1 InstaClaim™ - Death Claim in 1 Day Because we care.. *Trademark applied for We, the team, make it happen…. Max Life Insurance Acquire New Bank Distributor Max Life Overview Founded in 2000 210 branch offices spread across India Drive Protection Sales Grow Proprietary Channel Service Excellence /Customer Experience Cost Optimization Talent Management 1 Revenue INR 12,937 Cr Profit Before Tax INR 768 Cr Asset under Management INR 44,370 Cr Customers 39.12 lakh
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InstaClaim™ - Death Claim in 1 Day · 2018-06-14 · 1 InstaClaim™ - Death Claim in 1 Day Because we care.. *Trademark applied for We, the team, make it happen…. Max Life Insurance
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What background information of the company or those who selected the project is needed to better understand the context of the project? (Q2 – 1/3) 1.1.1
What background information of the company or those who selected the project is needed to better understand the context of the project? (Q2 – 2/3) 1.1.1
9
1.1.0
Helpfulness of executive
Ease of completing the claims form
Claim Communications Turn Around Time
Helpfulness of
executive
32%
Turn Around Time
68%
Factors driving customer satisfaction for Claims
Key Attributes to drive customer satisfaction for Claims Satisfaction Top Box = Excellent
Emotion Top Box = Very Happy
Max Life Insurance
What background information of the company or those who selected the project is needed to better understand the context of the project? (Q2 – 3/3)1.1.1
10
“Why can’t the company complete my request in 2-3
day’s time??”
“Your company should take less
time for my Claim Settlement “
“10 Days for Claims is too much in today’s age”
Ethnography –Discover latent needs of the customers and to provide a differentiator
▪ Top underserved OEs
• Maximize the likelihoodof acceptance of myclaim request
• Maximize my awarenessof requirements for theclaim process
• Minimize time requiredto receive claim amount
• Minimize my effort inlocating branch forsubmission of claimdocuments
What area of the organization had the opportunity? (3/3)1.2.1
Impact on project OpportunityProcess
• Claim Intimation process
• Claims Processing at HO
• Finance
• Claim intimation from branch office to
Home Office taking time
• Time taken during Claims Processing
• Finance processing taking time
H
M
H
13
• Technology • System design causing delay • System deficiency due to legacy issues H
Product research & design
Customer Acquisition
Policy Issuance &
Underwriting
Policy Servicing
Claim Management
1) ProductDevelopment
5) Marketing Research
10) Underwriting13) Policy
alterations19) Survival
Benefits payout
2) Risk Valuation6) Distribution Management
11) Policy Issuance14) Lapse & Revival
Management20 ) Claim
Assessment
3) RiskManagement
7) Brandmanagement
12) Policy endorsement
15) Loans & withdrawal
21) Claim Payouts
4) Product Launch 8) Publicity & Promotion
16) GrievanceManagement
22) FraudManagement
9) Direct Sales17) Policy
cancellation
18) Premium collection
Selection process
Selection of projects
Data Tools Why?
▪ Voice of Customer
▪ KPI Performance of Customer Service Process
▪ Voice of Business
▪ List of potential projects
▪ Project selection criteria
▪ List of potential projects
▪ Customer Insighting
▪ Customer Service Dashboard
▪ Strategic Plan
▪ Prioritization Matrix
▪ Project selection matrix
▪ Methodology table
▪Understand improvment opportunity areas
▪ Analyze process performance and KPI deviations
▪ To understand over served and underserved areas
▪ To quantitatively and qualitatively assess and prioritize projects
▪ Impact of each project on selection criteria
▪ Select appropriate methodology
Problem detection
Potential project identification
What data was generated to help select the project ? (Q1)1.2.2
Data Collection sheet for Ethnography1.1.1
14Max Life Insurance
8
Max Life Insurance 15
Impact on strategic priorities
Financial ImpactImpact on end
customerEase of
ImplementationScore
Reduction in grievances 5 4 4 6 480
Reducing incidence rate of Flow of queries to query resolution desk
4 5 5 4 400
InstaClaim – On time processing of claims ( % claims settled in 1 day)
5 5 5 5 625
Improving Surrender Retention 4 5 5 4 400
Improving straight pass% of policy issuance
4 4 4 4 256
Score 100-300 300-600 >600
Methodology Maximizer Green Belt Black Belt
ProjectsCriteria
Project Prioritization Matrix
Method
To quantitatively and qualitatively assess and prioritize the project based on its financial impact, ease of execution & implementation as
well as impact on end customer
Why?
What methods and /or tools were used to assess or prioritize the need for the project? (Q2)Why were these methods and/or tools used to select the project? (Q3)1.2.2
Max Life Insurance 16
What Goals (organizational and/or local), performance measures, and/or strategies is the project expected to impact? (Q 1)What is the relationship between the stated measures and perceived gap in 1.2.1? (Q2)
What is the problem statement that expresses where the organization wants to be at the end of the project? (Q3)
1.2.3
Project Title – InstaClaim – Claim Settlement in 1 day
Business Case
Claims is a service differentiator and a moment of truth for a Life Insurance company. In May’12, we launchedan Industry first initiative of Claims Guarantee which included settling claim within 10 days of receipt of lastdocument. We have met our promises consistently by settling approx 99.99 % claims within 10 days and areindustry leader in area of claim paid percentage consistently for the past 3 years. A TAT of 1 day will be a newbenchmark in Life Insurance companies in India. This will help enhance Max Life brand and create more valuefor customer thereby enabling Max Life vision to be the most admired Life Insurance Company.
