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FNB Funeral Automated Claims
Processing (STP)
End-to-end claims excellence in under 40 minutes
FNB Life provides Funeral Insurance policies to 1.3 million clients with an annual
growth of 5%. The advent of Covid-19 has increased the average number of
claims to more than 3,000 per month, which has placed tremendous pressure on
our operational claims staff.
Additional capacity through external call centre staff and overtime working hours
were required to maintain sufficient levels of client servicing throughout the
pandemic, leading to a large increase in operational costs.
We had to find a way to keep our promise to our clients by assessing and paying
out funeral claims to beneficiaries as quickly as possible during difficult and unsure
times, while also ensuring that our business remains stable in terms of costs.
T h e P r o b l e m
0
1,000
2,000
3,000
4,000
5,000
6,000
7,000
FUNERAL CLAIMS VS COVID WAVES
Wave 1 Wave 2 Wave 3 Wave 4
FNB Life identified an opportunity to scale its funeral claims processing capabilities
while also reducing resourcing costs through the development of an end-to-end
automated claims process.
The automated claims process brings technologies such as optical character
recognition, machine learning, integration with external third-party information
services and risk assessment models together on a single workflow orchestration
platform to assess claims and provide digital feedback to clients within minutes.
80% Claims Processed in Less Than 1 Hour
60% Claims Automatically Approved by System
Create Additional Claims Capacity with Existing Resources
T h e S o l u t i o n O u r G o a l s
A truly modular, transparent, and customer-centric claims process able to perform straight-through processing of claims
within a matter of minutes and with minimum human involvement
By combining a hyper-
automation approach with a
workflow orchestration platform
We’ve developed an
automated end-to-end funeral
claims process
Tangible Business Results
2583
The number of claims processed through the system
C L A I M S P R O C E S S E D
100%
Within 2 hours of submission
C L A I M S P A I D
2.2 min
On a claim being paid to a customer
Q U I C K E S T
T U R N A R O U N D
748
The number of claims approved by the system
C L A I M S A P P R O V E D
R 18.5 M
The value of the approved claims paid by the system
C L A I M S P A I D
3.8 min
For all automated claims – a reduction in 35 minutes
compared to our average
H A N D L I N G T I M E
M o n t h l y C l a i m s
3000
M i l l i o n A n n u a l
C o s t
R 1,6
M i l l i o n A n n u a l
C o s t S a v i n g
R 6,2
Detailed Claims Numbers
Tot
al
Pl
at
f
or
m
Jan-22 Feb-22 M ar
-22 Apr
-22 22-M ay 22-Jun Tot
al
Cl
ai
m sAssessed 56 443 812 1031 1628 1882 5852
Cl
ai
m sAppr
oved 10 91 276 364 504 470 1715
Pai
dVal
ue R328,
163 R2,
402,
864 R6,
820,
625 R8,
728,
194 R11,
970,
233 R11,
682,
945 R41,
933,
024
Aver
ageTAT 15 42 39 51 45 70 52
% Cl
ai
m sAppr
ovedUnder30m i
n 90% 84% 87% 80% 80% 76% 91%
% Cl
ai
m sAppr
ovedUnder60m i
n 100% 92% 95% 90% 93% 87% 96%
Cl
ai
m swi
t
hnohum ani
nt
er
vent
i
on
Jan-22 Feb-22 M ar
-22 Apr
-22 22-M ay 22-Jun Tot
al
Cl
ai
m sAssessed 1 91 338 490 784 879 2583
Cl
ai
m sAppr
oved 0 23 119 183 214 209 748
Pai
dVal
ue R0 R597,
068 R2,
900,
782 R4,
233,
734 R5,
302,
624 R5,
480,
071 R18,
514,
279
Aver
ageTAT 0 13.
7 3.
9 3 3.
2 4.
1 3.
8
C u s t o m e r I m p a c t & E x p e r i e n c e
Just want to compliment you on excellent
service. My father passed on and I had a
funeral cover with FNB. I submitted my
claim this morning and within less than 20
minutes my claim was paid out.
Job well done!
I just want to compliment FNB Funeral Insurance.
My mum passed on last week Monday and
because of being busy I couldn't claim on Monday.
