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Case management in insurance

Blog: Column 2 - Sandy Kemsley

Case Management In InsuranceI recently wrote a paper on how case management technology can be used in insurance claims processing, sponsored by DST (but not about their products specifically). From the paper overview:

Claims processing is a core business capability within every insurance company, yet it is
often one of the most inefficient and risky processes. From the initial communication that
launches the claim to the final resolution, the end-to-end claims process is complex and
strictly regulated, requiring highly-skilled claims examiners to perform many of the
activities to adjudicate the claim.

Managing a manual, paper-intensive claims processing operation is a delicate balance
between risk and efficiency, with most organizations choosing to decrease risk at the cost
of lower operational efficiency. For example, skilled examiners may perform rote tasks to
avoid the risk of handing off work to less-experienced colleagues; or manual tracking and
logging of claims activities may have to be done by each worker to ensure a proper audit
trail.

A Dynamic Case Management (DCM) system provides an integrated and automated
claims processing environment that can improve claim resolution time and customer
satisfaction, while improving compliance and efficiency.

You can download it from DST’s site (registration required).

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