Goal Statement
Metric Current level Goal/Target Target date
% Claim Settled in 1
day
31 %
(Sep ‘15 – Nov ’15)
Phase 1: 80 %
Phase 2: 95 %
Phase 1: 31Aug16
Phase 2: 31Dec16
Project Plan: Phase 2
Phase Start End Remarks
Define
Measure
Analyse
Improve
Control
1-Dec-15
16-Dec-15
1-Jan-16
1-Feb-16
1-Jun-16
15-Dec-15
31-Dec-15
31-Jan-16
31-May-16
31-Aug-16 Or whenever the result is achieved
Problem Statement
Pain: Only 31% of the non early claims are settled in 1 Day (Sep’15-Nov15)Impact – As per FY’16 trends, this will impact ~65 % of total claims. Also this willimpact the CSAT for claims unit.Opportunity – There is an opportunity to enhance the One Day Claim % of Eligibleclaims to 95 % with in 1 day
Project Scope
Process Under Improvement : Claims Settlement Process (Approval)Start Point : Claim Intimation, NAV available in case of ULIPEnd point : Claim SettlementIn Scope : Individual Life Non Early (>3 years) admissible claims Out of Scope : Reopen Cases, Repudiation, Policy reinstated with HDF in last 3 years, Suspected Fraud and claim where LA had multiple policies with Early claims as well
Problem statement : As on Sep’15-Nov ’15 data analysis, Only 31 % claims are settled in 1 day and there is an opportunity to improve upon this critical parameter.
Project team wanted to improve On time Claims processing to provide superior customer experience
17
Max Life Insurance
How were the stakeholder groups identified? (1/2)What or who are stakeholder groups ? (2/2)1.3.1
I ERoles :- Influencer Executor
18
Supplier(s) Input(s) Process(s) Output(s) Customer(s)S I P O C
▪ Claimant
▪ Agent Advisors
▪ Branch Office Exec
▪ Channel Partners
▪ Claim Documents
▪ Closure confirmation
▪ Approval SMS
▪ Policyholders
▪ Agent Advisors
Documents Received at front end & saved at FTP
Documents Uploaded Claim Processed Evaluated by Authority Decision Approved
What knowledge or skill sets were determined to be necessary for successful completion of project?(1/3)To what extent did the existing stakeholder groups have the required knowledge or skills? (2/3) What additional knowledge and skills were brought in to make the project successful? (3/3)
1.3.2
Sponsor
• Lean Six Sigma Awareness
• Strategic Vision
• Influence and Leadership
• Effective Communication
• Negotiation
• Lean Six Sigma Awareness
• Strategic Vision
• Influence and Leadership
• Decision Making
• Process Knowledge
• Champion Training
• Advanced Lean Six Sigma Methodology
• Innovation Tools• Influence and Leadership• Coaching and Training• Interpersonal Relationships• Project Management• Basic Underwriting & Claims
Knowledge
• None additional
• Champion training
(2 Days)
Champion
Black BeltMentor
Knowledge required Current level of knowledge Additional knowledge brought in
✓
✓
✓
✓
✓
✓
✓
✓
✓
✓
✓
✓
✓
✓
✓
c
19
• Innovation Tools – Brain-
writing, Idea Sorting &
Refinement, Design FMEA,
Ethnography
• Basics of Claimsc
Max Life Insurance
What knowledge or skill sets were determined to be necessary for successful completion of project?(1/3)To what extent did the existing stakeholder groups have the required knowledge or skills? (2/3) What additional knowledge and skills were brought in to make the project successful? (3/3)
1.3.2
Project Leader
• Advanced Lean Six Sigma methodology• Team work• Influence and Leadership• Coaching and Training• Interpersonal Relationships• Mortality Concepts• Project Management
• Effective Communication• Process knowledge• Conflict Management•Mortality Concepts• Analytical skills• Lean six sigma
• Black Belt Training (10 Days)
• Lean Six Sigma Green Belt - (5 Days) for 5 team members
• Maximiser Trainings – 2 days – Rest of the team members
• Generative Team Building Session for all Project team for 2 days
• Team building through generative team building exercise
• Awareness Training sessions for Branch Office Field SPOCs
Project Team
Stakeholder
Representatives
Knowledge required Current level of knowledge Additional knowledge brought in
• Team work• Process Knowledge• Change Management• Project Management• Basic Underwriting & Claims
• Statistical Analysis – Hypothesis testing, Sample and Proportion Test
Generative Team Building / Innovation basics(1 day workshop)
• Customer Insighting (To understand importance vs. satisfaction related to customers)
• Brain-writing, creative challenge, design FMEA
• Ideas sorting and refinement
• Team Building , Collaboration, Cross Functional Team Alignment
Trainings
Tools Learnt
Conducted by Internal MBB’s
1.3.2
Exam Based
Conducted by External
Consultant
Case Study Based
Max Life’s Lean Six Sigma Methodology
DMAIC MethodologyDefine Problem
Measure Performance
Analyze ProblemImprove
PerformanceControl
Performance
Max Life Insurance
Before the project started ,what was done to prepare the team to work together as a team?(2/2)1.3.4
Usage of GRPI Tool
Goal clarity provided to team members by explaining-
• Correlation between One Day Claim and Customer Satisfaction
• Team members contribution to the project’s Big Y
• “WIFME - What’s in it for me” clarity given to the team members.
