Insurance Claims System Design

The client was a global insurance provider with a presence in over 100 countries. The insurer was undergoing a large scale claims system transformation to bring all claims processing onto a single, global platform. I served as a member of the implementation team, working directly with the end users and client stakeholders to build a solution that was universal, while still satisfying local regulatory requirements.

  • Role

    Business Analyst

  • Deliverables

    Governance Plan, Requirement Documentation, User Flows, Annotated Mockups, Business Case

  • Client

    Global Insurance Provider

Discovery

As a member of the delivery team, I was responsible for designing and implementing a Global Framework Governance plan. The plan enabled over 30 team members to continuously build and improve the global system, while maintaining a common core solution.

All modifications and enhancements to the existing system required approval from a governance committee, which I helped facilitate.

GFW Governance Plan

During prioritization discussions with the subject matter experts, we identified a high priority request to improve the process for managing documents across systems. I met with end users, stakeholders and developers to understand the business needs and any technical constraints.

Summary of Requirements

Design

Once the initial requirements were validated, I evaluated the workflow users ran to manage files between the claims system and document management system. I then sketched potential solutions to streamline the existing process.

I proposed 3 options to the client stakeholders by mocking up the user interface to illustrate the potential changes.

  • Consolidated Work-list Approach
    Option 1
  • Editable Work-list Grid
    Option 2
  • Editable Work-list Item
    Option 3

Following our walkthrough discussion, we selected an approach that would consolidate documents across the two systems. I worked with the subject matter experts to craft the business case for the requested system improvement.

Solution

We estimated that the proposed solution would save the end users at least 40-60 minutes to complete a specific task. Our approach also eliminated 5 redundant steps and the need to navigate between systems.

Solution Workflow