You have been assigned as the project manager for the implementation of a claims processing system for a major insurance company. This company offers a variety of insurance options:

Home

Renter

Landlord

Auto and other vehicles (RV, motorcycle, etc.)

Boat

Business

Other

The claims processing operation is run out of five regional offices across the United States, with over 2,000 claims adjusters located in various local offices in each region.

Over the past several years the companys profitability has been negatively impacted due to the loss of customers primarily because of complaints about how their claims were handled. In addition, claim payments were in excess of standard industry benchmarks pretty much across all types of claims. Finally, the company has experienced a relatively high load of claims due to issues with their risk assessment process.

The business case for the new system contains the following information:

The project is expected to be completed in three years with an estimated cost of $75 million.

The initial budget is estimated to be 75,000 workdays, with approximately half of those days provided by external consultants.

Major requirements for the system includes:

Ability to accept claims from customers in a wide variety of ways

Ability to assign claims quickly to the appropriate adjuster

Ability for adjusters to update claim information remotely

Ability for adjusters to identify and negotiate with appropriate contractors

Ability to quickly approve claim resolution and payments

Ability to communicate with customers and contractors effectively

Effective integration with financial and other systems to process payments quickly

Effective fraudulent claim detection and contractor performance assessment mechanisms

Ability to support the approval process for insurance policies and accurately assess the risks and premiums for them

The project plan includes standard SDLC phases:

Planning and Requirements Definition

Design

Build

Test

Implementation

In your first meeting, the CEO and CIO ask that you identify ways in which the company does not have to wait three years or more in order to see the benefits from their investment. They have been reading articles about disruptive analytics-based technologies such as artificial intelligence, machine learning, Big Data, the advancement in Analytics models and algorithms, etc., and were wondering whether it would be possible to incorporate some smaller projects into the overall work plan to implement solutions using these technologies to more quickly address their key issues.

Pick a major business process for the insurance company (Insurance Policy Approval and Setup, Claim Processing, Contractor Setup, Contractor Payment, etc.). Think about how to incorporate analytics in order to support the process, then write a memo to the CEO and CIO responding to the following: QUESTION - Discuss the process and issue to be addressed, and what information is required to do so