EXL steers top insurer’s group disabilities practice to strike excellence in what matters

Challenge

A leading life insurance company recently acquired the group disabilities practice of another leading insurance firm, creating the need to integrate the acquisition and establish best practices. The acquisition occurred during the COVID pandemic.

Prior to COVID, loss reserves were adequate to cover the traditional long-term disabilities demographic – older claimants. However, COVID skewed the demographic younger, flooding the claims department with new claims and not enough resources to process the workload.

With resources in short supply, the firm began outsourcing demand to vendors, creating variable performance across the operation and no set governance to maintain quality. EXL was selected from a shortlist of qualified providers to transform the client’s long-term disabilities operation end-to-end in November 2021. The mission: install best practices, procedures, technology, analytics and governance to improve outcomes, cost efficiency, customer experience and ongoing brand differentiation.

A leading US life insurance company engaged EXL to help organize their newly acquired group disabilities practice for improved performance and greater focus on value.

Solution

EXL hosted a discovery and planning workshop to align stakeholders, clarify the current state of operations, formulate a holistic strategic plan and prioritize future-state initiatives around on roles and responsibilities.

The workshop provided insights into operational quality and productivity metrics useful in managing vendors and individual agents. It revealed opportunities to reduce time and cost across the claims lifecycle and suggested areas for repurposing reclaimed time to improve quality, productivity, pending claims and desk load. Participants also formulated a holistic data strategy, identifying bottlenecks and performance issues, while also addressing ways to improve data access and availability. Finally, a robust governance program was established to facilitate the transformation, measure what matters and ensure success against the strategic vision. Three focused workstreams emerged:

  • Performance Reporting: Supported by data-driven insights gleaned from vendor performance scorecards.
  • Performance Management and Quality Assurance: Based on review procedures to monitor vendor performance quality and work volume capacity.
  • Process Management: Based on documented process maps and process improvement opportunity log.

These workstreams were braced by organizational change management, right-shoring of outsourced resources, and EXL’s conversational AI solution, EXL EXELIA.AI™, an AI-powered, human-like, contextual interaction solution designed to promote customer self-service and improved customer experience in call centers.

Outcomes

The client’s new and improved long-term disabilities claim process successfully relieved key processing bottlenecks and streamlined the onboarding, investigation and handling of claims for greater efficiency and customer satisfaction end-to-end. Currently:

  • New vendor scorecards properly identify vendor quality, guide coaching of lower-performing vendor FTEs, and incorporate quality metrics.
  • Vendor quality scores improved 3-5% over the first three weeks following framework implementation and continue to improve.
  • 17 improvements have been identified in process flow documentation.
  • Preliminary findings suggest 50-60% improvement in process, technology, data analytics and documentation.
  • The team is building a portfolio of 35+ initiatives across an 18-month timeframe based on ideas formulated during the initial workshop.
  • Expected benefits include 10-20% NPS improvement, 20-30% increase in capacity for answering complex inquiries, and 60-70% voluntary customer adoption