Xceedance delivers a seamless claim management experience, real-time operational visibility, and cost optimization by leveraging intelligent technologies and a team of highly experienced claims professionals.
The client, a privately held US-based company specializing in homeowners’ insurance products and services, was facing several challenges concerning its incumbent third-party administrator (TPA). The TPA utilized the services of several “contract” examiners who lacked the necessary skillset, failed to capture critical data elements, and underutilized the claims system. Response times were slow, which led to sub-par policyholder experience, more complaints, and higher costs of public adjusters and attorneys, significantly increasing claim costs in an already difficult insurance market. The TPA vendor also failed to oversee SLAs, address pending claims, support improvement initiatives, or improve costs per case. Overall, the challenges from the client’s perspective included:
- Non-responsive adjusters at critical customer moments
- Lengthy cycle-times and inflated loss adjusting expense (LAE)
- High rate of claims litigation (over 30% of its pending claims)
- Absence of reliable claims data to improve underwriting and/or actuarial decision-making
- Poor customer reviews (Google review metrics: 1.6)
- A partially deployed and operationally inefficient claims platform
Specific challenges in terms of transitioning to a new TPA were:
- The new claims management system needed to go live within eight weeks
- Sizeable claim volume of over 10,000 annually, with heavy catastrophe volume fluctuation
- There was a need to recruit, build, and train a sizeable, qualified claims adjusting team
- A new vendor network was required
- Orientation and flow of the process had to be agreed upon with the client
Xceedance leveraged data, technology, and operational expertise to optimize claims handling and enable a more personalized experience for policyholders. Our team utilized leading-edge technologies to capture and accurately document claims communication, allowing the carrier to be more responsive to policyholders, save time, and reduce costs. By working closely with the client, Xceedance helped realize process efficiencies and improve service quality.