Insurance Intelligent Automation - www.hcltech.com Rangarajan Srinivasan Rohit Kumar Jain - FinTech Global
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Insurance Intelligent Automation Rangarajan Srinivasan Rohit Kumar Jain www.hcltech.com
Insurance Intelligent Automation Table of contents 01 Abstract 3 02 Insurance Intelligent Automation construct 4 03 Insurance Intelligent Automation framework 5 04 Intelligent Automation Reference architecture 6 05 HCL operating model for Insurance Intelligent Automation 7 06 Benefit realization framework 8 07 HCL Propositions, IPs and Accelerators 9 08 Digital Process Automation 10 09 Digital claims experience illustration 11 10 Conclusion 11 © 2020, HCL TECHNOLOGIES. REPRODUCTION PROHIBITED. THIS DOCUMENT IS PROTECTED UNDER COPYRIGHT BY THE AUTHOR, ALL RIGHTS RESERVED.
Insurance Intelligent Automation 01 Abstract Automation has evolved in the last decade from increasing individual productivity to trying to leverage integrated technology solutions that improve overall business value. However, most firms still run their business processes the same way they have done in the past few decades and the automation is still significantly focused on attended automation. While many firms have made progress, the integrated approach is still limited to a small percentage. 1 The evolution of automation moved through the early days of RDA (Robotic Desktop Automation), attended RPA (Robotic Process Automation) and unattended RPA to incorporation of chatbots, virtual agents, decision making and natural language processing in an integrated manner. This evolution also improved upon the benefits from the tactical efficiency to strategic business value.2 Within the Insurance industry, many initiatives are being implemented that cover the entire gamut of tools and mechanisms for automation. However, like many industries, these are siloed approaches in the Insurance industry that either focus on specific tools/mechanisms or a narrow subset of a process area.¹ This white paper attempts to provide a comprehensive view on an integrated “intelligent” automation approach for the insurance industry that covers the techno functional ecosystem of a carrier. The intelligent automation cannot just focus on building a siloed ML based decision system or a tactical RPA solution for efficiency/effectiveness gains without considering how the end to end business process gets aligned within the tech ecosystem. This can be achieved without a large engagement by ensuring that the larger “initiative” is implemented in a series of smaller “phases”, each of which has its own business benefit/ROI. Advances in technology provides opportunities for insurers to tie business process efficiency directly to customer experience and reimagine the fundamental business processes centered around the customer, through intelligent use of automation. ¹ RPA is dead, long live the Integrated Automation Platform, HFS Research, June 2019 ² Intelligent Automation – Reshaping the future of work with Robots, Ernst & Young, Knowledge Series, Chapter 1, 2017 © 2020, HCL TECHNOLOGIES. REPRODUCTION PROHIBITED. THIS DOCUMENT IS PROTECTED UNDER COPYRIGHT BY THE AUTHOR, ALL RIGHTS RESERVED. 3
Insurance Intelligent Automation
02 Insurance Intelligent Automation construct
While there are many depictions of the various tool sets for intelligent automation in the
insurance industry, the following image provides a very simple view of the various
technologies involved across the insurance value chain.
Artificial Open APIs NLP Driven Structured/ Low Code/No RPA
Intelligence/ Intelligent Unstructured Code Platforms
Machine Document Data Analytics
Learning Analysis
New Policy
Underwriting Billing Claims
business administration
Figure 1: Simplified View of Technologies Across the Insurance Value Chain
Even within this view, there are many
engagements today that execute on one of the
above elements as the automation focus
instead of treating these technology enablers
as “one of the tool sets in the tool kit”. Even if
an integrated approach is taken, it often fails to
incorporate the underlying tech ecosystem.
This situation results in solutions which create a
tactical “band aid” at a process level, while the
underlying functional or technical gap in the
tech ecosystem remain unaddressed. As an
example, a deficiency in the core system may
continue to exist while a “band aid” solution is
provided at a process level with an RPA
approach. While such a solution will provide
tactical gains, it will either be short lived or at
worst create a strategic gap in the overall
ecosystem in the long term.
Another significant challenge in designing a
holistic automation construct is to orches-
trate all the various tools and technologies
in a seamless manner. This should ensure
continuity and ease of maintenance in the
end to end business process.