Generative
Degenerative
Generative team building exercise was initiated to align everyone to the common goal of the project
Visual impact created through posters & real time case studies
22
12
Max Life Insurance
What roles and expectations were determined ahead of the project? (1/3)1.3.4
KEY STAKEHOLDERS DEFINE MEASURE ANALYSIS IMPROVE CONTROL
Steering Team A/I A/I A/I A/I A/I
Claims Team M M M M M
Field Operations Team R R R M R
Project team M M M M M
Quality Team R R R R I
What Role?
A - Approval of team decisions outside their charter/authorities, i.e., sponsor, business leaderR - Resource to the team, one whose expertise, skills, “clout” may be needed on an ad-hoc basisM - Member of team, with the authorities and boundaries of the charterI - Interested party, one who will need to be kept informed on direction, findings
Expectations
• Provide strategic vision
• Guarantee commitment of team
• Project definition
• Ensure alignment with business
• Ensure resource allocation• Decision making with
black belt
• Rigorous application of Six Sigma
• Lead the team to success• Decision making with
champion
• Data Collection• Active participation in
DMAIC Phases• Key players in the project• Improvement journey
• Support with training requirement
• Provide expertise when required
Sponsor Champion Quality & Black belt Project Team Support Functions
Various Departments came together for Creation of ARMI
23
Max Life Insurance
What deadlines and deliverables did the team have to consider ahead of actually starting the project? (2/3)
1.3.4
Deadlines Deliverable
Define & Measure Phase
ImprovePhase
Control
Analyze Phase
• Project plan sharing with champions &sponsors
• Weekly meetings with BB & GB for projectprogress
• Share outcome of analysis & root causers• Share customer insighting outputs with the
team
• 1st Dec, 2015 to 31st Dec, 2015
• 1 Months from the project startup
• 1st Jan, 2016 to 31st Jan 2016• 1 Month after the
measure phase completion
• 1st Feb, 2016 to 31st May, 2016• 1 Month after Analyze phase
completion
• 1st Jun, 2016 to 31st Aug, 2016
• 3 months after improvephase completion
• Project charter• CTQs• Process mapping• Data collected & MSA• Process performance• Toll gate review signoffs
• Hypothesis testing of historic data• Customer need analysis• Validation of improvement opportunities• Tollgate review signoffs
• Solutions designed & tested• Cost benefit & risk analysis• Implementation plan• Final solutions implemented• Tollgate review sign offs
• Process control systems• Governance & dash boarding• Control charts• Replication opportunity• Best practice sharing
• End of phase presentation to MBB & projectsponsor
• Standard DMAIC checklist verification• Review with champion & sponsor
Team routine & communication
24
13
Max Life Insurance
Before the project started, what team routines, including communication were established? (3/3)
1.3.4
Stakeholder-wise MIS expectations
Stakeholder Type of MIS Periodicity
Steering Team CTQ Performance Monthly
Field SPOCs Delay Case HighlightWeekly, Real time for delay
cases
Project Team CTQ movement with Performance review Monthly
What Why When Whom Who
Team meetings
Face-to-face groupmeeting of all project team members to discuss requirement, progress against plan, issues, milestone dates and upcoming events
Weekly Key project team Anil Sharma
MIS/reports Tracking and monitoring MonthlyChampion / Keyproject tam
Kapil Kaushik
Project plan updateTQMI presentation file is updated every weekend and distributed
Weekly Key project team Vinit Julka
Project reviewsFace-to-face meeting with project team
Monthly
Key project team Project sponsor and Project champion
Ashok S N
Detailed communication plan
CO
MM
UN
ICA
TIO
N
TEA
M R
OU
TIN
ES
Governance review with steering team on monthly basis
Project review rigor with project champion and project sponsor. Seeking suggestions for course correction
Cross functional team huddles on a weekly basis & plan of action for the next week
Monthly project progress report & CTQ movement
25
Max Life Insurance 26
Current Situation and Root Cause Analysis
Section 2
2.1.0 Key Measures Expected of the Project2.2.0 Possible improvement opportunities2.3.0 Final improvement opportunities2.4.0 Project Management Update
14
1.2.3
By the end of the project the company expected to
have improved on time claim processing by
completing 95% cases within 1 working day, there by
enhancing customer satisfaction as well.
2.1.1 What specific Goals and/or measures is the team trying to achieve with the project? (Q1)
27Max Life Insurance
95% Claim to be settled within 1 working Day
• Improvement in customer satisfaction scores
• Reduction in count of claim delay related queries Expected benefits
Additional Potential Benefits
(estimated by the team)
• Customer loyalty scores
• Process Maturity Index
40%
56 per month
50%
~40 per month
65%
3.5
75%
4.5
Current Estimated
Current Estimated1.1.0
2.1.1 What additional potential benefits, other than the specific goals and/or measures, will the project impact? (Q2)
Fish bone was used for grouping of potential causes by their
natural affinity to identify similar X’es thereby ensuring
exclusivity.
