Insurance the way we do it

Claims Analytics for Insurance

How much does your organization pay to process claims?

The cost of processing claims has the right decisions at various touch a large impact on any insurer. It is points during the claims process. estimated that for every dollar collected in premiums, 13 cents is spent on Capgemini has helped large global claims processing. Anything that can insurers derive insight from their data lower this cost increases profitability and optimize claims decision making and puts your company in a better by leveraging predictive analytics. position against your competition. Using analytics, insurance companies can reduce costs, minimize waste In addition to direct processing costs, and improve profitability for claims. the costs of fraud and litigation make We provide consulting and advisory claims more expensive than necessary. services around strategic assessment, The FBI estimates about $45 billion is planning and road mapping to lost per year in non-health insurance enable you to leverage analytics in fraud, and litigation expenses use decision making. up even more money earned on premiums. To minimize the money lost on these activities, insurers need to have accurate and timely data to make www.capgemini.com/financialservices

Our offerings include data mining, data IN PRACTICE: Predictive model for recovery helps insurance visualization, forecasting, optimization carrier save $3mm and other predictive analytic capabilities for insurance companies For a global insurance carrier, n False positives: Claim appears to be to help answer the toughest questions. Capgemini helped apply predictive subrogation but is not For example, a historical report cannot analysis to help minimize the claims n False negatives: Subrogation claim is not answer the question: what is the best sent to subrogation. The claims were detected because this is an unknown thing that can happen if I make this evaluated as follows: pattern product-line decision? An executive n Not all recovery claims are sent to with access to sophisticated forecasting subrogation The Results

n techniques and analytics can make n Not all claims sent to subrogation are For automotive and workers comp, the better, faster and more impactful recovered insurance carrier can now identify and prioritize high quality recovery opportunities decisions than an executive who is n Some claims sent to subrogation are looking at a simple rolling average. not relevant for recovery n The carrier achieved a 50% lift rate in quality referrals for workers comp and a 12% lift n Actual status of referred claim may be rate for automotive With analytics, insurance executives unknown can make decisions that impact the n Overall, the carrier projected $3mm in cost n This may lead to less accurate models company strategy, uncover new savings annually niche markets, or negotiate earlier contracts with vendors based on peak productivity forecasts. Predictive analytics can improve the ability of your insurance company to compete, Claims n First Notice of Loss routing including innovate and react to the changing Optimization of: claim complexity identification and insurance landscape. n Subrogation early salvage detection n n Evidence gathering Fraud detection including claimant, Capgemini can help make your vendor, agency and network fraud n Assignment including adjustor and claims process more efficient by detection introducing predictive analytics within vendor assignment the process to drive decision making, n Litigation avoidance For more information, contact us at [email protected]. from early identification of litigious n Medical management claims to fast tracking noncomplex claims to identifying recoverable claims accurately and optimizing recovery. This can all be achieved non-intrusively through offline scoring About Capgemini and the and reporting or the models can be integrated into your existing systems Collaborative Business Experience like Guidewire, enabling both adjusters and the system to optimize decisions Capgemini, one of focused methods and tools. Capgemini based on actionable predictions the world’s foremost utilizes a global delivery model called ® derived from the predictive models. providers of Consulting, Technology Rightshore which aims to offer the and Outsourcing services, has a unique right resources in the right location at way of working with its clients, called competitive cost, helping businesses Distribution and Servicing the Collaborative Business Experience. thrive through the power of collaboration. n Profitability and life time value n Simulated rating or renewal Backed by over three decades of industry Capgemini reported 2009 global revenues and service experience, the Collaborative of EUR 8.4 billion and employs over n Offer optimization to cross-sell Business Experience™ is designed to 90,000 people worldwide. additional products or up-sell help our clients achieve better, faster, additional features more sustainable results through seamless More information about our services, access to our network of world-leading offices and research is available at technology partners and collaboration- www.capgemini.com. FS201005120451CS Copyright © 2010 Capgemini. All rights reserved.