“Core replacement projects are all targeted to increase the ability of adjusters
to handle claims in a quality way,” he says.
Claims Are Core
California Casualty’s customers are
firefighters, law enforcement officers, and
teachers, and the company understands
how those customers base their insur-ance-buying decisions.
“We do business in fire stations, police
stations, and school lunchrooms. One
person’s claim experience is told and re-
told to every other potential customer
there, and we can’t afford to have a nega-
tive claims experience because it can im-
pact sales,” says Jim Kauffman, senior vice
president, California Casualty. “I can’t
beat the drum enough about how impor-
tant customer service in claims is.”
At California Casualty, claims spend-
ing is strategic and on par with—or even
ahead of—other areas. A Guidewire cus-
tomer since 2008, the insurer recently
completed an upgrade to the latest ver-
sion of the ClaimCenter platform.
Prior to the upgrade, California Casualty had developed two tools in ClaimCenter targeted at enhanced claim service. The first is a workflow tool that
automatically triggers claim file activity
based on specific conditions. The second
is a “recurring activity pattern” tool that
launches activities at pre-determined intervals of time when specific conditions
are met, such as the need to make a payment within a prescribed period of time.
One area where automated workflows have produced a bottom-line benefit is subrogation. Previously, the claims
process at California Casualty had been
linear, where claims were assigned to a
subrogation specialist only after settlement. Using the workflow tool, claims
with subrogation indicators are electronically routed for handling, with the claims
and subrogation investigation processes
Gloria Medlin, a senior claims business
analyst at California Casualty, illustrates
the change in process with a claim involv-
ing a fire caused by a defective appliance.
“Claims adjusters are understandably
worried about repairing damage from the
fire and putting the house back together,
but the investigation needs to preserve
the appliance that caused the fire so sub-
rogation can happen. Being able to seg-
ment a claim and have multiple people
working on the claim from different dis-
ciplines can ensure that happens and that
other areas aren’t overlooked,” she says.