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October 12, 2019

2019 AWARD FINALIST SPOTLIGHT: MetLife - Finalist in the Operational Excellence to deliver Digital Transformation Category

 

Read this article about MetLife, one of our finalists, in the category Best Achievement in Operational Excellence to deliver Digital Transformation, selected by the independent judging panel, for the 2019 Business Transformation & Operational Excellence Industry Awards program. Click here to read articles on other finalists.

 

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MetLife’s digital strategy aims to unlock the potential created by the shifting landscape of the digital age, where customers are highly empowered. The company is in the midst of a multi-year transformational effort to enhance claims processes through new digital solutions that increase efficiency and simplify the employee and customer experiences.

 

When a claimant comes to us to report a disability claim, it is a vulnerable time in their lives, so it’s imperative that their experience is an easy one. Through a value stream analysis of our U.S. Short Term Disability (STD) operation, we realized we had a significant opportunity to radically improve the claimant experience.

 

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Given that we initially approve approximately 90% of all STD claims received, we initiated a program to analyze claims in real time at intake, and automate the decision-making process for eligible claims. Enabled by a robust engine of analytical models, a cross-functional team across MetLife developed an innovative solution that segments and analyzes all claims received, with eligible claims being automatically adjudicated in real time:

 

  • Claim segmentation and assignment analytics, which combine segmentation results with resource capacity and skill requirements to assign the claim to the optimal specialist. This includes predicting involvement of specialized teams such as clinical or return-to-work specialists 
  • Likely claim progression analytics that identify the most appropriate path for the claim, including if the claim is likely to bridge from STD to a long-term disability (LTD) claim
  • Automatic adjudication analytics which drive the automated decision for eligible and appropriate claims

 

It’s important to note that all claims are run through the analytics engine, including claims which do not qualify for automatic adjudication.

 

This was an extremely complex transformation program that required strong collaboration and execution from a cross-functional team involving many groups within the company. Given that no group insurance competitor has been successful at developing a solution like this, it required the execution team to be creative, innovative and adaptive as they learned from their experiences throughout the project. The team started with small-scale proof of concept (POC) implementations for each of the analytics components, testing the logic and ability to deliver the right outcomes via the models. As they mined more data to refine the analytics, they expanded the POCs while also integrating the new workflows, analytical models and processes into the existing complex IT infrastructure.

 

Since its inception, we have automatically adjudicated approximately 46% of addressable STD claims.  We will be refining the existing solution and building new capabilities to target automatic adjudication for greater than 50% of STD claims by the end of 2019. Compared to claims that are not auto-adjudicated, we are seeing approximately 90% improvement in decision turnaround time and an average of five fewer calls per claim.

 

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About the Awards

The Business Transformation & Operational Excellence Awards have been established to showcase globally the most outstanding organizational achievements through the application of Operational Excellence programs. Click here to view the Press Release.

The winners for all categories and for The Platinum Awards will be announced at The Business Transformation & Operational Excellence Summit & Industry Awards on Wednesday March 20th, 2019, from 6.30pm, in the Venetian Ballroom at the Loews Portofino Bay Hotel at Universal Orlando Resort®. 

The Business Transformation & Operational Excellence Awards are open to all organizations, both private and public sector, across the globe, which have implemented Operational Excellence programs to deliver outstanding business results.

The 2019 Awards will be held in conjunction with the Business Transformation & Operational Excellence World Summit on March 20, 2019 in the Venetian Ballroom at the Loews Portofino Bay Hotel at Universal Orlando™

 

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BTOES.com

The issues in this article are just one of topic areas that are going to be discussed at the Business Transformation & Operational Excellence World Summit & Industry (BTOES19). March 18-22, 2019, Loews Portofino Bay Hotel at Universal Orlando Resort®

BTOES is the industry’s biggest and best, senior-level, cross-industry gathering of Business Transformation & Operational Excellence industry leaders and senior executives.

It also hosts the Business Transformation & Operational Excellence Awardswhich showcase globally the most outstanding organizational achievements through the application of Operational Excellence programs.

The summits hosts a number of private forums for C-Level & Global corporate-level leaders as well as business unit heads.

With over 150 speakers, over 100 sessions, 12 Keynotes, 9 Track Themes, 5 parallel tracks, 60+ track sessions, 50 roundtable discussions, 20 Interactive Workshops, 6 Thought Leader Panels, 5 Leaders Boardrooms, 5 co-located events, the Industry Awards Program, Site Visits, 20+ hours of social networking including 2 gala cocktail parties, dinners, numerous group activities, this is the ultimate event to benchmark, network and drive Operational Excellence to the next level.

 

Quick Links

Speakers

Agenda

BTOES19 Awards

 

There is a strong focus on Cultural Transformation, Customer Delight, Sustaining an Operational Excellence program, Need for end-to-end Business Transformation, Keeping up with new technologies/impact of digitalization and Leadership Buy-in & Understanding. We dedicated two tracks to advanced technologies, such as AI, Machine Learning, RPA, Predictive Analytics, Blockchain, Cloud infrastructure etc.

The agenda is designed to encourage active meaningful conversations though all day enhanced networking and interaction opportunities, including

  • All-day Refreshment & Themed Breaks

  • 1¼ Hour Hot Breakfast Networking Sessions

  • 1½ Hour Hot Plated Networking Lunches with Topic & Industry Sector focussed tables

  • 1½ Hour Roundtable Sessions by Topic & Industry Sector.

  • Keynote & Themes Panel Sessions

  • Hosted Welcome Receptions from 5.30pm

  • Expanded more lavish Awards Program

  • Newly launched Night Summit for attendees to meet after dinner

For more information or to discuss the summit in more detail please schedule a call below,

Click here to schedule a call. 


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