The Challenge
Insurers rely heavily on claims organizations to maintain high levels of customer satisfaction, minimize loss exposure and deliver strong annual operating results. The efficiency of the claims process can have a direct impact on an insurer’s loss adjustment expense and combined ratio — critical measures that tie back to the insurer’s overall underwriting profitability. Improving claims processes is often a challenge with product or line of business centric operations limited by legacy systems, manual workarounds and an inability to respond to change. To improve the operational efficiency of their claims organizations, insurers need an agile solution that can minimize expenses, mitigate claim “leakage” and quickly identify fraudulent activity. Daunting tasks when you factor in the pressures faced by insurers, from an ever-changing regulatory landscape, a challenging legal environment and deteriorating economic conditions.

The Solution
Pegasystems’ SmartBPM® technology provides property and casualty insurers with the tools they need to take control of their claims management processes. Pegasystems’ Claims Servicing Backbone (CSB) provides an insurer with the foundation to manage a claim event from "first notice of loss" straight through to claim closure. Insurers can leverage Pega’s unique claims management approach to efficiently manage work across functional areas of a claims operation. CSB provides insurers with a lifecycle process to accelerate the development of custom claims management solutions. Industry-leading BPM technology gives insurers the flexibility to design the claims processes that suit the needs of their business — building a foundation that can be leveraged across a global claims enterprise.

Solutions In Action


Agents Grow New Customer Equity	CRM Excellence Pleases Customers	Automated Decisioning System	Rules-Driven Documentation Delivers
$70 Million in New Business	Company Cuts 30% of Claims Examinations	BPM Saves $2.2 Million Over Five Years	BPM Makes Better Audit Trails
Cross-Selling and Up-Selling Increased	Insurer Increases Cross-Sell Success	Faster, More Accurate Retrieval	Claims Exceptions Cut Back
Massive Sales and Profitability Increase	CRM System Automates Customer Cases	Business Process Costs Cut with BPM	More Accurate Customer Data