The extended organization can be subdivided as finely as desired, creating specialist roles with specific permissions, responsibilities, and geographic territories for increased efficiency and expertise.

ClaimCenter provides continuous, real-time management of the claim process. Supervisors can see caseloads across their teams and drill into individual claims, while overdue activities or potentially risky claims are automatically escalated. As a result, managers can not only define their ideal claim processes, but also monitor them in operation and intervene as required. And by analyzing ClaimCenter's database of both claim information (coverages, claimants, vehicles, etc.) and process information (activities, completion times, service levels, etc.), they can better identify the key drivers of claim outcomes and refine their processes accordingly.

ClaimCenter's flexibility is underscored by the diversity of its customer base. Those customers, ranging from single-line insurers with less than $100 million in annual premiums to two of the top 10 U.S. insurers, have made ClaimCenter the most widely selected claims system in the United States in 2003 and 2004, according to the recent Insurance Software Deal Trends 2003-2004 report by Celent Communications. What those customers have in common is a vision of how technology can support innovation and make their companies more successful. ClaimCenter is their tool for making that vision a reality.

For additional information, call (650) 357-9100 or visit www.guidewire.com.

Special Reports /

Vision Becomes Reality with Innovation

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