Detection of Root Causes
Cross functional team got together to list down number of
potential causes that impacted the CTQ. A total of 46 causes
were identified basis affinity diagram and brainstorming
What methods and/or tools were used to identify possible root causes? (Q1)Why were these methods and/or tools selected?(Q2) (2/3)2.2.1
Max Life Insurance
Muti-voting was a way for the group to narrow down a list of causes to a manageable few. While multivoting is not a decision making tool, it was a great way for us to achieve consensus on an option that was most-favoured by the group.
Cause & Effect Matrix To understand the relationship between inputs and outputs and identify factors having critical influence. It enables the
numerical representation of process inputs and outputs and the relationship between them.
Pareto Analysis was done to analyse delay in claim intimation from different zones to enable decision-making. The idea was that by working on 20% of the causes we could generate 80% of the benefit.
What methods and/or tools were used to identify possible improvement opportunities? (Q1)Why were these methods and/or tools selected?(Q2) (2/2)2.2.1
What methods and / or tools were used to identify final improvement opportunities?(Q1)Why were these methods and/or tools selected ? (Q2)2.3.1
Tools Used?
Why?
How?
FMEA
Used to validate 1 cause –Delay in intimation fromBranch Office to HO – this wasfound to be significant withthe P value of "0" but notsignificant enough as its "RSquare adjusted" was merely16%
Done for 6 causes wheremultiple levels of Xs were to becompared for Claim settlementTAT. For Example Risk Scoringmodel Model enhancementhad an impact on ClaimsSettlement TAT
Conducted for 2 causesincluding Low Claim awarenessin filed and Team Alignment toidentify improvementopportunities by askingmultiple subsequent “why’s
FMEA was conducted for 1 X –System Process flow/DesignChanges - identified varioussystem flows hindering theachievement of 1 day TAT andbugs which had high occurrencesbut were being detected late
Hypothesis testing with mini-tab on data collected during measure phase.
Hypothesis testing with mini-tab on data collected during measure phase.
Hypothesis Testing - Logistic Regression
Hypothesis Testing – Chi Square
5 Why
Evaluating severity, occurrence and detection of failure modes of possible improvement opportunities
Asking subsequent questions to reach final root cause basis brainstorming with team
37
Max Life Insurance
How was team prepared to use the methods and/or tools? (Q3)2.3.1
Max Life’s Lean Six Sigma Methodology
Define Problem Measure Performance Analyse Problem Improve Performance Control Performance
Green Belt Six Sigma Training (5 days training for project team)
Internal MBB’s
Exam Based
DMAIC
Methodology
Tools Learnt
Training
▪ SIPOC, Process Maps▪ Brainstorming, Ishikawa▪ Cause & Effect Matrix, Pareto Analysis▪ FMEA/Risk Matrix▪ Basis Statistical Tools Like Chi square, Regression ▪ 5 Why Analysis
What data was generated and how was the data analyzed in order to identify improvement opportunities? (Q1)What are specific examples of data analysis that lead to the final improvement opportunities? (Q2)2.3.2
1. Branch Office Intimation TAT
2. Risk Scoring model issues
3. Channel
4. Zone
5. Account Value
6. Edit Claim Issues
7. System Issues
8. Claim Amount
9. Low Communication (Awareness)
Final Causes
Data
Analysis
Examples
What were improvement opportunity(ies)? (3/3)
FMEA
• List of potential failure modes
• Risk Priority Number (RPN) basis risk associated with each failure
• X 7 – System Issues
• Prioritization of highest risk index
• In built system issues like multiple policies have to be processed together instead of prioritizing one over another
HypothesisTesting – Chi Square
& Pareto
• Historic data for project Y & high impact Xs like:
• Hypothesis testing in mini-tab with data collected in measure phase
• Results of tests allowed to accept/ reject the hypothesis
• Due to system bugs wrong calculation of claim amount led to delay
5 Why analysis
• Root Cause Analysis done for 2 potential causes basis 5 Why Analysis technique by
X9-Low Communication
X10 Team Alignment
• Through Brainstorming
• Field SPOCs in Branch Office were not having full awareness of claim requirements leading to deficiency in claim submission
39
10. Team Alignment
• Historic data for project Y & high impact Xs like:
X 1- Branch Office Intimation TAT
• In case TAT is higher for Claim intimation from Branch Office to HO claim settlement TAT increases
HypothesisTesting –Logistic
Regression
• Hypothesis testing in mini-tab with data collected in measure phase
• Results of tests allowed to accept/ reject the hypothesis
Validated using Regression
X1 - Delay in Branch Office-HO
intimation TAT
X 2 - Risk Scoring Model
Enhancement Validated using
Chi Square
X3 - Channel
Validated using Pareto & Bubble Chart
X4 - Zone
Validated using Pareto
X5 - Account Value
Validated using Chi Square
X6 - High Edit Claim cases
Validated using Chi Square