© 2020, HCL TECHNOLOGIES. REPRODUCTION PROHIBITED. THIS DOCUMENT IS PROTECTED UNDER COPYRIGHT BY THE AUTHOR, ALL RIGHTS RESERVED. 4Insurance Intelligent Automation
03 Insurance Intelligent Automation framework
HCLs Insurance Intelligent Automation framework covers the various toolsets in three
different categories as depicted below:
Core systems
• Focus on enhancing and optimizing core
system function
Point tech solutions
• Document automation
• Low code/no code solutions
Intelligent • AI/ML
• Contact center transformation
Automation
Process automation
• End to end process - “advise to execute”
• Product agnostic
• Value discovery and prioritization framework
• From PoC to DPA@Scale
Figure 2: The Toolsets in HCL’s Insurance Automation Framework
An end to end process is analyzed for gaps – both strategic and tactical – before solutions
are considered in the three categories outlined above. The ideal approach would be to fix the
core systems if the gap is best addressed there before moving on to a point tactical solution.
Once the underlying process is “reimagined” with the appropriate core system and point tech
solutions, potential RPA solutions are considered as the “last mile” in process optimization.
HCL’s experience has been to drive automation from the core system, as the heart of the
workflow/business rules lies there. If it is not possible to do it in the core system, either due to
legacy system constraints or unavailability of business APIs (Application Programming
Interface), then automation should be considered through implementing point solutions.
Robotic Process Automation should be looked at as the last option post the exhaustion of
the underlying tech ecosystem. RPA has shown good success in repetitive administrative
tasks, but it cannot be controlled and orchestrated in a rightful way under all circumstances.
A case in point is that many insurers have used RPA for straight-through claims processing
but a challenge that is typically faced is the rigidity of the RPA construct that allows a bot to
be either run fully or not run at all. A mid-process manual intervention, if desired, based on a
specific dynamic situation, is not possible or, at best, complex to orchestrate.
Additionally, APIs are emerging as key building blocks in ensuring that a carrier’s internal
systems ‘collaborate’ to ensure smooth and seamless flow of bots in executing a business
process end to end, across systems. API’s have transformed the insurance landscape by its
ability to create an ecosystem around insurers core systems. This ecosystem has been
successful in enabling innovation in the Insurance world. Some of the examples are buying
insurance during ride-hailing, short-term insurance for vacation, insurance for personal
property, selling policies through wallet providers, packaged policies for auto and home.
© 2020, HCL TECHNOLOGIES. REPRODUCTION PROHIBITED. THIS DOCUMENT IS PROTECTED UNDER COPYRIGHT BY THE AUTHOR, ALL RIGHTS RESERVED. 5Insurance Intelligent Automation
04 Intelligent Automation reference architecture
The below architecture illustrates how the various layers come together to provide the
integrated eco system that enables Intelligent automation. The architecture broadly consists
of the following layers:
Core and Intelligence and Integration Customer
surround automation services and experience
systems APIs
Anatomy of Intelligent Automation Platform
Connected Omni-Channel User Experience
Applications built on a
unified no-code
Insurance
low-code platform for Customer Customer Agency &
claims Underwriter’s Your apps
omni channel service onboarding services/ partners
investigation desktop
excellence & 360o view self service services
& fulfillment
API Gateway
Product Rating & Policy Claims Billing/ Customer &
Config pricing admin payout Agency
• Eligibility • Risk assessment • Quote, bind & • FNOL/adjuster • Billing plan • Prospect
• Limits • Exposure analysis issuance process • Collection management
• Forms & rules • Pricing model • Endorsements • Recovery/ • Claims • Agency
• Cancel, rewrite, subrogation disbursement management
Unified automation reinstate • Fraud & litigation • Commissions
and intelligence renewals
capabilities to drive
seamless engagement
Intelligence & Automation
and end-to-end
fulfillment
Intelligence Automation Process Integration Services
Business rules Robotic automation BPM Technology adaptors
Real-time Decisions Low code Data visualization layer
Artificial intelligence Case management Real-time event processing
Leverage & extend existing core insurance platform and
enterprise application integrations
Leverage and extend
• Policy • Pricing &
exiting applications admin • Claims • Billing • CRM
• Underwriting
Rating
• Content
• GL & • Audit • Admin • Mailroom • EDW &
Management
account reporting
Core systems
Figure 3: Intelligent Automation Reference Architecture
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05
The HCL Operating Model for Insurance
Intelligent Automation
One of the success factors for effective
Intelligent automation is the close
collaboration needed between business and
IT.3 From avoidance of shadow IT to the
need to focus on enterprise security and
resilience, the collaborative operating model
becomes a critical need. In addition to
bringing in toolset expertise, IPs, insurance
propositions, partnerships, capabilities, and
experience in executing intelligent automa-
tion solutions, HCL will work closely with
clients in setting up and delivering a sustain-
able automation Center of Excellence (CoE).
