Policy administration, claims and billing transformation

The systems transformation imperative

Carriers have known for years that their legacy policy administration, claims and billing systems are out-of-date, but have largely worked around the problem with manual processes and front-end technology efforts. However, today's competitive environment, pricing pressures and changing market dynamics are forcing carriers to consider more comprehensive solutions. Accordingly, they are focusing on modernizing their insurance core systems in order to realize efficiencies, gain flexibility and facilitate generation of structured data for business analytics. Carriers that do not adapt risk losing market share while experiencing continually escalating costs.

How PwC can help

PwC provides insurance companies with a customized approach to core insurance systems transformations. We specialize in the following key areas:

  • Transformation strategy and roadmap: Many carriers implement transformation product suites on major business transformation programs. PwC helps property and casualty carriers develop transformation strategies and roadmaps based on leading practices to meet specific business and technical requirements for billing, claims, policy administration and underwriting. We utilize a proven estimation methodology that helps effectively determine necessary outlay for these projects.
  • Business and technology implementation: PwC helps clients implement transformation software by leveraging our accelerators and knowledge base from numerous global projects of all sizes, including:
    • Process narratives, flows and architectural designs, including specific and detailed business processes and rules
    • Pre-built integration adapters
    • Data conversion mapping for common internal and external system and partners
    • Leveraging offshore resources for cost-effective implementation
  • Organization readiness: Preparing and organization to effectively and successfully use transformation software requires changing fundamental behaviors via user training, deployment planning, communications organization and process change. PwC helps clients assess the requirements for and impact of these activities so they can make the most effective use of product suites.
  • Hosting and application management: Including infrastructure hosting (as needed), ongoing management and maintenance of apps, enhancements and upgrades, and leveraging offshore resources for cost-effective implementation.

How insurers benefit

A PwC-led systems transformation has the potential to:

  • Decrease underlying costs and overall expense ratio by over ten percent by:
    • Retiring legacy systems and simplifying existing ones;
    • Eliminating redundant platforms and processes;
    • Lowering maintenance efforts;
    • Increasing operational efficiencies by re-designing business processes, reducing data entry, and increasing productivity;
  • Increase premium growth by improving speed to market, automating risk assessment, and modernizing technologies, all of which decreases data entry points, increases customer self-service, and enables resources to focus on higher value tasks;
  • Expand business analytics, reporting, and data mining;
  • Improve consistency of vendor services outcomes;
  • Provide clear direction and practical recommendations while balancing goals around customer, process cost, and loss;
  • Improve identification of high quality referrals; and,
  • Improve user and customer satisfaction.

Our team

Our systems transformation credentials include:

  • Over 200 advisory professionals with US claims, billing, and policy administration experience who have consulted or worked for leading carriers, brokers, reinsurers and insurance technology vendors.
  • A multi-disciplinary team with expertise in audit, tax, actuarial, advisory and forensic services.
  • Expertise in core systems, with resources in North America, Europe and Asia-Pacific.
  • Numerous projects in core systems strategy, legal management, process design, systems selection, metrics and organizational structure.
  • More than 40 successful policy, claims and billing systems implementations in the last three years, as well as multiple ongoing claims business and systems projects. In fact, PwC is one of the only service providers to have taken a policy administration implementation from business case to roll-out.
  • Solution knowledge from strategic relationships with key insurance vendors and related technologies such as Guidewire, HP/EDS, PeopleSoft, SAP/Business Objects, Siebel/Oracle, Avaya, Pegasystems, and Cognos content management tools and integration technologies.