Automating Insurance Business Processes with Cloud-Based Fax Messaging

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1 Automating Insurance Business Processes with Cloud-Based Fax Messaging Reduce operational cost, increase competitive advantage, and improve profitability and improve profitability E N T E R P R I S E I N F O R M A T I O N M A N A G E M E N T 1

2 Executive summary Situation: Like many industries today, the insurance sector is experiencing a host of market forces that include economic uncertainty, changes in the regulatory environment, increased competition, and industry consolidations. Concerns about reducing operating costs, increasing productivity, and protecting policyholder information is leading insurance companies evaluate cloud services to reduce their IT expenses and streamline information exchange. Problem: Manual processes associated with fax machines and fax boards in multi-function printers (MFPs) are neither secure nor cost-justifiable. Re-keying information is time-consuming and error-prone, and there is limited oversight of that information and who is ultimately responsible for it. Insurance providers must consider the high costs associated with the use of manual fax processes and the alternative benefits of a more secure, productive way to exchange information that speeds policy administration and claims processing, reduces costs, automates critical fax messaging, and integrates with other business systems. Solution: A cloud-based fax messaging solution improves security, workflow, and productivity. Rather than relying on a paper-based workflow model, implementing an automated method of processing inbound and outbound fax communications via back-office applications creates a more cost-effective workflow system that increases productivity and reduces risk. Many business enterprises faced with similar information challenges are moving to a cloud computing model to address growing IT costs and improve the speed, security, and the efficiency of their business operations. Cloud computing eliminates direct IT costs hardware, maintenance contracts, telecommunications, utilities, and support. This offloads a sizable expense to an organization that can offer more robust capabilities and expertise on a more secure, manageable infrastructure with a predictable pricing model. EasyLink Fax as a Service Solutions provide insurers with flexible messaging options that best fit their business needs. Insurance providers can migrate their entire desktop and production fax operations to maximize operational efficiencies and cost savings, or apply a graduated implementation, selecting specific functions that addresses a specific operational or budgetary plan. Result: Cloud-based solutions offer lower costs, unlimited growth potential, and the ability to capture and integrate unstructured data into business systems. Cloud-based fax messaging services enable insurance companies to conduct critical, high-volume policy management transactions faster and more efficiently by eliminating the error-prone tasks traditionally associated with manual processes. Carriers can streamline claims processing and policy workflows, reduce operating costs, and better serve their customers. OpenText EasyLink provides a proven, next-generation fax messaging model that enables insurance companies to completely eliminate fax machines, enabling them to focus on process improvements that better satisfy business needs and improve the quality of customer service. This results in more lucrative transactions that improve bottom-line profitability for both insurance carriers and agents alike. E N T E R P R I S E I N F O R M A T I O N M A N A G E M E N T 2

3 The burden of shifting IT responsibilities for today s insurers The insurance industry is experiencing many of the same market changes as the rest of the enterprise business community. Greater economic uncertainty, changes in the regulatory environment, increased competition, and other industry forces are all driving insurance companies to reassess their existing processes in order to sustain revenue growth and profitability. According to a 2011 PricewaterhouseCoopers (PwC) report on top insurance issues 1, the industry has identified several topics that insurers must address going forward, which include: How to grow the business while reducing operating costs: With an uneven economic recovery, uncertainty about regulatory and tax legislation, a low interest rate environment, potential insurance buyers and sellers must consider whether to make deals. This is having a significant impact on the financial strategies and corresponding results within the industry. How to streamline fax-based claims processing and improve customer service: In order to grow and maintain profitability, many insurers are attempting to transform their business and operating models by taking a close look at their various products and services, including how they approach customer service and distribution. Costly communication models for claims processing and customer service must now be revisited and improved, and fax represents a large part of the model. How to deal with regulatory issues from both state and federal agencies: The tax legislative environment remains uncertain because of divided government, and insurance carriers remain concerned with the prospect of future higher taxes and its impact on their business. How to address new security and privacy issues: As insurance companies face increased pressures from new regulations, and the security gaps in aging technology systems, they must find more cost-effective ways of reinforcing existing security policies to ensure information privacy for their customers while satisfying regulators in the process. How to migrate old legacy data and siloed infrastructure processes: Insurance carriers are paying closer attention to how they generate, maintain, and apply information. They are particularly focused on making improvements to core operations, including migrating data residing in legacy and disparate information systems to lower-cost computing models accessible via the Internet. Despite these issues, many carriers still rely on expensive, resource-intensive fax machines to manage their customer communications when fax represents an integral part of the insurance policy management and claims processing function. Insurance companies must now find new ways to upgrade customer service, improve communications, and maintain competitive costs for both new and existing policyholders. Forward-thinking companies are looking for new technology solutions that will streamline their core business processes while easily adapting to rapid industry change. The goal of this white paper is highlight the benefits of automating messaging services and workflow processes with a platform-agnostic, cloud-based information service. Using cloud-based services, insurance carriers can increase their competitive posture, reduce operating costs, and seamlessly address future technology demands. 1 Source: PricewaterhouseCoopers, Top Issues: The Insurance Industry in E N T E R P R I S E I N F O R M A T I O N M A N A G E M E N T 3

