Salesforce Industries – Insurance
Intro for Architects & Developers
by Jiří Krám, Accenture

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- 17 years experience with
Salesforce
- Specialty: Financial Services
(Banking & Insurance)
- Core focus: Cloud & Multi-cloud
architecture
Jiří Krám
My position: Manager, Accenture

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Content
Salesforce vs Salesforce Industries
 Salesforce Financial Services Cloud for Insurance
Salesforce Industries – Omnistudio (Shared across all industries)
 Omnistudio – FlexCard
 Omnistudio – OmniScript
 Omnistudio – Integration Procedure
 Omnistudio – DataRaptor
 Omnistudio – Calculation Procedure & Calculation Matrix
Salesforce Industries – Insurance (Core modules)
 Insurance – Product Catalogue
 Insurance – Quote, Rate & Apply
 Insurance – Policy Admin
 Insurance – Contract & Enroll
 Insurance – Billing & Payments
 Insurance – Claims & FNOL
Salesforce Industries - Lessons learned (Q&A)

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CHAPTER ONE
SALESFORCE & INSURANCE

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Salesforce vs Salesforce Industries
Salesforce
 Generic data model / requires building
custom objects
 Integration has to be developed custom
 No pre-built industry specific processes
 No product catalogue, no embedded
industry standards
 Flows – generic requires customization
per industry
Salesforce Industries
 Industry data model / reuse standard objects
vs building own
 Optimized for integration with industry specific
backend systems
 Pre-built common industry specific processes
 Product catalogue optimized per industry
standards
 Omnistudio – Guided omnichannel flows

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Salesforce Insurance (High level view)

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Salesforce Insurance – Building Blocks
Salesforce Financial Service Cloud – Insurance
 Insurance specific data model / standard objects
 Insurance 360 customer view
 Bridge between Salesforce core (Sales, Service, Marketing) and SFI (Industries)
Salesforce Industries – Insurance
 Extends FSC Insurance and Salesforce (Sales / Service) data model
 Pre-built insurance specific processes and objects extending FSC
 Modular architecture: Quoting, Rating, Policy Admin, Claims, FNOL
 Insurance specific product model: Insured item, Insured party, Coverage

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FSC Insurance – Data Model

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When to use what?
Salesforce Financial Service Cloud Insurance
 You want to build Insurance CRM (Customer 360, Marketing, Generic service)
 You don’t want to do product & policy related tasks: Manage policies, Quoting, Rating, Claims, FNOL
Salesforce Financial Service Cloud Insurance + Industries
 You want to build Insurance Applications (Quoting, Policy Admin, Claims Management)
 You want insurance product model with all building blocks (product specs, insured items, insured parties,
coverages, rating facts…etc.)
 You need to create & manage insurance rules (underwriting, rating, claims)

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CHAPTER TWO
SALESFORCE INDUSTRIES - CORE

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Omnistudio – layered architecture

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FlexCard
• Graphical Data Presentation and Launch Framework
• Dynamic Presentation with Multiple Cards & Card
States
• Integrated with Vlocity Actions for Dynamic Link
Generation
• Ability to Fetch Data Independently from Salesforce,
REST or Custom Data Sources
• Deployable to Console, LEX, Community, Mobile &
External Web

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OmniScript

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Integration Procedure

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DataRaptor + IP + FlexCard + LWC

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DataRaptor + IP + OmniScript

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Calculation Matrix & Procedure

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CHAPTER THREE
SALESFORCE INDUSTRIES
INSURANCE

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Salesforce Insurance (FSC/FSI)

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Product Catalogue
• Innovation-Driven Product Catalog
Supports Coverages, Insured Items,
Rates & Rules
• Digital-Ready Policy Administration
75+ API-enabled Transactions and
Pre-Configured Portals and Apps.
• Comprehensive Claims Management
FNOL, to Auto-Adjudication to
All Claims Financials
• Seamless Customer-Centric Journeys
Lead through Issue on the Salesforce C360
• Automation-enabled Workflows
Low/No-Code Straight-Through Processing

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API DRIVEN CORE FUNCTION DESIGN

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Insurance Customer Data Model

