New Zealand-based life and supplemental health insurer Partners Life is getting more consistency in its claims handling after moving its claims management to cloud services from FINEOS, a Dublin-based insurance enterprise software provider serving clients globally.
Daniel Walker, COO, Partners Life.
Greg Bowker Visuals
After a partial first phase completed in April 2022, Partners Life has had all its coverages live on the cloud-based FINEOS platform for about six months, according to Daniel Walker, chief operating officer. Partners Life is also using FINEOS LISA, a business and regulatory content service.
“The efficiency comes from being fully integrated with our policy administration system,” he said. “We have quite complex products, with features like inflation adjustment. Historically, we didn’t have that automated, so we had to rely on humans to remember to adjust benefits and many of the calculated payments. Not only is it more efficient, but it’s led to better outcomes for our customers.”
In 2021, Partners Life realized that its custom built in-house claims system was no longer fit-for-purpose and would not be scalable for the insurer’s future, according to Walker. “Our claims volumes were increasing. We had a lot of new business books growing, and we absolutely needed to address this sooner rather than later,” he said.
At first, Partners Life considered upgrading its front-end claims filing system and rules engine, but decided to first address its back-end systems. “The decision was made to go to market and do an RFP and find a partner,” Walker said.
In April 2022, after 14 months, Partners Life completed a first phase to implement FINEOS risk controls and claims management workflow for its life, total and permanent disability, trauma and income protection claims. Then the project continued, adding Partners Life’s supplemental health insurance claims, which went live in March.
The carrier does intend to add a front-end system that will connect well with FINEOS, a link that will have greater benefits, Walker believes.
“We have a segmentation model that automatically triages and categorizes claims,” he said. “High-risk claims go to assessors straightaway and low-touch, rapid resolutions, we just pay and close out. Eventually, we can auto-adjudicate claims, fully end-to-end straight through processing. FINEOS is primed to be able to do that. We can build a front end which complements it.”