X7 - System Process flow/Design Changes
Validated using FMEA
X8 - Claim Amount
Validated using Chi Square
X9 - Low Claims process awareness in
field
Validated using 5 Why
10 Validated improvement opportunities Evidences
X10 - Team alignment
Validated using 5 Why
The use of various methods and tools with records/data were effectively used with the training by the lean six sigma champion at each phase of the determination of the improvement opportunities
Po
ten
tial
cau
ses
: 1
0, V
alid
ate
d :
8
2.3.3
How was (were) the final improvement opportunities validated?What evidence showed that the final improvement opportunities were validated prior to solution development? (Q2 – 1/2)
What evidence showed that the final improvement opportunities were validated prior to solution development? (Q2 – 2/2) 2.3.3
• What - Project checklist - Phase wise• Aim - Project key stages tracking and ensure methodology followed• How - Checklist to be reviewed by Quality dept and to be reviewed
before toll gate review by Champion & Sponsor
1.3.4
41
Max Life Insurance
How was the correctness of the initial project scope, deliverables, and timings verified? (Q1)2.4.1
Deadline Deliverable Scope
Define & Measure Phase
AnalyzePhase
• 31Dec2015• 1 Month from start of
the project • Successfully completed
• Project charter• CTQs• Process mapping• Data collected & MSA• Process performance• All approved at tollgate with
checklist
• Sponsor & team in tollgate• Causes found within initial
scope• No need to change the scope
• 31Jan2016• 1 Month after the
Measure phase completion
• Successfully completed
• Hypothesis testing ofhistoric data
• Customer need analysis• Validation of improvement
opportunities• All Approved at tollgate with
checklist
Governance, Reviews & Project Team Meetings Conducted At Every Key Milestone Stage of the Project
Sponsor, Champion, Master Black Belt & Project TeamMake a Project Management Review for the Final Tollgate For The Phase
Value StreamBenchmarkingConsultation with IT team and Subject Matter Expert
Data
List of improvement ideas organized into themes
List of process gaps and rework loops
Suggestions related technical enhancements for self
service options
HowAnalyzed?
Through team workshops
Understand impact of each gap if bridged on the CTQ
By understanding what is offered by Competition vs.
Max Life
Estimate contribution of each idea in reducing Claim
settlement TAT
What data was generated and how was the data analyzed to determine the possible solution(s) / improvement(s)? (1/3)
34 Possible Solutions
Generation of possible solutions / ideas
49
List of best practices from competition including
International Life and Non Life Insurance Cos viz Aflac
Max Life Insurance
What are the possible solution(s)/improvement(s)? (Q2/3) 3.1.2
Root Cause Possible solutionsS.No
X- 1 Delay in Branch Office to Head Office intimation TAT
Initiate GB project on Branch Office Intimation TAT as a part of this Black belt projectStabilize UCHIT roll out at pilot Branch OfficesDay 0 upload of documents on FTP/EmailTraining - Presentation on UCHIT Intimation process and using Claim Omni Docs - In Person in Delhi 1 & Over Call on 4 locationsIntensive Branch Office communication campaign around DO’s & Don’ts for claim handling Close Monitoring of quality of Intimations to be done at HO by case level trackingLive Status of Claims at Branch Offices
X-2 Risk Scoring model enhancement
Automation of SMS at various stages through UchitFinance tickler time changed from 10.30 am to 12 noon to enable ‘One Day claim ’NAV tickler timing changed from next day 6 am to same day 10 pm to enable processing of ULIPsRisk Scoring model limit raised from Rs 25 Lacs from Rs 10 Lacs
Align Spocs of Agency to support on express settlement agendaCreate awareness with in Max life Channels/Branch Offices for Express Claims settlementMake front end staff at Channels/Branch Offices for claim related queries Regular conference calls with Axis/Amsure channel spocs for claim awarenessSimplified claims form Launched at the front end
X- 3
&
4
Channel/Zone
GB Project initiated to fix system gaps pertaining to automate edit claimsIntimations & Scanning to be done on a daily basis Daily Approvals including on boarding new approversApproval MIS to be circulated with in the teamClaim received vide CSMS/Email - sent to intimation team without delay
X -6 High Edit Claim cases
Uchit Claims system under revamp – to be done under 3 phases during FY ’17 Approval SMS automation under progress (plan to Branch Office live on 24 July, 2016)Online claim intimation (website & mobile) – requirement placed as part of corporate website projectIn-house GB project & Cross functional project done with PAG & Claims team with assistance from Actuarial teamRe- certification exercise completed – 100% cases executed and analysed as per plan, 38 issues identified and logged with IT team for RCANecessary rectification actions to be planned post RCAApproval SMS - Automation on Uchit
