Business Challenges in Insurance Complaints and Risk

Complex and large insurance business and legacy systems, combined with the complex long-term insurance products makes complaints one of the main business pains in insurance. Failure to deal with complaints effectively leads to regulatory fines as insurance regulation is increasingly becoming a pressing challenge for insurance companies across the world. Customer attrition, is core problem - anything that can be done to reduce it is importance is key. The understanding of costs and risks first associated to complaints are not known at any point in time by the firm.

In addition, the fragmented complaints analysis process and fragmented business process across functions and systems makes the analysis of complaints and the risk associated to it a very complex process that requires lots of staff, manual effort and IT support to collect, aggregate, analyze and distribute the information.

The information that could be extracted from the process is often lost and this leads into lack of compliance, delays and regulatory risk due to the inability of the firm to correctly analyze and report on complaints. The lack of understanding of the value of complaints analysis and the lack of visibility of risks that can be identified in key processes using the complaints analysis are also major challenges that insurance firms face.

Finally, complaints data is a key challenge as this data is usually recorded using different schema in different unrelated systems. This makes the collection, extraction, aggregation, and distribution of information a complex and lengthy process -more than often- extremely costly and inefficient using traditional data warehouse and Business Intelligence systems and solutions. The firms has to rely on manual processes, specialized propriety custom solutions that cannot be standardized to reduce the Total Cost of Ownership and increase the Return of Investment.