Then I submitted claim via FNB app on Tuesday
around about 15h00. All required documents were
submitted. To my surprised money was into my
bank account round about 17h00. It was easy to
make preparations. I was so impressed with
outstanding service. Most of the time people will
complain about other insurance companies but
FNB have outdone themselves. When you are
mourning you don't want to be stressed when you
don't get money for making preparations.
The entire platform is designed, built and
managed through our internal platform’s
workflow and decisioning engine,
allowing for a transparent and
configurable claims process that can be
scaled and updated with minimal
technical or development intervention
required
Automated Claims Document
Indexing & Capturing with
Optical Character Recognition
Automated Validation of all
Indexed and Captured
Information
Automated Death Validations
Automated Beneficiary
Account Validations on
payment partner platform
Automated Beneficiary
Screening through internal
customer data system
Claims Rules through
Decisioning Engine
Automated Claims Risk
Assessment
Automated Claims Payment
Automated Client
Communications during
Claims Processing
>
Live Process Monitoring &
Management
On-the-fly Process
Configuration & Rule
Adjustments
Process Performance
Analysis and Reporting
Process Capabilities InsureWorX Platform Capabilities
F e a t u r e S u m m a r y
Email
Mobile App
Online
Telephonic
Future Development
Timeline
Next Steps
The scalability and cost saving potential created by this work
lays the foundation for us to further grow the business - and
more importantly, customer satisfaction levels - without
growing the cost base by the same margins.
This solution will be further enhanced and scaled to include all
of FNB Life’s mortality products, which will lead to the
realisation of a singular mortality claims process capable of
assessing claims for a wide range of products in a configurable
and modular fashion.
Risk and fraud models will also be enhanced to include a wider
range of data and real time feedback from the fraud desk will
enhance our predictive capabilities.
July 2022
May 2022
June 2022
September 2022
Enablement of parallel assessment for
multiple funeral claims linked to a single
deceased
Enablement of automated beneficiary
tracing through social networking and
lineage analysis
Addition of improved predictive capabilities
to current risk and fraud models
Expansion of current process to include
the assessment of other products with
mortality benefits
Development Journey
The development took a total of6 months. The first full development
cycle took 4 months to complete, from the initial design concepts to
final testing. Numerous enhancements have been implemented since
the first release over the last 3 months.
Thank You

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FNB South Africa - Insurer transformation Award 2022

  • 1. FNB Funeral Automated Claims Processing (STP) End-to-end claims excellence in under 40 minutes
  • 2. FNB Life provides Funeral Insurance policies to 1.3 million clients with an annual growth of 5%. The advent of Covid-19 has increased the average number of claims to more than 3,000 per month, which has placed tremendous pressure on our operational claims staff. Additional capacity through external call centre staff and overtime working hours were required to maintain sufficient levels of client servicing throughout the pandemic, leading to a large increase in operational costs. We had to find a way to keep our promise to our clients by assessing and paying out funeral claims to beneficiaries as quickly as possible during difficult and unsure times, while also ensuring that our business remains stable in terms of costs. T h e P r o b l e m 0 1,000 2,000 3,000 4,000 5,000 6,000 7,000 FUNERAL CLAIMS VS COVID WAVES Wave 1 Wave 2 Wave 3 Wave 4
  • 3. FNB Life identified an opportunity to scale its funeral claims processing capabilities while also reducing resourcing costs through the development of an end-to-end automated claims process. The automated claims process brings technologies such as optical character recognition, machine learning, integration with external third-party information services and risk assessment models together on a single workflow orchestration platform to assess claims and provide digital feedback to clients within minutes. 80% Claims Processed in Less Than 1 Hour 60% Claims Automatically Approved by System Create Additional Claims Capacity with Existing Resources T h e S o l u t i o n O u r G o a l s A truly modular, transparent, and customer-centric claims process able to perform straight-through processing of claims within a matter of minutes and with minimum human involvement
