Increasingly, funds are looking to in-the-Cloud software solutions, based on the Internet, using web-based tools or applications that users can access and use through a web browser as if those applications were programs installed locally on their own computer. The typical Australian superannuation fund’s trustee office, which is currently managing or looking to manage insurance claims, is asking some or all of the following questions: • How can delays with insurance claims be reduced so members’ waiting times are decreased, increasing customer satisfaction levels? • How could the trustee office potentially better manage, track and report on insurance claims to all parties • How can we reduce reliance on the member to interpret and clearly understand what actions need to be taken to make their claim more efficient? The superannuation industry is now beginning to embrace technology as a viable, efficient and cost-effective way to: • communicate with members about how to ensure that their claim is successfully received and processed • integrate with insurer processes to minimise claim rework • improve internal processes around document management and distribution To some extent, underuse of technology in the trustee office (in particular, the not-for-profit funds) has originated as thirdparty administrators (TPAs) have previously filled the above needs. Today there is far greater demand for new communication, collaboration and insurance claim status updates to be delivered to members securely via the internet from anywhere, anytime. Given this, what is holding the super industry back? The answer lies in two key areas:
1. I nsurance claims processes Insurance claim processes are one of the biggest potential barriers to new technology adoption on two fronts: • manual workflow because it has always been done that way • technology gaps, or implementations that fail to deliver the goods For example, during a Total Permanent Disability insurance claim initiation, a significant amount of time and effort is consumed going back and forth between members, the trustee office, the TPA, insurer and doctor(s) in collecting the required paper-based forms, medical certificates and other relevant documents, and so several months may pass before the member knows the current claim status. So how does the industry overcome this hurdle? • Member fulfilment through the implementation of a rules-based online questionnaire to capture the relevant member details • Automatic creation of a claim pack, including Insurer medical forms • Claim lifecycle management using case management which allows ability to manage a case endto- end via tracking tasks, notes and documents • Automation of governance tasks that helps the claims team manage cases more effectively whilst adhering to service-level standards • Ability to generate correspondence templates while completing tasks for a case • Business process management using personalised dashboard for claims team members to view active tasks • Audit all activities on a case via automatic roll-up of completed task comments • Lookup a particular case by member number, first name, last name, type of claim or keywords search • Claims team collaboration using shared workspaces including team announcements, favourites/ links, contacts, calendar etc.