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Advisory process

Integrated Claims and Benefits Management

For an insured person, claims management is the “moment of truth”, where the insurer shows whether the promises in the policy are being kept. For an insurance company, this is not only a central lever for reducing costs but also for increasing customer satisfaction. However, realistic improvement measures supporting the business and clients are needed to take advantage of this opportunity. 

Although the processes and expertise differ between the lines of business, some general optimisation trends exist, like technology-supported forms of prevention, collaborations with external data providers, process automation, and intelligent triage and monitoring processes that optimally support case management.

Client benefits

  • Reduction of claims management costs and customer complaints through optimised claims reporting, verification, triage, and prevention processes
  • Definition and effective implementation of suitable improvement measures by closely collaborating with claims experts
  • Optimised cost-benefit ratio through professional analysis of the actual situation and possible target solutions

finalix contribution

  • Design and provider evaluation for the integration of external data sources; evaluation of implementation options for the new claims processes within a feasibility-cost-benefit analysis
  • Operational improvement and documentation of the claims processes (incl. touchpoints with sales, underwriting and customer service) utilising training and involving process SPOCs within different claims teams
  • Requirements specification for triage and rule-based validation systems and definition of preventive measures (care management) to achieve the optimal balance between claims processing costs and claims costs

Our experts

Marcus Steger 1
Dominic Keller 1
Senior Manager

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