What are the possible solution(s) / improvement(s)? (Q2/3) Contd.. 3.1.2
Express Claim Settlement Communication plan to be rolled out- Phase 1 Branch Office Dashboard publication (Head Field Ops & his DRs) Daily Email to respective Branch Office's(Delayed Intimation >0)
Root Cause Possible solutionsS.No
X - 9 Low Claim process awareness in field
X-10Team alignment
Dedicated team with expertise in non-early claims aligned with adequate back ups Strong outsourced team aligned with timelines with back up plan Shift working with 2 shifts (8.30 am & 11 pm) to maximize efficiencyWork from home facility being used for 2 resources
51
Max Life Insurance
What evidence showed that the solutions(s) / improvement(s) identified were possible instead of final? (3/3)
3.1.2
52
•What – Project Checklist – Phase wise•Aim – Project key stages tracking and ensure methodology followed•How - Checklist to be reviewed by Quality dept and to be reviewed before toll gate review by Champion & Sponsor
1.3.4
27
What methods and/or tools were used to identify the final solution(s) / improvement(s)? (Q1)Why were these methods and/or tools selected? (Q2) (1/3)
Method - Define criteria aligned with strategic priorities34 Possible Solutions
To decide best solution considering criteria
Final Solution and Implementation Plan
Who Project Team + Process Owners + Specialists
Tool Team meeting with stakeholders and Quality Leader
Why? To translate strategic criteria into operational metrics for the project
Who Project Team + Process Owners
Tool Solution Selection Matrix
Why?Most suitable tool to evaluate potential effectiveness of solution in line with organizational Goals and multiple criteria
3.1.2
53Max Life Insurance
3.2.1
3.2.1What methods and/or tools were used to identify the final solution(s) / improvement(s)? (Q1)Why were these methods and/or tools selected? (Q2) (3/3)
Impact
Ease
Cost
On project indicators
Of implementation
Of implementation
Criteria Description
Selection Matrix
Impact9
Cost9
Ease9
Impact
7 to 9 – High
4 to 6 – MediumWeighted average for degree of
contribution of each solution to the selected criteria
3.2.2 How were the methods and/or tools used to determine the final solution(s) / improvement(s)? (Q1)
CTQ Impact
Cost Impact
EasePriority
No.
8 5 7 180
9 9 9
19 final solutions selected
Impact on CTQ
Cost Impact Ease
Solution Selection Matrix
1 2 3
7 to 9 – High
4 to 6 – Medium
>=150 – High
<150 – Low
56Max Life Insurance
29
Max Life Insurance
3.2.2P
eo
ple
Pro
cess
Tech
no
logy
What is (are) the final solution(s)/improvement(s)? (2/2)
19 Final solutions were categorized under 3 strategic themes
57
Technology
Process
People
Training - Presentation on UCHIT Intimation process and using Claim Omni Docs - In Person in Delhi 1 & Over Call on 4 locations
Align Spocs of Agency to support on express settlement agenda
Create awareness with in Max life Channels/Branch Offices for Express Claims settlement
Make front end staff at Channels/Branch Offices for claim related queries
Daily Approvals including on boarding new approvers
Express Claim Settlement Communication plan to be rolled out-Phase 1
Dedicated team with expertise in non-early claims aligned with adequate back ups
Initiate GB project on Branch Office Intimation TAT as a part of this Black belt project
Stabilize UCHIT roll out at pilot Branch Offices
Day 0 upload of documents on FTP/Email
Finance tickler time changed from 10.30 am to 12 noon to enable ‘One Day Pay’
NAV tickler timing changed from next day 6 am to same day 10 pm to enable processing of ULIPs
Intimations & Scanning to be done on a daily basis
In-house GB project & Cross functional project done with PAG & Claims team with assistance from Actuarial team
Re- certification exercise completed –100% cases executed and analyzed as per plan, 38 issues identified and logged with IT team for RCA
Uchit, Claims system being re-engineered – Basic work flowbeing changed under 3 phasesending FY ’17
GB Project initiated to fix system gaps pertaining to automate edit claims
Approval SMS automation
Online claim intimation (website & mobile) – requirement placed as part of corporate website project
How were the final solution(s) / improvement(s) validated? (Q1)
Final solution validated through Pilot Test, 2P Test and FMEA
How
58Max Life Insurance
3.2.3
30
Max Life Insurance
Potential solution
3.2.3
Pilot Plan & Implementation
59
Q2.What evidence showed that validation was performed prior to implementation? (1/2)
Statistical Validation FMEA
Max Life Insurance
Q2.What evidence showed that validation was performed prior to implementation? (2/2)3.2.3
60
• What – Project Checklist – Phase wise• Aim – Project key stages tracking and ensure methodology followed• How - Checklist to be reviewed by Quality dept and to be reviewed
before toll gate review by Champion & Sponsor
1.3.4
31
Max Life Insurance
Q1. What additional potential benefits were anticipated from the final solution(s)/ improvements? Q2. Were the additional potential benefits anticipated prior to implementation?
