Tag Archive for: Financial Services Leadership

Operational Excellence in Claims Management - Quality Business ServicesQuality Business Services

Operational Excellence in Claims Management: Scott’s COE Journey

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As an experienced manager of complex claims in the financial services sector, Scott was well aware of the unique challenges his team faced. Unlike typical operational teams, his group of experts dealt with high-value claims often involving litigation, each with its own complexities and nuances. Recognising the need for improvement, Scott turned to QBS’s Core Operational Excellence program, which provided him with the tools and strategies to achieve Operational Excellence in Claims Management. Through this program, he identified small, actionable changes that, when combined, delivered significant improvements to his team’s processes and outcomes.

THE ISSUES

Using a sharpened operational excellence perspective, Scott identified several key challenges that needed to be addressed:

  • Process documentation was rudimentary with limited standardisation
  • An over-reliance on individual expertise and judgement
  • A highly technical team – excellent depth but not breadth
  • Complex claims that were incorrectly sitting with normal claims teams 

ACTIONS TAKEN

Scott worked with his team on a number of targeted actions designed to address theses issues:

  • Developed guides and relevant job aides for complex claims
  • Standardised case management practices and increased use of templates, where applicable
  • Introduced fortnightly team knowledge sharing and lessons learned on large value claims using live case studies
  • Implemented a monthly learning calendar of relevant technical topics
  • Reinvigorated complex claims referral process
  • Allocated claim type based on team member skill
  • Engaged quantity surveyors and building consultants on large value claims
  • Introduced guides/checklists to identify recovery opportunities and ensure optimal case management

By standardising case management practices and implementing guides for complex claims, Scott demonstrated how Operational Excellence in Claims Management can address inefficiencies and deliver measurable improvements.

RESULTS

The results Scott achieved within six months are nothing short of amazing:

  • Productivity increased with the team servicing 15%-20% higher volume with same FTE
  • Complex claims referrals increased 50% resulting in savings of > $200k
  • Claim cycle time reduced from 250 days to 150 days 
  • Average claim cost reduced by 2% and increased claims with partial acceptance by 5%
  • Recovery rates from 3rd parties increased from 1-2% to 5-6%
  • Reduced claim cost on mid/large value claims by an average $10-15k per claim

The remarkable results achieved by Scott’s team showcase the true potential of Operational Excellence in claims management to optimise workflows, reduce costs, and enhance overall team performance.

If you would like your leaders to identify issues and quickly drive local operational improvement, click here to learn more about Core Operational Excellence and QBS’s other development programs.

Transforming Dispute Resolution: Tim’s COE Journey - Quality Business ServicesQuality Business Services

Transforming Dispute Resolution: Tim’s COE Journey

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As the manager of an internal dispute resolution team in the financial services sector, Tim was a passionate advocate for his organisation’s customers. Any complaints that weren’t resolved within the various business lines became the responsibility of his team.  If his team are unable to resolve the dispute within prescribed timeframes it is escalated to AFCA at significant financial and reputational cost.  Furthermore, a recent acquisition had added further complexity to an already complex business, selling various products through multiple channels.

Tim needed to sustainably improve the dispute resolution process for the benefit of all parties and when QBS’s Core Operational Excellence leadership training program came along, it was the perfect vehicle to achieve this.  He took responsibility to analyse, optimise and improve his own function using proven operational excellence concepts.  

THE ISSUES

Through the lens of operational excellence, Tim was able to identify the priority issues that needed to be addressed:

  • Varied, undocumented complaint processes across the business
  • Insufficient dispute resolution (DR) process documentation – in addition to causing variation, this also placed a reliance on the experienced team members to support the less experienced
  • Highly variable DR team capability
  • Skill gaps within DR team 

ACTIONS TAKEN

With the above issues in mind, Tim was able to drive specific actions to sustainably shift the needle for his business and team:

  • Documented current business complaint processes
  • Dispute resolution processes agreed and documented (by the team, for the team)
  • Skills matrix created to prioritise skill gaps to be closed with team members achieving Society of Consumer Affairs Professionals accreditation
  • Changed the process to ensure team member speak with the customer at the outset and used open ended questions
  • Developed templates and increased standardisation for common complaint types
  • Increased collaboration within the business 

THE RESULTS

The results that Tim achieved within just seven months are astounding:

  • Time to resolve complaints decreased from a median of 22 days down to 17 days 
  • Reduction in complaints escalated to AFCA from 72% to 34% (similar total number of complaints).   Each complaint that escalates to AFCA costs ~$3,150.  This saved the company around $130k in one month alone!
  • Productivity gains from less effort expended on each complaint resulted in 1 FTE headcount reduction
  • Happier customers, happy regulator, happy business!

Next frontier? Work with the business to reduce the number of complaints!

This is a fabulous example of how leaders can improve their operational performance without engaging external consultants – it is usually achieved through a handful of relatively small actions to address the specific challenges in that area. In addition, the skills Tim learnt will be with him throughout his career.

If you would like your leaders to turn their function around without engaging expensive consultants, click here to learn more about Core Operational Excellence and QBS’s other development programs.