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Thurs,june26 215pm-the powerofadvancedanalytics
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Thurs,june26 215pm-the powerofadvancedanalytics



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  • 1. Analytics in Practice: Westfield Insurance’s Claims Analytics and Data Journey www.westfieldinsurance.com Pat Hamilton, VP/ Partner, Strategy and Transformation, IBM  Robert Bowers, National Claims Strategy Leader, Westfield Insurance 
  • 2. Perceived: Europe West Great Brittain
  • 3. Actual:
  • 4. SESSION OBJECTIVES: Learn about Westfield’s claims data and analytics journey and how we: • Leveraged our organization’s budding analytics culture • Prioritized analytics as a primary driver in overall claims strategy • Utilized analytics to inform our transformational effort decisions • Are using analytics and data to improve our organizational and claims operational results Learn IBM’s take on: • Why insurer’s are leveraging analytics • How insurer’s models are evolving • What competencies you need to master for competitive advantage
  • 6. THE ANALYTICS JOURNEY AT WESTFIELD INSURANCE Began analytics journey in 2007 with business intelligence (BI) program • Data silos with mainframe production reporting • Inconsistent standards and definitions • Relationship-based, intuitive decision making bias • No corporate governance of analytics projects • Analysts scattered among business units Where we are now • BI environment / warehouse built out with multiple data cubes covering agency insight and business insight • Data governance structure & awareness across the organization • Leaders more data-focused and asking data questions; tie to performance objectives • Analytics supporting highest priority corporate initiatives • Centralized analytics unit with a focus on delivering business value and developing talent
  • 7. WESTFIELD INSURANCE’S CLAIMS STRATEGY GOALS • Increase customer experience capabilities • Increase analytical capabilities • Optimize indemnity and productivity • Achieve these through: • Introducing multiple data and analytics items • Introducing new processes by line of business • Transforming the organizational design • Introduce new First Notice of Loss (FNOL) processes • Implementing new technology like Claims Management System (CMS) and Electronic Content Management (ECM) capabilities
  • 9. Why use simulation?
  • 10. • Westfield is undertaking a replacement of the legacy claims system. • In addition to dramatically changing the intake channel strategy, we had several business process and staffing changes we were considering. • We had no way to test their options prior to implementation. • In addition, we were at least 1 day above industry average for assigning a claim. • Finally, we needed to know the impacts of implementing predictive analytics at various points in the process. Problem Statement:
  • 11. Results: 1. Reduction of non-claims report related calls. 2. Increase hours & days of operations of internal call center and after hours. 3. Align allocation specialist hours with claims arrivals 4. Increase direct report to 80% of calls (vs. current 25%). 5. Automated office and adjuster assignment . Other outcomes informed by Business Simulation: 1. Used to inform FNOL/Customer Call Center organization structure 2. Insource loss entry function 3. Consideration of expansion of adjuster hours to hit customer service goals 16
  • 13. Coverage Construct Components Westfield  Coverages Coverage  Types Exposure  Types  (Define CMS  screen flows)  Feature  Codes (Causes of Loss)  Data to build   LOB Tree  File  CMS Coverage Sub‐Type • Avg  Reserves • AIA  Coding • ISO  Coverages Feature level  attributes “As‐Is” “To‐Be”
  • 14. Policy ODS Overview CMS  Policy ODS  5.3 System Policy & Coverage  Data  “As‐Is” Policy & Coverage Data   “As‐Is” “To‐Be” Policy & Coverage  Data  “To‐Be” Legacy  Back feed A key component of the new  Policy ODS is the Coverage  Construct which enables the  implementation of detailed  Rating coverages in CMS… A key component of the new  Policy ODS is the Coverage  Construct which enables the  implementation of detailed  Rating coverages in CMS… and enables the mapping of  claim feature causes of loss  back to legacy systems.      
  • 15. • As systems (CMS, ODS, others) built, ensured terms used in system were defined similar to those across organization. • Spent effort to “clean up” old unstructured data in mainframe in the translation layer. • Ensured our organization’s analytical team participated in all aspects of project to ensure quality and consistency. Data Quality Improvements
  • 16. Key Lessons Learned • Enlist senior leadership • Building an analytical culture is critical • Ensure your Claims analytics effort is first an organizational effort • Claims information is an organizational asset – involve loss control, underwriting or others to define goals, objectives and outcomes • Find folks with problems who are willing to accept help; take a very collaborative approach. • Focus on business value – like any other major investment, analytics needs to create value to sustain itself. • Data governance is an organizational issue • It’s a journey • Experiment • You may not get it all done in first release so plan ahead with a roadmap • Pace and space
  • 17. Q&A
  • 18. Robert Bowers, National Claims Strategy Leader Westfield Insurance Contact Information: Westfield Insurance 1 Park Circle Westfield Center, OH 44251 Cell: 330-421-8170 Office: 1-800-243-0210 Ext. 4306840