3.2.4
61
Not Anticipated
INR 50 Lakh Cost saveCost save from efficiency improvement to be
measured from Opex report
> 60 %QDNA – Awareness and EngagementNumber of people trained on quality concepts
What data were generated and how was the data analyzed to justify why the chosen final solution(s) / improvement(s) should be implemented? (Q1)
Indicators
Improvement in on time processing
Customer Satisfaction Top Box scores
Expected Results
95% in 1 day
50%
Pilot Test Results
How and when
• Before full scale implementation of solutions , pilot roll out results were presented to the steering team
• Cost benefit analysis to show that the investment made had a higher rate of return
• Impact of the results on the project objectives were encouraging leading to approval for full scale implementation
1.2.3
Claim delay related query count 45
Pilot Test
82% in 1 day
51%
43
1.1.0
62Max Life Insurance
3.2.5
32
What evidences showed that justification was performed prior to implementation? (Q2)
Evidence of cost benefit analysis prior to pilot & full
scale implementation
Basis the encouraging pilot results and financial justification, the steering team approved the full scale implementation plan of identified solutions
3.2.3 (1/2)
63Max Life Insurance
3.2.5
How was the correctness of the initial or updated project scope, deliverables and timings confirmed (or, what changes were made)?(Q1)
Project scope check
Project Timelines Check
Through toll gate review the correctness of the project scope, deliverables and timeline were checked
What is the cost benefit analysis?
Was a pilot conducted before full scale
implementation?
64Max Life Insurance
3.3.1
33
Max Life Insurance
Q1. How were stakeholders involved and / or communicated within solution / implementation stage of the project?(2/4)3.3.1
Stakeholder
Steering Team Approvals for final solutions & suggested modifications
Quality Team
Claims Team
Training Team
Assuring correct use of tools & techniques
Idea Generation, IterationPilot implementation
Pilot handholding & supportValidation of solutions
Providing System training to Field SPOCs
Involved in Degree of Involvement
High
High
High
Medium
High
High
Medium
Idea Generation, IterationPilot implementation
1.3.1
65
Field Operations Team
Finance Team Support CBA Validation of solutions
Technology Team
Max Life Insurance
Q1. What stakeholder resistance was identified and / or addressed in this phase of the project? (3/4)3.3.1
Stakeholder
Budget & Resource allocation in view of Merger plans
Valuable inputs & addressing the impediments
Promotion of quality tools through improvement initiatives
None
None
Enhanced focus from field staff helped in controlling bad business at first gate
None
Due to process improvement lot of rework will be saved
None
Training all Field SPOCs across regions is not practical
Resistance in change of Finance Batch Time and non availability of Finance Approver
Regular updates of data
Positive impact Resistance
• Using stakeholder analysis •Holding meetings between team & stakeholders
How?
InstaClaim adopted as Best practice by COO & CTO
Positive load testing results during pilot run
Influencing strategy
Claims System training packIncluded in induction & Regular training programs
1.3.1
66
Steering Team
Quality Team
Claims Team
Training Team
Field Operations Team
Finance Team
Technology Team
34
Max Life Insurance
How was the appropriateness of the initial team membership and management routines confirmed?(4/4)
GRPI Management
• Workload manageable so need to change any team membership
• No change in the knowledge & scope so no need to change or add members
• MBB approved use of DMAIC• Updated stakeholder feedback• Increase communication with stakeholders• Meetings held• Deadline& deliverables achieved
Team Membership (GANTT Chart)
Stakeholder Analysis Matrix
( Document Review)
Management Routines( Document Review)
How: Assessment in TollgateTeam with Sponsor & Master Black Belt
3.3.1
18% Improvement
67
Max Life Insurance
Section # 4
Implementation and Results Verification
4.00 Implementation and Results Verification4.10 Stakeholder Consideration in Implementation4.20 Solution/Improvement Implementation4.3.0 Project Results
68
35
Max Life Insurance
Q1. How were stakeholders involved in planning the solution/improvement implementation? 1/2Q2. How were stakeholders involved in implementing the solution/improvement? 2/1
4.1.1
StakeholderHow were they Involved in Planning?
How were they Involved in Implementation ?
Steering Team
Quality Team
Field Operations Team
Claims Team
Training Team
Technology Team
Approved the planning timetable & tasks with list of resources proposed
Approved the planning timetable & tasks with list of resources proposed
Actively participated as a team member in implementation planning
L&D -Actively involved in training initiatives for implementing solutions
Actively participated as a team member in implementation planning
Actively participated as a team member in implementation planning
Provided approval on Cost, Changed ticker timingsFinance Team
Ensured cross functional availability of resources from the departments involved
Accepted the new working ways by signing on the new process checklist
Accepted the new working ways by signing on the new process checklist & supervised new process
By preparing required training calendars & training the required resources
Conducted pilot tests & all system changes
Not much involvement in planning
Validation of methodology used in new processes & implementation
1.3.1
69
Q1. What was done to anticipate resistance before it occur? (1/3)Q2. What type of resistance were actually encountered during the course of solution/Improvement implementation? (2/3)4.1.2
Stakeholder
• Using stakeholder analysis •Holding meetings between team & stakeholders
How? What we did toanticipate resistance?