  • 4. By combining a hyper- automation approach with a workflow orchestration platform We’ve developed an automated end-to-end funeral claims process
  • 5. Tangible Business Results 2583 The number of claims processed through the system C L A I M S P R O C E S S E D 100% Within 2 hours of submission C L A I M S P A I D 2.2 min On a claim being paid to a customer Q U I C K E S T T U R N A R O U N D 748 The number of claims approved by the system C L A I M S A P P R O V E D R 18.5 M The value of the approved claims paid by the system C L A I M S P A I D 3.8 min For all automated claims – a reduction in 35 minutes compared to our average H A N D L I N G T I M E M o n t h l y C l a i m s 3000 M i l l i o n A n n u a l C o s t R 1,6 M i l l i o n A n n u a l C o s t S a v i n g R 6,2
  • 6. Detailed Claims Numbers Tot al Pl at f or m Jan-22 Feb-22 M ar -22 Apr -22 22-M ay 22-Jun Tot al Cl ai m sAssessed 56 443 812 1031 1628 1882 5852 Cl ai m sAppr oved 10 91 276 364 504 470 1715 Pai dVal ue R328, 163 R2, 402, 864 R6, 820, 625 R8, 728, 194 R11, 970, 233 R11, 682, 945 R41, 933, 024 Aver ageTAT 15 42 39 51 45 70 52 % Cl ai m sAppr ovedUnder30m i n 90% 84% 87% 80% 80% 76% 91% % Cl ai m sAppr ovedUnder60m i n 100% 92% 95% 90% 93% 87% 96% Cl ai m swi t hnohum ani nt er vent i on Jan-22 Feb-22 M ar -22 Apr -22 22-M ay 22-Jun Tot al Cl ai m sAssessed 1 91 338 490 784 879 2583 Cl ai m sAppr oved 0 23 119 183 214 209 748 Pai dVal ue R0 R597, 068 R2, 900, 782 R4, 233, 734 R5, 302, 624 R5, 480, 071 R18, 514, 279 Aver ageTAT 0 13. 7 3. 9 3 3. 2 4. 1 3. 8
  • 7. C u s t o m e r I m p a c t & E x p e r i e n c e Just want to compliment you on excellent service. My father passed on and I had a funeral cover with FNB. I submitted my claim this morning and within less than 20 minutes my claim was paid out. Job well done! I just want to compliment FNB Funeral Insurance. My mum passed on last week Monday and because of being busy I couldn't claim on Monday. Then I submitted claim via FNB app on Tuesday around about 15h00. All required documents were submitted. To my surprised money was into my bank account round about 17h00. It was easy to make preparations. I was so impressed with outstanding service. Most of the time people will complain about other insurance companies but FNB have outdone themselves. When you are mourning you don't want to be stressed when you don't get money for making preparations.
  • 8. The entire platform is designed, built and managed through our internal platform’s workflow and decisioning engine, allowing for a transparent and configurable claims process that can be scaled and updated with minimal technical or development intervention required Automated Claims Document Indexing & Capturing with Optical Character Recognition Automated Validation of all Indexed and Captured Information Automated Death Validations Automated Beneficiary Account Validations on payment partner platform Automated Beneficiary Screening through internal customer data system Claims Rules through Decisioning Engine Automated Claims Risk Assessment Automated Claims Payment Automated Client Communications during Claims Processing > Live Process Monitoring & Management On-the-fly Process Configuration & Rule Adjustments Process Performance Analysis and Reporting Process Capabilities InsureWorX Platform Capabilities F e a t u r e S u m m a r y Email Mobile App Online Telephonic
  • 9. Future Development Timeline Next Steps The scalability and cost saving potential created by this work lays the foundation for us to further grow the business - and more importantly, customer satisfaction levels - without growing the cost base by the same margins. This solution will be further enhanced and scaled to include all of FNB Life’s mortality products, which will lead to the realisation of a singular mortality claims process capable of assessing claims for a wide range of products in a configurable and modular fashion. Risk and fraud models will also be enhanced to include a wider range of data and real time feedback from the fraud desk will enhance our predictive capabilities. July 2022 May 2022 June 2022 September 2022 Enablement of parallel assessment for multiple funeral claims linked to a single deceased Enablement of automated beneficiary tracing through social networking and lineage analysis Addition of improved predictive capabilities to current risk and fraud models Expansion of current process to include the assessment of other products with mortality benefits Development Journey The development took a total of6 months. The first full development cycle took 4 months to complete, from the initial design concepts to final testing. Numerous enhancements have been implemented since the first release over the last 3 months.