Competitive forces and the loss of investment income in recent years have pushed insurers to focus on their operations to become more profitable. Insurance carriers and risk managers at self-insured companies are actively searching for ways to increase productivity and reduce costs. The struggle to internally handle the management of claims has drained many firms of the needed intellectual capital to drive their vision in their core competency. Many executives believe the quality of claims management is suffering, specifically as it concerns the next generation.

These facts translate into a growing interest – by insurance carriers and risk managers – in business process outsourcing to manage claims and reduce claims losses so that they can devote their resources to their core lines of business.

In a 2004 study, 86% of senior insurance executives stated that they believe improving their core operations is the best route to bolster profitability.¹ Only 25% described their claims management process as excellent; fewer than half believe their processes are good.² Less than one quarter of survey respondents, 23%, reported that their company’s internal control environment is always reliable. Clearly insurers recognize that claims management is a problematic challenge for them to mange well internally, and a significant risk to their profitability if claims losses are not monitored and reduced.

As one of the leading claims and loss cost management companies in the U.S. and Australia, Cambridge combines a highly educated workforce in each home country with the back office support abroad.  With decades of experience in the most complex areas of insurance and claims management, Cambridge is truly the BPO partner that can take insurance carriers and self-insured companies where they need to be for success in the global economy.

PROPERTY & CASUALTY

Application Intake, Set Up, Management, and Underwriting

• Initial application system set up
• Application requirements gathering (e.g., MVR, property details)
• Current coverage contact change
• First premium collection verification
• Rules based rate quoting
• Broker agent call center
• Application processing
• Standard underwriting
• Policy issuance
• Non-standard underwriting
• Rate setting
• Risk analysis

Policy Administration: Policy Coverage Change

• Changes with underwriting (addition of riders, increase/decrease coverage, new products or changes in coverage)
• Policy renewals

Policy Administration: Policy Owner Services

• Change of address, personal family status, financial info, notification of property improvements
• Policy owner correspondence
• Policy statements
• Premium lapse notification, cancellation notification
• Policy reinstatements
• Payment reminders
• Payments (EFT, credit)
• Renewal notices
• General customer inquiries

Claims Intake and Registration

• Intake of data
• Application set ups
• Level 1 eligibility, policy verification and coverage determination
• System claims set up, claim routing and assignment to adjusters
• Initial claims notification of loss
• Reserve allocation estimation

Claims Management and Specialty Risk management Services

• Workers’ Compensation
• General Liability
• Auto Liability
• Professional Liability
• Product Liability
• Property
• Personal Lines
• Assumed/Ceded Reinsurance
• Managed Care
• Special Investigations
• Recoveries Management
• Structured Settlements
• Outcomes Management and Audit Consulting

Premium Accounting

• Cash applications
• Suspense account handling
• EFT set up and transfer
• Processing of payments

Claims Accounting

• Reconciliation of claims loss and reserve accounts
• Tracking and posting of all claims payments to all parties
• Reporting of accounting to respective dept. heads

LIFE & ANNUITIES

New Business: Life Tasks

• Address Change
• Endorsements
• Form Request
• General Correspondence
• Annual Statement
• Waiver of premium
• Premium Accounting
• EFT setup
• Direct Bill
• Mode Change
• Non-Forfeiture options (Surrender, ETI, RPU)
• Policy Loan
• Policy Change
• Change List
• Reinstatement
• Over Loans
• Replacement

Annuity Tasks

• Loans
• Partial Withdrawal
• Surrender
• Policy Maintenance
• New Business
• Incoming Correspondence
• Premium Accounting
• Annuitization
• Required Minimum Distribution
• Divorce
• Death Claims

For more information on how your company can explore the wide range of business process outsourcing opportunities and advantages available from Cambridge, please contact us today.

Cambridge Insurance and Claims Services

We get you where you need to be.

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1. Deloitte Survey “Insurers Getting Back to Basics.”
Insurance Networking News, Jan. 2, 2004.

2. Ibid