The operating model for such a CoE is
depicted below:
Business value Performance Strategic alignment
Governance management management & prioritization
Demand management Architecture & Advisory, standardization License/contract Academy, training
PMO
& prioritization innovation & knowledge management management and compliance
Omni-channel Digital workforce factory – agile release trains with development sprints
Experience
API gateway, Backlog Design & Support
Execution Backlog
services grooming review
Construction Validation Acceptance Implementation
operations
Analytics, BPM Infrastructure & security DevOps & release Product partner
& automation management management collaboration
Change management Stakeholder management Training Internal and external communication
Insurance Tools & Partner Technology Agile Digital &
HCL Enablers practice automation network expertise practice analytics CoE
Figure 4: HCL’s Operating Model for Intelligent Automation in Insurance
³ The New RPA Manifesto, HFS Research, Dec 2019
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06 Benefit realization framework
A critical component for executing an effective intelligent
automation program is the benefit realization mechanism.
Research reports indicate that many of the automation initiatives
(up to 50% of the RPA initiatives) fail.4 Beyond having a
prioritization framework, it is very important to have a benefit
realization framework to track and ensure outcomes that were
envisaged in the business case.
• Enable immediate and "in-the-moment" response to customer transactions
• Help customers become more efficient
• Keep centralized, complete, and integrated system of record for comprehensive policy related information
• Provide operational assurance, consistency, and auditable verification to meet evolving regulatory oversight
• Implement an extendable and adaptable system architecture
• Meet technical requirements of organization to stay competitive
• Reduce operational costs by improving efficiencies
• Support data-driven management and operational decisions
• Use flexible business rules to manage operational changes & workflow
• Enable continuous improvement of current products, services, and development of innovative solutions
Benefit type
Increase employee Increase customer Reduce costs Enable regulatory Improve Enable
satisfaction satisfaction compliance operational continuous
efficiency improvement
Opportunities
Draft benefits register
Identify & benefits cards
Review, quantify &
Validate
sign-off the
benefits identified Enable
Monitor, measure, &
report on the
Realize
benefits identified
Figure 5: The Benefit Realization Framework
⁴ Get Ready for Robots, Ernst and Young, 2016
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07 HCL Propositions, IPs and Accelerators
HCL’s insurance offerings include multiple accelerators and propositions that covers the three
categories of intelligent automation. The key propositions for core systems and point solu-
tions are provided below:
System Accelerator Value proposition
• A Guidewire based configurable framework to
administer multiple automation plans with its limits,
scores and business rules
iAuto • Add/update/remove the automation business rules from
administration screens
• Automation statistics for no touch, low touch and high
touch claims by LoB (Line of Business)
• Covers a series of solutions that directly address the
Core speed and effectiveness of underwriting
• Digital business transactions – allows insured to buy
system policy digitally by reducing the middleman’s
Accelerated
involvement
underwriting • Business rule driven SLA based activity tracking system
• Availability of required historical information for underwriter’s
usage
• Pricing finalization without manual work
Intelligent Document Automation : HCL Image and Data
iDo Optimizer
An Auto Claim assessment solution using photographs that are
processed using AI/ML and an appropriate parts/service
Automated claim
database to derive an estimate of the claim with requisite details
assessment of the impacted parts. HCL brings its partner ecosystem with
ClaimGenius to provide this solution.
Claim fraud propensities are highlighted using outlier
Fraud analytics identification using fuzzy logic using a partner solution – Daisy
Intelligence
Point tech Exacto Intelligent Document Automation from HCL
solutions
Power Insurance/ Omnichannel engagement, CRM and automation using the Power
Power Objects Objects offering using Dynamics CRM, Power Apps and Power BI
LEAP platform Low-code/No-code platforms to enable business solutions
Analytics/AI/
Decision-making solutions for the insurance life cycle
ML solutions
© 2020, HCL TECHNOLOGIES. REPRODUCTION PROHIBITED. THIS DOCUMENT IS PROTECTED UNDER COPYRIGHT BY THE AUTHOR, ALL RIGHTS RESERVED. 9Insurance Intelligent Automation
08 Digital Process Automation
HCLs DPA practice offers a comprehensive set of skills, experience, partnerships and
solutions to address the overall process automation needs.
