measure results on claims outcomes. BI
also provides a mechanism for monitoring and establishing alerts based on an
insurer’s defined targets, providing immediate notification of claims hot spots
or areas needing attention.
Tracking key measures such as frequency, severity, claims closed, open to
close ratio, and average duration/settle-ment timeframe, arms an insurer with
actionable knowledge. How many claims
went to litigation and what were the results? With this knowledge, insurers can
better determine what future cases make
sense to pursue.
Additional examples of where BI is
used in performance management of
E Tracking reserve statistics
E Monitoring losses by class code and
exposure to determine where an insurer
can establish or improve loss control procedures
E Tracking LAe expense and recovery
metrics to determine improvement op-
BI claims performance management
also looks to incorporate data external
to the claims system. The more data, the
more thought goes into what to analyze.
Combining loss data with data stored in
surements, such as cycle time analysis,
track the time required for each step in
the claims process—information valu-
able in determining how the claims op-
eration is performing to standard and
When effectively put to use via business intelligence
(BI) tools, the secrets buried deep in the data can help
transform claims managers into knowledge managers.
the policy system to tap into key policy
attributes can uncover more about the
specific nature of the loss. This new information can help future product design and underwriting, and also offer
helpful considerations for loss prevention. Incorporating vast data sets available on social networking sites can assist
in monitoring claimant activities to uncover potential fraud.
Whether called operational BI or operational management, it is designed to
monitor the business process. key mea-
where potential bottlenecks may exist.
Operational management provides
the trend analysis required to measure
continuous improvement efforts. Delivering near real-time views of the claims
process via dashboards as well as easy
reference to benchmarks, enables an
insurer to track overall process performance rather than considering resolution of an individual claim.
However, operational data tends to be
less standard, and data quality can be a
challenge in getting good analytics.
Some insurers use BI for cycle time
analytics to track various claim recovery