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Insurance Customer Data Model
 Reusing Accounts & Contacts, Account Contact Relationship from CRM
 Repurposes Asset for insurance specific record types
 Introduces Party model for financial services
 Adds Insurance Policy & Insured / Insurable Items
 Adds Products & Services (held and non-held)
 Adds Financial Accounts, Statements, Billing Accounts
 Adds Attributes model

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Policy Administration
• Complete system of record with Full Policy Lifecycle Support
• Metadata-based Product Management, including Rules and
Rating, for Easy Code-Free Maintenance
• Pro-Rata Endorsement and Cancelling Pricing, including Out-
Of-Sequence Endorsements
• Automated Renewals and Payment Plan Processing
• Earned Premium Schedule and Reporting
• Policy Transaction Posting
• Guided, omnichannel user experiences
• Native Support for Salesforce FSC Object Model

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Policy Data Model

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Policy Data Model
 Extends Insurance Policy & Insured / Insurable Item data model from FSC
 Allow manage Policy Member Assets including difference between insured person and beneficiary
 Creates Product / Product Spec / Coverage / Policy / Plan relationships
 Maintains Policy Transactions, Revenue Schedules and Surcharges
 Introduces Partner (Tied Agent, Broker) model including Carrier / Writing company / Producer / Commission
relationship
 Leverages SFI Insurance Product Catalogue: Product Specs / Coverage Spec / Insured Item Specs / Rating
Facts…etc.

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Quote, Rate & Apply
• Guided, omnichannel quotes and applications
• Based on Salesforce Opportunity, Quote and Product
Objects
• Real-time Call-Outs for Data Enrichment
• Attribute-driven Policy Configuration with Real-Time
Repricing
• Automated Underwriting and Referral Rules
• Underwriter Workstation for Approval andAdjustments
• Template-driven Proposal Generation

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Quote Data Model

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Quote Data Model
 Extends Salesforce’s Quote / Quote Line Item / Opportunity / Product2 model
 Adds Attributes (JSON) from SFI Product Catalogue (beyond SF Fields in Product2 object)
 Combines multiple SFI & FSC object to Quoted Insurance: Coverage / Insured Item / Insured Party / Quoted
Policy / Quote Item Relationships
 Product Availability & Eligibility driven by rules set in SFI Product Catalogue
 Deals with Product Taxes / Fees / Adjustments
 Deals with Commission / Producer / Carrier / Writing company relationships

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Claims Management
• Peril-based Omnichannel FNOL
• Data Capture and Rules based on Policy or Peril
• Automated Adjudication and WorkflowRules
• Claims Adjuster Workstation embedded within Salesforce CRM
• Coverage Assignment, Verification and Payout Calculations,
including Limit and Deductibles
• Salesforce Approvals for Reserve and Payments
• Integrated Document and Image management, including
Rules-based Document Placeholders

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Claims Management Data Model

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Claims Management Data Model
 Reuses data in Policy Admin (Coverage / Product / Insured Item / Insured Party)
 Establishes relationships between Claims Participant (e.g., Driver / Other Driver / Witness /
Adjustor)
 Deals with Adjustment of Reserves & Payments
 Link to Claim evidence adjustors (images, documents, videos) from multiple sources
(email / call center / FNOL)
 Deals with Claims related to partners / brokers / tied agents (e.g., negotiating on behalf of the
client)

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CHAPTER FOUR
SALESFORCE INDUSTRIES
LESSONS LEARNED

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SFI INSURANCE – LESSONS LEARNED
1. Product is the King – everything starts and ends with the product, do a lot homework before you start building
your product.
2. Rule is the Queen – every product comes with the rules, when, how and to whom you can offer it, rules will
take a lot effort.
3. Know Omniscript in and out – this is the area you will spend most of your time, well designed Omniscript
means your products and rules are clear.
4. Use Integration Procedure when you can – think first about IP before thinking about any other way to
integrate, and reuse IP if you can.
5. Simplify processes and products when possible – often firms have processes wrapped around legacy
systems, SFI can help rethink and simplify.
6. Don’t forget SFI is not standard Salesforce – many classic SF developers can get confused from
DataRaptors and other concepts

Thank you! #CD22