4 Challenges of maintaining traditional fax infrastructures Fax represents a massive volume of claim activity and transactions, such as sending and receiving applications, claim processing forms, affidavits, and proofs of signature for individuals, spouses, witnesses, notaries, and authorizations. Insurance carriers must now account for several cost factors associated with the use of human/manual processes that include: The time it takes to rekey information The limited oversight to that information The difficultly in tracking information from department to department Who is ultimately responsible for that information? There are three primary IT-related challenges for insurance carriers that rely on paper-centric fax processes: Challenge #1: Infrastructure challenges associated with the administration, support resources and personnel needed to maintain an infrastructure of stand-alone fax devices necessary to process paperbased insurance transactions and functions. Challenge #2: Operational challenges apply to the human side of insurance claims processing, such as rekeying of paper-based information into electronic form, interdepartmental communications between the agency and carrier organizations, managing inbound claims-related documentation, policy and accounting changes, policy turnaround time, and managing any associated oversight/tracking/audit trails. Challenge #3: Cost-related issues associated with maintaining a traditional fax infrastructure: Scalability Costs: Because there is a potential for unanticipated spikes in volume at any time, carriers must maintain a peak volume infrastructure on an ongoing basis. Carriers incur a high cost to maintain this built out infrastructure despite the reality of peaks and valleys in day-to-day fax usage. Liability/Accountability Costs: These are costs associated with the high security risks from personal information contained in paperwork that sits on a fax device. These risks increase as paperwork is faxed from the agent network to the insurer s IT department or between carrier departments without any oversight to prevent personal information, such as Social Security numbers, from falling into the wrong hands. These risks increase the potential for legal penalties. Integration Costs: These are costs related to categorizing, distributing, and archiving fax-based documents. As the volume of paper increases, the human cost associated with managing and categorizing that paperwork also increases. Migration Costs: Mergers and acquisitions require the consolidation of fax workflow processes. Costs related to downtime, moving, and re-routing communications equipment can quickly escalate. E N T E R P R I S E I N F O R M A T I O N M A N A G E M E N T 4

5 Advantages of a cloud-based messaging model for the insurance industry A more cost-effective, secure, and scalable communications solution is available to replace traditional fax messaging. This model must include an on-demand (or cloud-based ) fax system that enables efficient computer-originated communications and fax automation by leveraging the existing IT messaging infrastructure. This system can ultimately improve efficiency and profitability while reducing risk for insurance carriers and agencies alike. EasyLink Desktop Fax and EasyLink Production Messaging (the exchange of information to and from back-end systems) enable insurance companies to conduct critical, high-volume transactions faster and more efficiently. EasyLink hosted services eliminates the error-prone tasks traditionally associated with manual processes so that carriers can streamline claims processing and policy workflows, reduce operating costs, and better serve customer needs. Fax communications will remain a critical component of an overall messaging architecture for insurance claim processing. EasyLink s Production Messaging Services will improve the efficiency of today s claims handling systems by extracting, formatting, and delivering content from enterprise applications and business systems to carriers over multiple channels. A recent survey by Accenture Property and Casualty Insurance Services of 50 U.S. P&C claims executives shows that more than half (54 percent) of respondents surveyed said their core claims systems are more than five years old and one-third (32 percent) rely on more than five different applications to process claims. 2 In terms of claims-related faxes alone, the consolidation of all faxing through one centralized service would streamline the processing of inbound fax communications to desktop users and back-office applications, regardless of the system(s). Cloud computing moves most of the traditionally direct IT costs, such as hardware and software, maintenance contracts, telecommunications, utilities, and support, to external third-party resources without requiring any capital investment. This offloads what would normally be a sizable direct expense to third party organizations that can offer extensive capabilities on a more manageable, transaction-based pricing model. EasyLink Desktop Fax and Production Messaging enables enterprises to do what they do best: refocus their valuable IT personnel and resources on new and more lucrative revenue-generating strategies. Customers pay only for services used, leveraging economies of scale available only from a large global vendor, while enabling role-based information security and confidentiality. A complete audit trail is included for every transaction that passes through the cloud network. OpenText EasyLink provides fax messaging options that best align with a company s business needs. Insurance carriers can either migrate their entire fax operation to maximize operational efficiencies and cost savings, or they can apply a phased implementation for specific applications or messaging functions that addresses their current operational or budgetary plan. 2 Source: Accenture, North American Claims Investment Survey: A Foot in Today, a Leap into Tomorrow for P&C Claims Functions E N T E R P R I S E I N F O R M A T I O N M A N A G E M E N T 5

