KM improves risk, fraud and sales opportunity management for insurers [KM World]

The insurance industry balances risk against opportunity, and then determines the right price to charge to profit from that gamble. Success is based on using the right knowledge to make those decisions. Insurance-focused KM solutions are designed to collect, analyze and present knowledge in the most appropriate, accurate and actionable form.

KIE Square Consulting (kie square.com) provides KM software to insurance companies. Its solutions help them manage their sales cycles, monitor policy performance and reduce the loss of clients due to policy lapses.

"Where we come in is to provide a lot of end database analysis," says Dr. Kamaljit Anand, KIE Square's director of delivery of client services. For instance, its KM software helps an insurer look at a specific client and weigh the factors that might lead to its policy lapsing. The software's analysis helps suggest ways to prevent such a lapse, plus any opportunities to sell additional coverage.

A more realistic picture

KIE Square's KM solutions also help insurance companies compare their sales and customer retention performance against industry averages - with the ability to crunch data on a regional basis. The result is analytical knowledge drawn from the insurer's own databases that aids the company in making better decisions about accepting and retaining clients, determining appropriate underwriting fees and generally managing its business in ways that more closely match reality.

KIE Square insurance clients use what Anand calls "intelligent KPIs" (key performance indicators). Intelligent KPIs do more than provide a standard KPI "snapshot" of business performance, such as looking at this month's percentage of policy renewals and comparing it to industry averages. Instead, intelligent KPIs take that data and present it as part of an overall business picture.

A case in point: If policy lapses (surrenders) go up during a given period, then policy persistency goes down, resulting in a drop in revenues and share prices. Intelligent KPIs can provide such "big picture" views on an ongoing basis, helping insurers manage their businesses better by giving them knowledge that is "actionable," says Anand. For insurers, such knowledge can make the difference between financial success and failure.

High adoption rate

Red Wolf Online (redwolfon line.com) takes a Web-based approach to knowledge management for insurers. Its product is the OnDex knowledge management system, a cloud-based service that gives insurers a central location to organize, store and make accessible all of their procedures for company staff.

OnDex provides a KM skeleton within which information can be properly organized, cross-referenced, tracked and accessed online by authorized users. Buñt-in checks ensure that information origination and updates are properly approved and documented. Meanwhile, OnDex's search system makes it easy for insurance employees to get access to the policy information they need fast, so that clients are given answers that the company can stand behind.

OnDex uses push technology to note and then make the most used Web pages readily available. "Within the enterprise, 20 percent of content tends to be used 80 or even 90 percent of the time," says Paul Goldenberg, Red Wolf Online 's COO. OnDex monitors which content is most popular, and makes sure it is close at hand whenever users access the system. That reduces search time and speeds up customer service.

Overall, OnDex's KM approach is designed to be intuitive and user friendly, which allows Red Wolf Online to achieve a 100 percent adoption rate by new clients, according to Goldenberg. "We've had a couple of rollouts to 1,200 users," he says. "At the end of the day, everybody was up and running, and we had not received even one call for support."

Resolution tool for CSRs

Consona (consona.com), which merged recently with CDC Software to form Aptean (aptean.com), has provided end-to-end customer relationship management (CRM) and enterprise resource planning (ERP) solutions for healthcare insurance companies. Its Knova KM software offers a "resolution workbench" for customer service representatives. In plain language, Knova is the knowledgebase that customer service reps (CSRs) consult when dealing with customers. But the system does more than that: It is engineered to provide actual resolutions to customer situations.

In coming up with resolutions, Knova cross-references its suggestions against state laws. Based on which jurisdiction the policy operates under, Knova tells the CSR accurate instructions on "how they can answer," says Duane George, Consona's director of product management. That saves the CSR time spent manually searching for the legally appropriate response - and minimizes the chances for human error.

Fraud detector

In general, the KM solutions noted so far are concerned with standard insurance industry procedures. In contrast, Attensity's (attensity.com) insurance industry solution is a more radical approach that harvests social media to help insurers do their jobs better.

Attensity's KM solution is a text analytics platform that scans Facebook (facebook.com), Twitter (twit ter.com) and about 150 other social media sites, looking for keywords that can help insurers combat fraud and identify new sales opportunities. Attensity's text analytics software is so powerful that "it can summarize a document for you without ever reading it," says Michelle de Haaff, VP of corporate development.

Attensity developed its text analytics software in response to the growth of social media. Such user-generated content represents a vast resource for insurers - as long as they can find a way to sort through all the content. Fortunately, Attensity's KM solution does that for them. By analyzing the user content it finds on the Web, the software can tell insurers how consumers feel about their products.

Attensity software also can be used to detect insurance fraud. For instance, a customer could file a compensation claim for two broken legs with his or her insurer, and subsequently post on Facebook about winning a break-dancing competition. Attensity can spot the discrepancy, and report it to the insurer.

Gleaning sales opportunities

However, not all of the "over 100 out-of-the-box reports, dashboards and prebuilt analytics" produced deal with potential fraud, according to Attensity. Some of them crunch through social media information, looking for sales opportunities. If the software sees someone complaining about a competitor's insurance products online, the platform can alert the client insurance company's sales department, so that the staff there can make a pitch of their own.

Meanwhile, keeping an eye on one's own customers using social media can improve retention, says de Haaff. Online complaints logged by unhappy policyholders - "those who are likely to churn," as she puts it - can be dealt with quickly, before the customer's resentment turns into action.

Taken as a whole, KM solutions for insurance are more than just enhancements to databases. Today's applications allow insurers to better manage their risks, resolve customer situations more quickly, track down cheats and reduce the loss of policyholders to competing companies.

By analyzing the user content it finds on the Web, the software can tell insurers how consumers feel about their products.

James Careless is a freelance writer who has covered business processes for a number of industry-specific magazines, including Streaming Media (streamingmedia.com), e-mail [email protected].