Claims Transformation:
Positioning for the Future
PCS Catastrophe Conference
April 29, 2013
Karen Furtado
Partner
Strategy Meets Action
[email protected]
978.239.2741
Twitter @karenmfurtado
© Copyright Strategy Meets Action 2013
SMA: Strategic Advisory Firm
Our mission is to advise, influence, and keep a finger
on the pulse of the insurance industry
 Advisory Retained Relationship
 Project-based Consulting
 Research – Syndicated and Custom
© Copyright Strategy Meets Action 2013
2
Today’s Presentation
• Thinking Strategically about Risk
• Claims Evolution
• Examine the Marketplace – SMA Research
• The State of the Possible
• SMA Call to Action
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Definition - Single View of Risk
The advance capability of real time insights and information
of policy level and aggregate level risk exposure and the
potential impact of the company’s book of business from a
catastrophe, either natural or man made.
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Definition - Single View of Risk
It’s a common view that leverages risk aggregation and risk
visualization techniques and is shared across all
stakeholders internally and externally.
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Definition - Single View of Risk
To create the single view of the risk, insurers must leverage
clean/complete transaction and external data sources,
various advance geo/location tools and risk analysis tools.
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SMA Top 10 Imperatives for Insurers
Single View of Risk Aligns to 5 SMA Imperatives
Redefine
the Impact
of CORE
Accelerate
Paper to
DIGITAL
Transformation
Optimize
CLAIMS
beyond the
Transaction
Transform
the CUSTOMER
Experience
INNOVATE
for
ADVANTAGE
Extend
ANALYTICS
Profitability
across
the
Analysis
Enterprise
Evolve RATING
with PRODUCT
CONFIGURATION
Capabilities
Commit
to Dynamic
DISTRIBUTION
Capabilities
Take
UNDERWRITING
Claims
Differentiation
Analysisto the
Next Level
Source: Strategy Meets Action 2013
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Big Data – Power of Multiple Data Sources
Transaction
Data
Unstructured
Corporate
Data
External
Datasets
Embedded
Chips and
Sensors
Social Media
/ Web
Source: Strategy Meets Action 2013
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Key Lines of Business for Risk Data & Tools
Percent of Respondents Citing as Key LOB
Source: SMA Research 2012
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Most Important Methods of Enhancing Data
Source: SMA Research, Data and Analytics 2012, n=165
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Innovative Advantage of Surrounding Big Data with
Advanced Tools
Geo-coding
Data cleansing
Risk analysis
Business
Intelligence
Visual mapping
Source: Strategy Meets Action 2013
© Copyright Strategy Meets Action 2013
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Today’s Presentation
• Thinking Strategically about Risk
• Claims Evolution
• Examine the Marketplace – SMA Research
• The State of the Possible
• SMA Call to Action
© Copyright Strategy Meets Action 2013
12
Future
Emphasis
The Future Claims Value Chain
Safety
Loss Control
Engineering
(all lines)
Programs
Loss
Restoration
Loss
Mitigation
Loss
Prevention
Disaster
Wellness
Programs
Real-time
Monitoring
Preparedness
& Alerts
Programs
Current
Emphasis
Mobile
Enablement
FNOL
Negotiati
Coverage
on
Recovery
Assign- InvestigLoss
Verificatio
&
Litigation (Subro &
ment.
