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Xebia Solutions

Connected Claims on Appian

Streamline your claims processes, minimize claims leakage, and deliver an exceptional customer experience across the entire claims lifecycle

Offer an outstanding, personalized customer experience with an end-to-end digital claims management system powered by Appian

Employing the Appian Low-Code platform, our Connected Claims solution provides a comprehensive view of each claim's journey throughout the claims processing lifecycle. Users can seamlessly access and review claim data from all claim systems, policy systems, and third-party applications by utilizing the solution's actionable dashboards. This empowers organizations to streamline their claims processes, minimize claims leakage, and deliver an exceptional customer experience across the entire claims lifecycle. 

 

The Challenge

Claims operations teams frequently face the challenge of managing multiple systems simultaneously, causing delays in the claims process and leading to various potential issues, including: 
01

Increased claims leakage and costs

02

Inaccurate decision-making

03

Delayed settlement of claims

04

Decreased customer satisfaction

05

Inefficiencies in claims operations and processes

The Solution

Xebia's digital end-to-end claims management system powered by Appian provides the capability to offer an outstanding and personalized customer experience through tailored and superior claims management with precision and flexibility. 

The Connected Claims solution is specifically designed to cater to the needs of both Property & Casualty (P&C) and Life Insurance to optimize the claims procedure at each stage of the claims lifecycle, spanning from the initial notice of loss to the final claim settlement. 

 

Property & Casualty modules: Disability and Life modules:
  • First Notice of Loss
  • Fraud Case Management
  • Claim Operations and Settlement
  • Customer Service
  • Litigation & Recovery Management
  • Field Inspection
  • Continuous Improvement Analysis
  • Omni-channel Loss Intake
  • Fraud Case Management
  • Claim Operations and Settlement
  • Customer Service
  • VIP and Concierge Mobile Anywhere
  • Continuous Improvement Analysis

 

Features

Omni-Channel Claim Intake

The solution facilitates an efficient and intelligent claims intake, improving customer experience and reducing operational costs, allowing the claims intake process to be managed with precision and ease. It enables customer interaction using omni-channel capabilities (e.g., calls, chats, SMS) while leveraging Dynamic Case Management driven by Appian Records and Intelligent Automation. The claim intake is supported through multiple channels, including but not limited to email, call, customer portal, text, and much more. 

Claim 360

A consolidated perspective of claim details is provided to effectively oversee the entire claims processing journey, from initiation to resolution. The claim dashboard serves as a comprehensive hub for handling all claim-related information, presenting a 360-degree view that encompasses policy details, customer information, claim lifecycle progression, task completion status, past communications, notes, settlement financial particulars, and the ability to respond to customer inquiries through any available channel.

Built-in Analytics

Provide executives and senior management with actionable information critical for any business decisions. Utilizing the Continuous Process Improvement modules within the solution, built-in analytics and insights are accessible for diverse workflows associated with different types of claims. These analytics provide insights into the performance of workflows in terms of both time and cost, enabling decision-makers to analyze current processes to make them more optimal and streamlined. 

Seamless Integration

As the solution is hosted on Appian, it optimizes existing technology investments by seamlessly integrating and consolidating enterprise applications, including current CRMs, policy management systems, payment gateways, and legacy systems. This integration facilitates the comprehensive management of all claim operations.

Omni-Channel Customer Service

Deliver smooth and uniform customer service across various channels such as the website, phone, email, chat, social media, and other digital platforms. Ensure a unified perspective with real-time updates available on the customer case dashboard.

Call Centre Automation

Streamline call center operations through seamless integration with the preferred call center platform, empowering agents to address customer requests/complaints efficiently, create cases, and enhance customer satisfaction through an end-to-end case management framework.

Self-Service Configuration Engine

A specialized self-service configuration portal is provided, empowering authorized users with the flexibility to customize and establish rules for diverse actions according to their specific requirements. These configurations enable administrative users to tailor the workflow journeys for different lines of business, oversee Service Level Agreements (SLAs) and business rules within claim workflows, determine escalation and deadline protocols for various phases of a claim workflow, and designate whether phase step execution is automated or human-driven. Additionally, it facilitates user access management, configuration, and oversight of payment and reserve authorization rules, customization of communication templates, management of configurations associated with field service agents, and many other functionalities. 

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