Insurance Services Firm
Claims Fulfillment Process
Discovery and service design to streamline claims processes. Future state roadmap with AI and automation recommendations.
The Challenge
Operations unit engaged our team to analyze and improve their claims fulfillment journey. The project focused on understanding the current state of operations, identifying bottlenecks and pain points, and envisioning a future state that leverages new technologies to streamline processes.
Results
- Comprehensive discovery of current claims fulfillment journey
- Stakeholder and SME operator interviews
- Bottleneck and pain point identification
- Guiding principles for future state development
- Future state vision with streamlined processes
- AI and automation opportunity assessment
- Phased implementation roadmap
- Technology integration recommendations
Discovery + Service Design
Through a series of interviews both with Stakeholders (to understand the environment and priorities), and with individual SME operators who handle various phases of the process, we uncovered a number of bottlenecks and end-user pain points and opportunities. At the same time, we helped crystallize their guiding principles for the outcomes.
Current State Analysis
Our discovery work mapped the entire claims fulfillment journey, identifying each touchpoint, decision point, and handoff in the process. This comprehensive view revealed where delays occurred, where manual interventions were required, and where customers experienced friction.
Discovery Activities
- Stakeholder interviews to understand priorities
- SME operator interviews across process phases
- Process mapping and bottleneck identification
- Pain point and opportunity analysis
Current state journey mapping
Future Vision + Guiding Principles
Working collaboratively with stakeholders, we established clear guiding principles that would inform all future state recommendations. These principles ensured that any proposed changes would align with Genworth's strategic goals and operational constraints.
Responding to the specific pain points of the experience, and brainstorming with the operations and data AI teams, we developed a vision for how the various phases and interactions could be streamlined and more transparent.
This became a roadmap of potential initiatives to implement new technologies to support existing processes and eliminate branches of the process in the future.
Future state journey with automation opportunities
Implementation Roadmap
A key component of the future state vision involved collaboration with Genworth's data and AI teams to identify opportunities for automation and intelligence. We explored how AI could help with document processing, claim routing, fraud detection, and decision support while maintaining human oversight where needed.
The future state vision was translated into a phased implementation roadmap. This roadmap prioritized initiatives based on impact, feasibility, and dependencies, providing a clear path forward for Genworth to transform their claims fulfillment process over time.