ation Reserving
n
Settlemen Mgmt Salvage)
t
Fraud Detection
Case Management
Claim Analytics
CAT Management
Source: Strategy Meets Action 2013
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The Future of Claims
•
•
•
•
•
Instrumentation/GPS
Safety Engineering
Enhanced Risk
Selection
• Location based data
• External risk data
• Analytics
Risk Mgmt. & Loss
Control across lines
• Social media
• External risk data
Wellness focus
Prevention
Mitigation
• Instrumentation/GPS
• Mobile access
• Claimants
• Adjusters
• Partners
• Disaster preparedness
• Improved CAT
management
Restoration
• Mobile adjusters
• Automated/Self-adjusting
• Fully networked providers
• Customer Communications
Management discipline
• New technologies
Source: Strategy Meets Action 2013
© Copyright Strategy Meets Action 2013
14
Today’s Presentation
• Thinking Strategically about Risk
• Claims Evolution
• Examine the Marketplace – SMA Research
• The State of the Possible
• SMA Call to Action
© Copyright Strategy Meets Action 2013
15
IT Spending by Capability Area 2013
IT Spending Moving Out of the Back Office
Front
Office
Middle
Office
Back
Office
Increase
Flat (No Change)
Decrease
Source: SMA Research, Insurance Ecosystem 2013, n=157
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Top 5 Business Drivers of Technology Investment
Percent citing as a key business driver
Source: SMA Research, Claims Transformation 2011, n=337
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Business Capabilities Focus
The focus areas … compliance, efficiency and data
Source: SMA Research, Claims Transformation 2011, n=337
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Technology Capabilities Focus
Efficiency, service and information are the critical areas of focus
Source: SMA Research, Claims Transformation 2011, n=337
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SMA Next-Gen Technologies for 2013
1. Mobile Maturity
2. Social Media Momentum
3. Analytics and Big Data Leverage
4. Collaboration Expansion
5. Cloud Computing Growth
6. Telematics Tipping Point
Source: Strategy Meets Action 2013
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Proactive and Reactive Mobile Interactions
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Data & Analytics for Claims
Reporting
Claim
History
Spreadsheets
Policy
External
Risk Data
CAT Models
Operational
Results
(Efficiency)
Paperbased
Reports
Business Intelligence
Dashboards
&
Scorecards
Ad-hoc
Queries
Analysis
Business
Planning
Information
(Effectiveness)
Fraud
Advanced Analytics
Vendors
Advanced
Statistical
Analysis
Predictive
Models
Predictive
Analytics
Legal
Analytic
Collaboration
Proactive
Loss Control
& Disaster Mgmt
(Transformation)
Source: Strategy Meets Action 2013
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Telematics Tipping Point
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Leveraging Conjoinment
Applications
Technologies
Portals
Front
Office
Rules
Connectivity
Predictive
Analytics
BPM
Illustrations and
e-Submissions
Product Management
Mobile
Data
Middle
Office
Rating
CRM
Social
Media
Underwriting /
New Business
CCM
Policy Administration
Back
Office
Workflow
UXP
Business
Intelligence
Claims
Billing
ECM
Cloud
Source: SMA Research, Insurance Ecosystem 2012, n=126
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Leveraging Conjoinment
Applications
Technologies
Portals
Front
Office
Rules
Connectivity
Predictive
Analytics
BPM
Mobile
Data
Workflow
Middle
Office
Social
Media
CCM
Back
Office
Claims
Business
Intelligence
ECM
Cloud
Source: SMA Research, Insurance Ecosystem 2012, n=126
© Copyright Strategy Meets Action 2013
25
Today’s Presentation
• Thinking Strategically about Risk
• Claims Evolution
• Examine the Marketplace – SMA Research
• The State of the Possible
• SMA Call to Action
© Copyright Strategy Meets Action 2013
26
SMA Definition of Innovation
idea
RETHINK
REINVENT
REIMAGINE
RETOOL
ROLES, PRODUCTS, SERVICES, AND/OR PROCESSES
RANSFORMS CUSTOMER/EMPLOYEE EXPERIEN
AND/OR
ACHIEVES GAME-CHANGING RESULTS …
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Innovation in Action
Travel Industry
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Innovation in Action
Travel Industry
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SMA Business Value Maturity Matrix
Innovate
Excellence
O
P
E
R
A
Effectiveness T
I
O
N
A
L
Competitive
Advantage
Optimize
Modernize
Typical End Point
Replace+
Maintain
Status Quo
COMPETITIVE POSITIONING
Laggard
Mainstreamer
Mover
Market Leader
Source: Strategy Meets Action 2013
© Copyright Strategy Meets Action 2013
30
Today’s Presentation
• Thinking Strategically about Risk
• Claims Evolution
• Examine the Marketplace – SMA Research
• The State of the Possible
• SMA Call to Action
© Copyright Strategy Meets Action 2013
31
SMA Business Value Maturity Matrix
Claims Moving Beyond the Transaction
Innovate
Excellence
O
P
E
R
A
Effectiveness T
I
O
N
A
L
Competitive
Advantage
Optimize
Claims CAT
Capabilities
Modernize
Typical End Point
Replace+
Maintain
Status Quo
COMPETITIVE POSITIONING
Laggard
Mainstreamer
Mover
Market Leader
Source: Strategy Meets Action 2013
© Copyright Strategy Meets Action 2013
32
Claims Transformation:
Positioning for the Future
The content in this deck is the
property of Strategy Meets Action and
a copy has been made available to
attendees of the PCS CAT Conference
April 2013.
Do not distribute externally.
Karen Furtado
Partner
Strategy Meets Action
[email protected]
978.239.2741
Twitter @karenmfurtado
© Copyright Strategy Meets Action 2013