Short-term insurance and medical aid companies in Africa are under extreme pressure to keep up with the growing volumes of claims, with vital information embedded in faxes, emails, handwritten notes and phone calls that have pertinent information which need to be processed timeously.
However, the fact is that these forms of data have traditionally been too big and too complex to collate. As a result, insurance companies haven’t known what information to look for to effectively manage these data sources from a claims processing perspective.
Most of us have experienced the frustration of dealing with insurance contact centres when all too often, claims fall through the cracks, resulting in unexpected expenses. Not only are costs incurred by these companies to compensate for these operational inefficiencies, but there is also the annoyance and embarrassment of having to explain to suppliers why these claims have not been paid.
The end result – Poor customer service and operational risk issues, often with legal implications. But all is not lost and these challenges can be avoided. The solution lies in adapting proven technologies to address the key challenges that this big data brings into the claims processing environment One such approach is the adoption of a Claims Data Quality platform to bring order and structure to this deluge of information.
The Claims Data Quality platform is optimised to collect and analyse the growing volumes of data necessary to improve overall claims management. The platform extends existing claims management systems through applying business rules to process and collate useful and important information that may be buried somewhere within a document, facsimile or email. Such information include, for example, address, policy number, claim number and any time specific information that has to be acted on, and then routed to the appropriate staff member that deals with that claim.
So, instead of embarking on a ‘rip and replace’ project of their claim management systems, short-term insurance firms now have access to a platform that integrates to existing systems to provide a solution to this growing problem.
This approach not only speeds up claims processing but can extend the lifespan of their claims management systems. These claims are made actionable in a workflow system and monitored by, for example, an operational claims manager, to ensure that the claims process is followed through in the required time frame.
Furthermore, it is an essential component that short-term insurance companies urgently need to address. Companies that develop a reputation as poor or slow payers quickly lose credibility and market share. On the other hand, companies that process claims quickly and accurately not only ensure customer loyalty, but also increase profitability through reduced loss adjustment expenses and improved risk management,
Claims data quality enables business staff to work side-by-side with IT to improve and manage the quality of information. Through an intuitive, easy-to-navigate environment, companies can quantify data conditions, develop business rules, deploy data quality services, and support governance with dashboards and reporting that assesses the compliance of data to business policies and requirements. In this way, they are able to not only extend the lifespan of their systems, but focus on being a more efficient, reputable company.
Gary Allemann, MD at Master Data Management