About. Suncorp, the largest insurance group in Australia and second-largest in New Zealand, in collaboration with the Queensland University of Technology (QUT) conducted a 6-month project involving the application of process mining techniques to analyze unstructured insurance claims handling processes.
Objective. To gain insights into how insurance claims were processed at Suncorp. In particular, we were interested in process improvement ideas to reduce the lengthy claims processing time for a group of “simple” claims.
Key Question. What are the key differences in the way claims were processed between claims that completed on-time and those that did not?
Data. Data related to a subset of claims finalized within a 6-month period was extracted from the claims management system. Through minimal data cleansing and filtering activities, the data was split into a number of logical clusters.
In total, more than 32,000 claims of Suncorp, made up of more than 500,000 events, were analyzed using process mining techniques.
Approach. Novel algorithms and effective data visualization facilitated evidence-based extraction of pain points in the claims handling processes.
For each cluster, a number of process and data mining techniques, including process discovery, performance analysis, and process animation were applied. Together with Suncorp stakeholders, initial results were interpreted and subsequently refined to obtain the final results.
Results and Impact
The results of the case study, as reported at Australian Financial Review (09 July 2013) have assisted Suncorp in
- the reduction of the claims processing time from 30-60 days to 1-5 days, and
- the de-bunking of “anecdotal wisdom” regarding how processes should be improved.
Claims that were stuck in a loop often resulted in lengthy claims.Often, the loops were the results of the need to request more documents from customers or other parties involved.
Insights from this project have contributed to the rolling out of a one-touch program by Suncorp, which has substantially reduced claims processing time.
Low Efforts, Maximum Gain
Low efforts required from Suncorp to participate in this project
- Part-time involvement of a Suncorp’s employee for the first few weeks, followed by weekly meetings with the stakeholders from Suncorp
- No more than two rounds of relatively straight-forward data extractions
- Results directly benefit core Suncorp’s businesses
- Injection of exciting new innovation into the organization
- Awareness raising across organizational hierarchy
- New way of thinking for improving business processes
S. Suriadi, M. T. Wynn, C. Ouyang, A. H. M. ter Hofstede, N. van Dijk. Understanding Process Behaviours in a Large Insurance Company in Australia: A Case Study. In Proceedings of the 25th International Conference on Advanced Information Systems Engineering (CAiSE), vol 7908, pp. 449-464. LNCS, Springer, 2013. Published Version. Technical Report.