6 Ancillary OpenText EasyLink services for expanding the automation of cloud-based fax communications Workflow Services Workflow services enable insurers to take control of their incoming fax messages and create an efficient, rules-driven workflow for routing and managing inbound policy applications, trailing documents, orders, claims, and other time-sensitive materials. Using workflow services, inbound fax forms routed to an online queue as an electronic form triggers notifications to designated recipients. This not only assists in faster response but also guarantees that the information is traceable. In addition, workflow services allow authorized personnel to categorize the information, add annotations, and authorize the forms while identifying and managing exceptions. This lowers operating costs by accelerating the delivery of validated transactions into back-office systems. The benefits of workflow services for insurance companies include: Greater Visibility and Control - Workflow services transform the manual handling of inbound transactions into an automated, managed business workflow. Embedded business rules allow administrators to control queues, sorting, routing, prioritization, assignment, and field validation. Real-time dashboards let supervisors assign policy and claim transactions from one user to another, track work-in-progress, and identify and resolve issues before they become problems. Daily reports give managers a view of overall efficiency and areas identified for improvement. Superior Exceptions Handling - Workflow services supports queue management, routing, assignment, field validation, security, and auditing based on embedded, defined business rules. Exceptions can be quickly identified and handled without creating bottlenecks or rework. Supervisors can identify errors or missing information, add custom fields and annotations to transactions, and, if necessary, route them to separate exception queues. Once corrected, they can be routed for processing. Balanced Workloads - Workflow services offers supervisors real-time visibility into the workflow for real-time problem resolution, whether it involves locating and reassigning work from an employee or shifting entire batches of tasks between regions, the system helps supervisors quickly assign and manage tasks within the workflow. Administrators are alerted instantly when queues get too big, transactions get backed up, or tasks sit for too long. Work can be rebalanced rapidly to ensure maximum productivity. Document Capture and Management Document capture and management (DCM) enhances high-volume inbound fax applications by automating the processing of forms-based data into electronic formats importable into your business systems (e.g. claims and policy processing). DCM eliminates the need to manually rekey faxed and ed forms such as policy documentation, insurance claims, purchase orders, or any document that needs to be processed quickly. When an insurance claim or other form is received via fax, DCM technology extracts data fields from the form, and sends this data to the carrier for integration into back-end enterprise systems. This saves both time and cost by eliminating the time and expense associated with manually rekeying of information. E N T E R P R I S E I N F O R M A T I O N M A N A G E M E N T 6

7 DCM converts scanned information into common data types such as EDI, XML, ACORD XML, or more than 100 other electronic data formats. The data is delivered into a designated business system within one to two hours, with a guaranteed 99.5% field-level accuracy rate. The benefits that EasyLink DCM provides for insurance carriers include: Reduced Infrastructure and Personnel Costs EasyLink lowers infrastructure costs by reducing the need for manual fax, scanning, and data capture systems, as well as a dedicated data entry staff. Greater Data Accuracy With manual fax and paper handling, each incoming form must be retrieved, routed, and manually rekeyed into your system. Once an error is introduced into the process, it can cost hundreds of dollars to find and fix the problem downstream. DCM significantly reduces errors and the time required to correct them by eliminating rekeying. Rapid Scalability - EasyLink DCM enables insurance companies to handle unexpected surges of incoming faxes by scaling services to process high-traffic volumes without any deterioration in cycle times. This is especially helpful when catastrophic events occur, (for example, a severe weather event), and corresponding claims can inundate the claims department. EasyLink cloud-based messaging services provide a proven, flexible fax-messaging model that enables insurance companies to improve efficiency with lower operational costs and greater capabilities to satisfy business needs, provide exceptional customer service, and ultimately grow the business. Case Study: EasyLink Fax Services streamline policy processing and reduce costs A nationwide U.S. property and casualty insurance provider realized that they were incurring exorbitantly high labor and operating costs associated with their existing policy processing services. These high costs were directly related to redundant manual procedures used to manage new policy administration and the processing of trailing documents along with supplemental policy-related information. A significant portion of these costs stemmed from the management of faxed documents. When a fax was received, it was then redirected to one of two policy services locations, where it was manually sorted and distributed to an administrator responsible for a specific policy category. The administrator would then rekey the information into their policy management system. The completed form was also rescanned and saved to a third-party archival system. In summary, a communication went from fax transmission to electronic image, then to hard copy printout, and finally back to electronic data via rekeying - clearly representing a highly inefficient, manuallyintensive, and costly information management process. In addition to its extensive and error-prone system, the company projected double-digit growth for their fax usage over the next several years, which required additional resources. Senior management, however, was unwilling to increase IT or personnel budgets in accordance with a corporate initiative to reduce operating costs. They decided to find the most efficient alternative to manage the anticipated document volume while decreasing their operating costs, increasing information accuracy, and improving customer service. E N T E R P R I S E I N F O R M A T I O N M A N A G E M E N T 7

