1. Analytics in Practice:
Westfield Insurance’s Claims Analytics and
Pat Hamilton, VP/ Partner, Strategy and Transformation, IBM
Robert Bowers, National Claims Strategy Leader, Westfield Insurance
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
5. FROM OHIO FARMERS TO WESTFIELD GROUP
6. THE ANALYTICS JOURNEY AT WESTFIELD
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
7. WESTFIELD INSURANCE’S CLAIMS STRATEGY
• 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
8. BUSINESS SIMULATION
9. Why use simulation?
10. • Westfield is undertaking a replacement of the legacy claims
• In addition to dramatically changing the intake channel strategy, we
had several business process and staffing changes we were
• 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.
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
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
• 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
• 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
• You may not get it all done in first release so plan ahead with a roadmap
• Pace and space
18. Robert Bowers, National Claims Strategy Leader
Westfield Insurance 1 Park Circle Westfield Center, OH 44251
Office: 1-800-243-0210 Ext. 4306840