Case Study
UST helps a global insurance technology company automate and modernize its claims processing system, cutting costs 250%
OUR CLIENT
Founded nearly a century ago, this global claims management company provides innovative, technology-based solutions to help the risk management and insurance industries streamline processes, improve accuracy, and accelerate claims resolutions. The company employs approximately 10,000 people, operates in more than 50 countries, and generates more than $1 billion in annual revenue.
THE CHALLENGE
Replacing legacy claims processing system with efficient, automated, modern solution
The claims management company acquired a competitor with an outdated automobile claims handling application. The legacy system was built in the 1990s, and it was the acquired company’s central claim management system. While the system processed more than 200,000 claims annually, the average claim value was less than $750. This high-volume, low-value workflow demanded efficiency to be profitable. However, the aging system presented these challenges:
- Inflexible and unscalable architecture—The decades-old claims processing application wasn’t designed to accommodate additional computing power, hard drive capacity, data storage, or memory, leading to processing bottlenecks.
- Manual processes increased operational costs—Back-office employees and field-based claims adjusters spent excessive time on manual tasks and faced higher workloads, increasing operational costs.
- No mobile access—Field agents were not able to efficiently manage claims on-the-go because of the lack of mobile functionality.
- Batch processing delays—Since the system didn’t provide real-time claims processing, claims were logged into the system but couldn’t be acted upon immediately.
- Lack of flexibility—Application administrators could not define or configure business rules to keep pace with changes in the marketplace, resulting in bottlenecks and manual workarounds.
- Minimal exception reporting—Since the system could not easily detect and escalate exceptions, critical issues weren’t resolved in a timely manner.
The company wanted to replace the outdated claims management application with a modern, scalable solution that could be delivered as a minimum viable product (MVP) within a tight timeline of three months to address these pain points and facilitate growth quickly.
THE TRANSFORMATION
Modernization and automation deliver efficient claims processing with scalable cloud services
UST provided a comprehensive solution that streamlined workflow processes to settle the high-volume, low-value claims. Automated, time-saving workflows included:
- Producing and sending customer correspondence—such as acknowledgment letters, service level agreements at 30, 60, and 90-day intervals, and denial letters
- Closing abandoned claims—to avoid unnecessary work
- Following up on required documentation—to avoid delays and keep claims processes on track
- Prioritizing claims queues—to ensure more critical claims were addressed first
UST went beyond the initial MVP requirements by delivering additional features, such as manual interventions for complex cases and an administrative portal. These additional capabilities enabled the IT team to easily adjust business rules and the user interface for continuous workflow improvement.
The claims management company replaced its outdated legacy application with a greenfield development solution using modern Microsoft Azure cloud technologies. This new system included web and mobile capabilities, empowering field agents with real-time access to manage claims efficiently from anywhere at any time. The solution also utilized web services and APIs to ensure scalability, allowing the system to handle increased claims without performance degradation easily. By leveraging pre-existing Microsoft Azure services, UST integrated time-saving technology solutions, such as search, caching, and queuing, accelerating development cycles and enhancing overall system performance.
Now, the company has a fully automated claims processing solution that drastically reduces manual effort, increases efficiencies, and enhances customer satisfaction. The company achieved the scalability to handle increased claims by modernizing with cloud technologies. The shift to the cloud also improved disaster recovery and system resilience, ensuring continuous application availability. By adopting agile development practices and a continuous integration ecosystem, the company’s IT team could detect and resolve application issues quickly using automated builds, reducing the risk of major disruptions and improving overall system reliability. The combination of these factors provided a modern, flexible system that could easily adapt to the company’s evolving needs, positioning the client for sustained growth and success.
THE IMPACT
Extraordinary improvements—80% acceleration in claims processing cycles, 250% cost savings
The company achieved these remarkable benefits after transforming its outdated claims processing application:
- 80% improvement in claims processing cycles—The average settlement time accelerated from two and a half hours to just 30 minutes, dramatically increasing operational efficiencies and customer satisfaction.
- 250% cost savings—The automations enabled the company to process a significantly larger volume of claims without the need for additional resources.
- 15% of claims processed without an adjuster—The fully automated processes reduced labor costs, contributing to massive cost savings and boosting profitability.
- Enhanced field operations through mobile access—The mobile, real-time system access for field agents and adjusters improved claims management and productivity from anywhere.
RESOURCES
https://www.ust.com/en/what-we-do/digital-transformation
https://www.ust.com/en/what-we-do/digital-transformation/automation