Special Risk Insurance Provider

This leader in special-risk insurance plans sought a fast-acting remedy to its operational growing pains. It needed to reduce its claims backlog, boost service levels, lower processing costs, and create a platform for growth. The Powers Company established performance standards by position, enhanced supervisory training, and implemented management systems to track productivity, backlog and cost of claims. The results? A 30 percent decrease in cost per claim handled and 70 percent drop in claims processing time.

Our client is a self-contained division of a large insurance company. It offers high-limit-accident medical expense products to colleges, universities, K-12 schools and sponsoring organizations. These plans cover student-athletes competing in sponsored activities, games and practices. Among other functions, the business unit markets, underwrites and services policies; collects premiums; administers claims; and handles case management.

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Objectives

The company needed to reduce its claims backlog, boost service levels, lower processing costs, and create a platform for growth.

Problems

  • High claims processing costs
  • Back log of claims and related correspondence
  • Lack of an effective Management Operating System
  • Declining service levels

Strategy

  • Enhanced supervisory training via workshops & train-the-trainer programs
  • Implemented front-office tools to support growth
  • Improved the Management Operating System:
    • Central reporting system
    • Identified process bottlenecks
    • Developed time & performance standards
    • Implemented claims inventory tracking system
    • Developed daily/weekly reports

Results

By reshaping the behavior of their people and implementing new management controls, the contracts group sharply reduced its case backlog and turnaround times.

70%

Decrease in inventory backlog

30%

Reduction in cost per claim processed

30%

Increase in productivity

70%

Cut overtime hours

40%

Reduction in claim review and processing time