BPM (Pega) for Insurance

Insurance firms are burdened by legacy systems, some as old as working on a mainframe. It is not an easy task to modernize the systems or migrate them to the Guidewires and DuckCreek's of the world, and this is where the Business Process Management Tools, like Pega ,can come into the picture.

Consider some simple service transactions like Change of Address, Change of Beneficiary Details, Updating the contact details and addresses, or even initiating a Claim process. Many insurers have to undergo changes in multiple systems for such basic needs of the customers, which tends to take days. In the generation of Facebook and Google, customers expect faster responses from everyone, and especially from Financial Services organizations.

This is where tools like Pega come as a savior. Pega can sit at the center and connect to the insurer's systems, providing a single point for various transactions.

There are numerous in-built capabilities that it offers and also has an entire framework built for Insurance - Pega Customer Service for Insurance, that comes in handy.

Let us look at some of the features that Pega has which can tremendously power an insurer's processes:

1. Integration to External Systems - Pega offers REST and SOAP APIs that can integrate with Insurer's external systems. It can easily fetch and update data from and to these systems. So, even if your external system has a poor UI or does not offer a good experience, the activities can be performed in Pega UI which can take it to the original systems.
2. Customer Service for Insurance Framework (CSI) - This is a framework that comes with Pega and has many micro journeys built inside it. Say, for example, you want to set up a Life Claims Insurance initiation in Pega. There is no need to individually design pages and fields because the CSI framework already has this customizable micro journey designed. The same goes for many other service transactions. All one has to do is to use this journey which eventually integrates with the concerned systems for life claims.
3. Single Sign-On (SSO) - Leverage Pega's SSO features that can utilize existing Azure AD groups or similar to help the users sign on to various systems (Pega and as well as the ones that are integrated into it) in just one touch.
4. Digital Experience (DX) API - Consistency across channels is the key for any organization including insurer. The DX API in Pega offers you endpoints that help emulate the same experience in other channels as that in Pega. This means you can simply build pages, modules, forms, etc. in Pega and use that in other channels through their DX APIs. This achieves the needed Omni Channel Experience.
5. Configure users - It is very easy to configure and give 'rights' to the various users required to operate a given transaction. One of the key features of Pega is the Skill Based Routing that allows you to set rules (simple and complex) to route the case to an appropriate user based on the journey. Say, for example, there are multiple users for a Life Claims check - the initial person for FNOL, claim analysts, contestable analysts, payout team, etc., all of them are configured in Pega and the claims journey automatically routes the case to the relevant ones as and when the process proceeds.
6. Reporting - It is easy to customize reports that insurers have to prepare for various modules. Many of such reports also come as a part of Out of the Box features in Pega. Additionally, SLA management is again an important feature.
7. RPA and Chatbots - Pega also offers RPA and Chatbot tools to help complete all the mundane tasks and make the process more efficient.
8. Data Storage and hosting - Many insurers do not want to store data on an external platform like Pega and instead want to simply use it as transactions. This can be achieved in Pega too as it offers you stateless mechanisms to purge the data after use.

There are numerous other benefits of such Business Process Management tools. Talking specicially about Pega, if you are an insurer, then reading about Pega on its website with all the training and modules available, is a good start. It will help realise the potential of a BPM tool and how it can help in various processes of Insurance.

The views expressed are personal are do not endorse any company or organization's viewpoint.