Capgemini/Efma Report Urges ‘Re-focusing,’ ‘Operational Efficiencies’

January 21, 2011

In their recently released 2011 World Insurance Report Capgemini and Efma explore how insurers can “dissect their business to identify opportunities that will make fundamental and lasting improvements to their core operations, with a focus on enhancements to claims transformation. It draws on research insights from 14 countries and covers both non-life (including health) and life insurance segments.” It includes in-depth focus interviews and extensive surveys with 58 insurance executives. 

The report makes five key conclusions regarding the need for insurers to act on the following:
1) Transform claims to meet customer needs while driving results
2) Stabilize reliable claims processing platforms
3) Manage indemnity expenses more effectively
4) Leverage claims data for enterprise-level decision making
5) Ensure critical business agility especially if seeking to thrive long term

 “By the second half of 2009, the economy had started to improve but many insurers were still faced with the challenge of meeting their financial obligations despite losses in investment income, increases in premiums, and other less than ideal operating conditions,” explained Jean Lassignardie, vice president, sales and marketing for Capgemini’s Financial Services Global Business Unit. “The financial crisis is a stark reminder for insurers that they cannot rely on investment income alone to deliver results. Instead, to achieve sustained growth, they must also re-focus on core drivers of operational excellence.”

The report tackles the long-standing issue of how to best handle claim. It points out that “with a less-than-satisfactory claims experience prompting one-in-five customers to switch insurance providers, claims transformation is where many insurers, especially non-life insurers, are finding both operational efficiency improvements and the tangible substantiation of their brand platform necessary to deliver on customer commitments.

“According to the 2011 World Insurance Report, opportunities exist for non-life insurers to capture operational efficiencies in claims, where costs are rising fast. In fact, from 2006 to 2009, the claims ratio rose in nearly every country (except the Netherlands) and outpaced the expense ratio at a greater rate of 4.6 percent to 0.3 percent (acquisition plus operational).

“Inefficiencies – stemming from environmental, technical and organizational factors – are all driving the imperative to transform claims processing. While the potential for driving efficiency varies by firm strategy, country and service segment, within claims, three areas can have immediate impact on achieving efficiency. They include: creating a reliable, predictable claims processing platform, managing indemnity expenses to the right levels and leveraging claims data for enterprise decision-making.”

As a result the report urges insurers to “implement and stabilize a reliable claims platform that leverages technology to enable integrated claims processing, enhance process efficiency and cost effectiveness, reduce cycle times, and allow performance measurement. By closing process gaps, insurers should be able to reduce existing loss-adjustment expenses and drive continued improvements.”

In addition it points to the fact that “while much attention is paid to the cost of paying and administering claims, there is also a significant need for insurers to tackle contingent liabilities (for example, overpayments in vendor transactions or suboptimal recovery practices). Insurers should optimize fraud management to reduce costs (and ultimately improve combined ratios) by making sure fraud is detected quickly and effectively, without undermining customer satisfaction or unduly raising litigation costs or creating net new costs.”

In addition the report advises insurers that the “ideal business information system makes efficient use of enterprise-wide data to support business decisions. Insurers need to leverage the full value of claims data by making sure the right data is captured and used to support business decisions, delivering benefits in terms of profitability, efficiency, strategic planning, and regulatory compliance.

Ultimately, in an intensely competitive insurance market, differentiation through innovative claims management practices is going to be the most important and effective way to maintain market share and profitability. Claims transformation not only improves everyday efficiency and effectiveness, it also enables insurers to deliver on their brand promise and enhance brand value for the long term. It can help drive top-line and bottom-line growth by improving client acquisition, client retention, procedural efficiency and effectiveness, and risk management. Without it, insurers will be challenged to differentiate themselves and maintain and evolve their market position.”

Turning to another sector of industry concern, the report’s authors cite “continued shifts in regulation, customer preferences and technology.” As a result, they advise insurers that it’s imperative to “demonstrate agility in adapting to conditions effectively if they are to solidify customer relationships and achieve sustained results,” they advise.

“Using its proprietary Business Agility Maturity Model,[2] Capgemini assessed the degree to which insurers are agile in various elements of the insurance value chain, such as claims, as well as product design, front office, and policy administration/underwriting. The report found that although agility depends in part on a firm’s business line, insurers can be highly successful by targeting agility in just a few key areas. For example, claims agility is most relevant to non-life insurers, while front-office activities are equally pertinent to life, health, and non-life businesses.

“The model also showed a distinct pattern linking the scale, region, line of business, business strategy and corporate structure of a firm to the maturity of claims agility, as well as other areas of the value chain such as front-office agility. For example, large insurers perform relatively better on agility related to centralization and scalability, and demonstrate low to average maturity in areas related to synchronization and personalization. Small and medium-sized insurers are generally highly agile in areas that impact customer-service levels.”

Source: Capgemini, Efma

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