Implementation
• Identifying automation • Process discovery / definition • Setup RPA CoEs
candidates (RPA assessment) / • Solution design • Setup robotic automation
business case / develop PoCs / • Solution development & implementation factory’s (CoE expansion) to
Pilots support robotization efforts
• Product / capability/ vendor Support enterprise wide
fitment / evaluation Automated process management
• RPA strategy & roadmap • Command center management -
formulation process scheduling and monitoring of
• Develop governance strategy & automated process
design implementation • Exception management – monitoring
frameworks and analyzing exception, and problem
management
• Application enhancement -
robotizing new business scenarios &
bug fixes
1. Advisory / consulting
3.Establish CoE & establish scale
2.Implementation & support
RPA maturity
Initialize Establish capability Industrialize Replicate & ramp-up Institutionalize Deliver differentiated
performance
Focus
Quick cost reductions Improved process efficiency Standardized process delivery
Partnerships
Figure 6: HCL’s DPA Practice
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09 Digital Claims Experience
The following image illustrates the application of the HCL Insurance Intelligent automation
framework for auto claims function:
Process automation Process
Third party engagements, subrogation negotiation automation
Intelligent
document CRM/CX Analytics solutions
management Power Insurance for personalization
iDo/Exacto
Point
solutions
AI based Claim Assessment Fraud Analytics
(Auto) With
iAuto – GW CC
Core
Claim automation administration
systems
No touch, low touch and high touch
Figure 7: Auto Claims Assessment with HCL
The above solution components can be implemented either individually in phased manner or
as a comprehensive function optimization. The intended outcomes cut across efficiency gains
through reduction of manual effort and strategic business value through insights and
personalization.
10 Conclusion
Automation has moved beyond the tactical focus covering
modest efficiency to a cognitive solution that addresses the cost
effectiveness and service delivery of the underlying business.
While the core tool sets cover process automation tools,
analytics and machine learning to support decision making and
natural language processing to address customer engagement
needs, they need to be orchestrated together for sustainable
effectiveness. The analysis of the overall process should not only
identify automation solution options, but should also prioritize
the category of the underlying gap. A gap that is ideally
addressed in the underlying core system should not be solved
with a tactical RPA or a point solution. Once the appropriate
analysis is done, the larger initiative can be broken down into
smaller phases with each of them having their own ROI. HCL’s
Insurance Intelligent automation framework provides all the
technical tool sets and process frameworks along with a clearly
defined mechanism to implement the underlying solution for
sustained effectiveness in the long term.
© 2020, HCL TECHNOLOGIES. REPRODUCTION PROHIBITED. THIS DOCUMENT IS PROTECTED UNDER COPYRIGHT BY THE AUTHOR, ALL RIGHTS RESERVED. 11Rangarajan Srinivasan Rohit Kumar Jain
Head of Insurance Solutions Head - Insurance Practice
Ranga comes with 30 years of experience Rohit Jain is a Post Graduate in Information
across the entire Insurance spectrum, from Technology from East London Business School,
multiple IT roles, Solutioning covering both UK. His core strength is techno-functional
technology and operations, as well as being a experience which enables him to provide
CIO for an Insurance TPA. He has diverse solutions with business benefits. He heads the
experience across Insurance covering Life and Insurance practice in HCL and has played varied
Annuities, Property and Casualty and roles in IT delivery, management, solutions for
Reinsurance. As part of this experience, he was large deals spanning application maintenance,
involved in large legacy modernization/ digital application development, digital projects.
transformations, conceptualizing and guiding Strategic thinker with hands on experience
initiatives around As a service solutions and across multiple technologies in diverse areas.
providing end to end solutions across Strength in application of technology to solve
technology and operations. Ranga has also real business issues based on
setup technology practices geared towards technology-cum-functional knowledge. Strong
servicing Insurance organizations. leadership, problem-solving, planning,
team-building and project management skills.
Based out of New York, Ranga heads HCLs
Insurance solutions and is actively involved in
helping clients in their transformation journeys
focusing on New business, Underwriting, Loss
control and Claims. Ranga drives HCLs
insurance propositions by coordinating across
various technology practices and partner eco
system.
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