One of the largest U.S. insurance companies needed strong performance management systems to manage its 16,000 claims representatives. Nuvento offered a web-based Business Reporting Framework that provides scorecards based on user types.

Nuvento’s client is one of the largest insurance companies in the U.S, offering a range of insurance and financial services products. The organization operates across 41 states with a client base of more than 15 million customers managed by 16,000 claims representatives.

As a market leader, the insurance company’s vision is to drive innovation and operational excellence and give each one of their customers the best value and experience.

Claims management plays an integral role in achieving this objective and is responsible for the decision making and operating expenses.The claims representattive is the first point of contact for insurance customers when they file a claim. The representative need to be highly capable in providing customer service and processing requests, while at the same time ensuring policy holders do not violate insurance contract payment terms. The revenues of the company are directly dependent on the competency of the claims representatives.

With increased competition, a volatile economy and the profitability of the organization riding high on the performance of these claims representatives, the insurance company needed a robust performance management system to manage the productivity of its 16,000 representatives. They required a platform that could give a holistic view of the talent available. This included proficiency levels,outcomes against determined performance measures, behavioural patterns, customer satisfaction levels and areas of training and development.

The insurance company invested in a Business Intelligence (BI) solution for the performance management of its claims representatives.

Unfortunately, the organization was unable to experience the full benefits of the solution even after several months.

Nuvento Solutions

Nuvento adopted a multi-pronged strategy and took up data cleansing as the first priority. A centralized Data Warehouse was built, bringing down the volumes of data to 16 terabytes organized into Star Schema.As a performance management framework, we built a balanced scorecard to monitor and implement strategy maps covering auto, commercial, property and workers compensation lines. The metrics and Key Performance Indicators (KPIs) were created and based on 4 million claims with more than 200 million transactional activities on a yearly basis.

We implemented a web-based reporting system that integrates with Lightweight Directory Access Protocol (LDAP), providing access to wider information. The reporting system assists the entire organization spanning 20,000 employees, to make performance decisions based on operational data.

Nuvento used its own product called Business Intelligence Report Center to organize the data in OLAP models. Users across the organization were able to generate self created reports in a record time of 5 seconds. Prior to this implementation it took 10-15 minutes to create any report.

Predictive analytics were used on the volumes of organizational data to create a proprietary claim scoring algorithm.

The BI solutions were developed on the best technologies in database management systems:

SQL Server Analysis Services (SSAS)

SQL Server Reporting Services (SSRS)

SQL Server Integration Services (SSIS)

NET Framework 3.5

Supporting applications used to make the performance management system effective were:

Claims System (Siebel) to extract data on claims, reserves, payments, vendors, inventory, etc

Employee Management System (Oracle) for employee based data

Audit Management System (Oracle/Text Files)

Estimates Management System

Vendor Management Systems

Customer Service Survey Management System

Policy Management System

Since its inception in 2007, Nuvento has built strong expertise in Business Intelligence solutions. Our BI capabilities are complemented with consulting, process engineering, technology and quality assurance to provide a complete experience. Nuvento also creates its own intellectual property to provide customized solutions to our clients across industries. Nuvento provides its customers with Rapid Development models by combining the right mix of People, Process , Tools and Technology.

Claim Data Consolidation

There were several new fields that were added to the system which were mapped to the reporting data warehouse by Nuvento team. Most of them were created as a part of end user system change. To state an example, the system was updating certain claim quality information for the claims representatives. Later the system was modified to accommodate the historical value. This change was absorbed into the ETL package development task after a detailed analysis and delivered the modified ETL package to production within a week time. The agile approach helped in developing the performance scorecard system efficiently.