8 The OpenText EasyLink Solution The insurer selected EasyLink s Fax Services, which created a highly efficient and fully-automated system in support of their policy administration and claim processing services. Now, when a new policy document is faxed to them, EasyLink extracts the information where it is automatically fed into their backoffice system. The data is then pushed to the EasyLink Workflow system, where an administrator analyzes the document content and sends it to one of two service cues for policy-specific service processing. Once completed, it is archived to a remote system for long-term storage (Figure 1). Figure 1. OpenText EasyLink reduced the costs of manual document processing by integrating with the customer s back-office system to extract key policy and claim data, and then push the data into appropriate service queues to be managed by account services teams. Result The solution provided a fully-automated system with greater flexibility, extensibility, and the economies of scale they were seeking, without incurring the expense of expanding their IT infrastructure and staff. The insurance company has continually been able to rapidly implement new and re-engineered workflow processes as business operations change - without having to immediately replace their legacy information systems. As a result, the insurance company estimates a reduction in policy-related manual operating expenses by more than 30 percent. Customer response time has increased from hours to minutes, and faster new policy processing leads to faster time-to-payment for the carrier. EasyLink Fax Services can be rapidly implemented. Integrating a complex workflow solution into an existing IT infrastructure, module by module, can take years, and run into the millions of dollars. OpenText EasyLink is able to significantly reduce the time it takes to design and implement automated fax services that meet budget and timeline requirements, without any impact on daily operations and existing IT resources. E N T E R P R I S E I N F O R M A T I O N M A N A G E M E N T 8

9 Figure 2: EasyLink Cloud-Based Messaging Services With OpenText EasyLink messaging services, business documents are processed directly through the EasyLink Cloud into your applications in the format you need. Concluding summary OpenText EasyLink cloud-based messaging services enable insurance carriers to have the best of both worlds: improving business processes with adaptive technology while improving customer satisfaction in the process. When extended to a high-volume fax environment, these services improve customer support policies and related service capabilities. In summary, insurers realize three bottom-line business advantages with OpenText EasyLink cloud fax: Lower Operating Costs Cloud-based messaging is a pay-per-use model. This enables a manageable and predictable cost without any disruption of services due to scalability limitations. Since there are no infrastructure costs, no dedicated support costs, and no need for support, supplies and maintenance, insurance carriers realize significantly lower operating costs. Increased Operational Efficiencies Cloud-based messaging eliminates manual processes and creates an integrated workflow that improves customer service and agent response while improving the accuracy of information. Better Management and Reduced Risk Cloud-based messaging provides a fully redundant, secure, and scalable network, ensuring that all transactions are traceable. This eliminates lost faxes, provides proof of delivery, and safeguards security risks to personal information. Intelligent real-time reporting gives the status of each fax message. Status can be returned directly to the application, ed or downloaded on demand. These reports provide complete visibility and accountability for every fax transaction, ensuring support for regulatory compliance requirements. E N T E R P R I S E I N F O R M A T I O N M A N A G E M E N T 9

10 About OpenText OpenText provides Enterprise Information Management software that enables companies of all sizes and industries to manage, secure, and leverage their unstructured business information, either in their data center or in the cloud. Over 50,000 companies already use OpenText solutions to unleash the power of their information. To learn more about OpenText (NASDAQ: OTEX; TSX: OTC), please visit As part of the OpenText Information Exchange portfolio, the EasyLink & Fax and Document Distribution Group (FDDG) provides market-leading document exchange, messaging, and notification services for businesses ranging from the smallest offices to the largest enterprises. EasyLink & FDDG can deliver even the largest files quickly, securely, and reliably in the format of your choice. At your office or in the cloud, FDDG has a solution for you. or or NORTH AMERICA EUROPE +31 (0) AFRICA, MIDDLE EAST JAPAN CHINA HONG KONG AUSTRALIA Visit online.opentext.com for more information about OpenText solutions. OpenText Corporation is a publicly traded company on both NASDAQ (OTEX) and the TSX (OTC). Copyright 2012 OpenText Corporation. OpenText and OpenText are trademarks or registered trademarks of OpenText Corporation. This list is not exhaustive. All other trademarks or registered trademarks are the property of their respective owners. All rights reserved. SKU# Cloud-based Fax Automation for Insurance_

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