Claims

Claims / DLT Project Update

This year a LM TOM Claims / DLT project has been agreed and funded in order to investigate options that would deliver a world-leading and superior claims service, underpinned by a modern and flexible claims agreement platform. The guidance from LM TOM Steering was to make sure that any solutions focused on the end customer’s claims experience.

Project Structure

The Claims / DLT project has two main work streams: Strategic Claims - looking at mid / long term solutions and Claims ‘Quick Wins’ looking at solutions that can be delivered in 2018.

Strategic Claims

Strategic Claims has two sub-workstreams:

  1. DLT
    DLT is building on last year’s LM TOM innovation proof of concept to further explore the feasibility of a distributed ledger platform (blockchain) to provide a possible alternative to the bureau for certain processes. Currently five suppliers are involved in building a simple DLT prototype to take to our market as a springboard for further consultation in Q3 this year.
  2. Strategic Claims
    A claims model vision statement has been generated and approved at Claims Steering Group. The layers within the model include:

    1. Customers - flexible distribution models, interfaces and portals
    2. Claims agreement process - to include simple claims, complex claims and DA claims
    3. Settlement and fund management
    4. Data reporting, MI and analytics

A set of workshops have been organised in June / July to drive forward design principles requirements and vendor capabilities under the above headings. The output from those workshops will be a more detailed set of requirements, benefits and costs. Each of the workshops’ sub-streams has approximately 10-12 members, including strong representation from the market U35 groups and increased broker representation.

Claims Quick Wins

The ‘Quick Wins’ workstreams have been considering two main areas:

  1. SCAP Automation
    Having considered several alternative options, it has now been agreed to proceed with a SCAP automation project with DXC which is kicking off in June 2018 with a gradual transition from manual processing support to robotics automation during H2 2018.
  2. Improving claims management process on legacy systems
    This workstream is continuing into H2 2018, having identified a series of problem statements.