2023 KMWorld Media Kit Available Here 

Protecting the future through good relationships: Portals help insurers and their customers

The insurance industry is taking advantage of portals for knowledge management, using the Web-based tools for sharing information with a number of departments within an organization, including underwriting, billing, finance and customer service.

By Kim Ann Zimmermann

While Web portals have been around for while, the trend now is toward ones specifically designed to meet the demands of an industry, and insurance is among those adopting this KM strategy. While insurers face the same basic needs as any organization—customer service, human resources and accounting—the industry also has some distinctive workflow requirements that can be met through a tailored Web portal.

For example, a claim that has come in for processing might take one route if the dollar amount is under a certain figure, and another route if the claim is above a certain figure. An application must be reviewed by a number of people in the organization before it is approved, and the group of people reviewing an application might vary depending on the type of insurance the applicant is seeking and the level of documentation required.

While KM can streamline communications within an organization, insurance companies also need strong knowledge sharing capabilities with their agents and representatives in the field. Agents need the most up-to-date information on products and services to represent the company to the client. A doctor dealing with dozens of insurance companies needs to automate the process of submitting the reams of documentation his office is required to submit to the insurance company.

The need for more effective communication and improved service spurred Humana to look for a Web-based KM system. Humana is one of the nation’s largest publicly traded health benefits companies, with about 6.4 million medical members located in 18 states and Puerto Rico. The company offers a range of health insurance coverage and related services to employer groups and government-sponsored plans.

In August, Louisville, KY-based Humana launched a Web-based community “hub” for doctors, patients, employers and insurance brokers called Emphesys. The insurer deployed technology from InSystems. Electronic certificate delivery provides a dramatic reduction in the time it takes to put benefit plan information in customers’ hands as well as improved efficiency and customer satisfaction.

“The speed of service delivery is exceptional,” explains Jim Hartman, senior manager of application development for Humana. “Documents can be generated almost instantly, so members can see their benefit coverage immediately.”

Certificate revision is also paperless. “With InSystems' Calligo, new versions can be generated, delivered and maintained in the repository without having to reissue everything on paper,” says Hartman. “If a state mandates a change, for example, we can generate and deliver the revised document electronically, as well as highlight the differences for our customers to see. The potential to do changes and put the documents in the hands of the insured quickly is a tremendous benefit and enhances our relationships with our customers.”

Initially, Humana is using Calligo to generate group health and life certificates for all new customers using Emphesys. “We built the templates for each site using set rules based on different criteria such as state, type of benefit, package, etc.,” says Hartman. “All documents and revisions are stored in a repository for online access.”

InSystems has since packaged an insurance-specific portal, which was unveiled in April. “We’re seeing a shift in philosophy in terms of portals,” says Andrew Jackson, chief marketing officer and general manager of eXterity, a product division of InSystems. “There is an ever greater need to support agents and representatives. Insurance products are becoming more complex as competition increases, and insurance companies need fast and effective ways to communicate.”

As competition in the insurance industry becomes even more fierce—with more companies offering various products and services—customer relationships are even more crucial, according to InSystems’ Jackson. “The insurance companies need more information about their customers. They need to have transactional events trigger interaction with the customer,” he says. For example, if customers add a new dependent to their policy, it might trigger the system to send them some marketing material about additional life insurance for their expanded family.

In order to perform those tasks effectively, the KM system must be linked to all of the insurance firm’s legacy systems, which is often a difficult but necessary task. “These systems need to be integrated with the back-office systems, and there can be as many as 30 or 40 in an insurance company,” Jackson says. They are sometimes developed in house, or they have been heavily modified, making the task even more challenging.

While communicating with agents and representatives in the field is crucial, insurance companies also look to portals to strengthen their relationship with users. Many companies have pushed out much of the process to users--employees--and are using KM systems to help them provide information quickly and accurately over the Web. They need to be able to access physician directories, account information and other information online that was traditionally provided in book form by human resources departments.

Canada Life, the first InSystems eXterity customer, and one of the first Canadian carriers to offer booklets, contracts and self-service online, now offers its 7,700 group insurance customers advanced self-service functionality. Canada Life implemented eXterity for group self-service in summer 2001.

“All of our important stakeholders are benefiting from the enhanced functionality, and our call centers are seeing a dramatic improvement in terms of productivity,” says Tom Corcoran, VP of group insurance for Canada Life. “Working with InSystems, we were able to revolutionize our interactions with our extended and external relationships.”

Boosting customer service was a key issue for the annuity arm of AIG, which purchased American General Annuity last year. The company is using Optika’s workflow and imaging products in its AIG Annuity Insurance division.

“This area primarily deals in fixed annuities, so we really needed a head-down workflow process to hit our customer service benchmarks,” says David Hays, network application manager. The system has enabled the establishment of process times and provides reports about how close the company has come to its target.

“We set a standard for each type of transaction,” Hays says. “For example, we’ve set a standard of three days for processing withdrawals, and the system can monitor the workflow and provide reports on how close we came to achieving those goals.”

Kim Ann Zimmermann is a free-lance writer, 732-636-3612, e-mail kimzim2764@yahoo.com

KMWorld Covers
for qualified subscribers
Subscribe Now Current Issue Past Issues