Positive Impact Resistance
Steering Team
Quality Team
Field Operations Team
Claims Team
Training Team
Finance team
Technology Team
Improvement in Claims TAT result in providing superior customer service and CSAT scores
None
Promotion of quality tools None
Contributes in Timely Intimation of Claim
Resistance to adopt to the new processes & practices fearing increase in workload and error due to new process
Direct contribution in one day payment TAT, potential cost save for future
Q1. What was the evidence of stakeholder buy in ? 4.1.4
Who? How?Sponsor & ChampionSix Sigma Team
Team ObservationsMeetings with stakeholder
Stakeholder Evidence of Buy In
Steering TeamProject phase completion approval at every tollgate stage of DMAIC journey
Quality TeamProject phase completion Approval at every tollgate stage of DMAIC journey
Field Operations TeamPositive feedback during meetingsEnthusiasm expressed during pilot results
Claims TeamActive support during pilot testsHigh degree of cooperation in the definition of rolesOpen approvals & communication of results
Training Team Regular training delivery and adhoc support for any changes
Regular Payment Deliveries as per timelines
H
M
M
M
M
L
Promotes Changes
Accepts Changes
Doesn’t accept changes
Degree Of Buy In
HTechnology Team M
H
H
H
Finance Team
Delivery of all scheduled IT changes
73Max Life Insurance
Q2. What evidence showed that buy-in was obtained prior to implementation? (1/2)4.1.4
Major systemic process changes done and Uchit Claim system underwent complete overhaul post CBA approval from all the stakeholders
Planned IT releases
System enhancements
IT releases approvals
74Max Life Insurance
38
4.2.1 What processes or system were changed or created to implement the solution / improvement? (Q1) (1/2)
Automation Business Reports automated to track and monitor One day Claim processing
Automated reports availability
System Changes done
75Max Life Insurance
76
New Process 4 sheeter updated – 5 process steps removed from earlier process to bring efficiency Process ChangesSystem
ChangesRevised Claim Forms Launched to include additional information and authorization Risk Scoring model Limit increased from Rs 10 Lac to Rs 25 lac to enable more cases to be processed Finance batch Time changed from 10.30 am to 12 Noon to maximize same day processing
NAV batch time changed from day 1 to same day 10 pm to enable Market linked policy claims processing on same day
4.2.1 What processes or system were changed or created to implement the solution / improvement? (Q1) (2/2)
Max Life Insurance
39
What systems were changed or created to measure and manage the performance of the implementation? (Q2) (1/2)
4.2.1
Process Control System-Tracking in place to monitor 1 day Claim TAT
Input Process outcome indicators Control limits Checking item Frequency Responsibility
MTD Performance for One Day TAT % >95% Performance Monthly MIS Team
Reasons of Ineligibility Ongoing Performance MIS Weekly MIS Team
Reasons of Not Approved cases in 1 day Ongoing Performance MIS Weekly MIS Team
Approval SMS Ageing Ongoing Performance MIS Weekly MIS Team
77Max Life Insurance
78
Unified View of customer at Branch office – UNO
Online web based dashboard for Customer experience scores
System enhancements
Complaint logging through customer portal
Uchit Claim System Available at branch office
What systems were changed or created to measure and manage the performance of the implementation? (Q2) (2/2)
4.2.1
Max Life Insurance
40
Q1. What were the results?Q2. How did the results compare to the specific project goals/measures from Item 2.1.1? (1/2)4.3.1
79Max Life Insurance
Quick wins implemented
But Quick wins did not had permanent
impact
Solutions under Process and People
theme implemented
All Automation & Tech solutions implemented
One Day Claim – Trend lineIMRB Customer Satisfaction Survey - % respondents giving Excellent scores
High scores commensurate Big Y results
Claims delay related Queries reduced from 56 per month to an avg of 40 per month !!
Our Leadership position in Claims paid percentage in last 3 years helped us achieve significant %share of selection( max. of 21% )
With market launch of InstaClaim in end Oct’16 and continued industry leadership in Claims Paid percentage, our absolute Unique selections went up by 26 % in Dec’16 and by 70 % in Jan’17
Claims is one of the key driver for protection sales of the company
Max Life Protection Policies sold by leading Web Aggregator
Premium
Claims Experience
Plan Feature
Key drivers for protection sales
Advertising/Market Campaigns
80Max Life Insurance
Q1. What were the results?Q2. How did the results compare to the specific project goals/measures from Item 2.1.1? (2/2)4.3.1
Q1 What additional benefits were realized from the project? Q2 How did the team measure any of the additional benefits that were ‘Soft’? Q3 How do the actual additional benefits that were realized compare to the expected additional benefits identified in item 3.2.4?
4.3.2
Additional benefits Pre-Project Expected Results Achieved Measure of Success
Customer Loyalty Score
Process Maturity Index
Ad
dit
ion
al B
enef
its
Not Anticipated
70%
INR 55 Lakhs to be realized in next 3 years, Rs 10 lakhsrealized in FY’17
79%Annual Customer Loyalty Survey by IMRB
Max Quality System
Cost Save
Soft
65%
Not Anticipated Opex Cost Save Dashboard
Max Quality System QDNA – Awareness and Engagement
3.5 4.5 5
69 % 80 %75 %
81Max Life Insurance
Section # 5
Preservation and Stakeholder
Communication5.00 Sustaining and Communicating Results5.10 Sustaining results Over Time5.20 Communication of Results
What was done to make sure the benefits obtained from the implementation(Item 4.2.1) were maintained? (Q1)
5.1.1
Measurement & Control system designed for the projects with control charts & Time series graphs
Weekly One day claim TAT Updates through regular dashboards
1.Control Plan Developed
Input Processors
Control Limits
Checking Item
Frequency
Responsibility
Contigency Plan
Daily WIP
MIS
100% Accuracy
Emails
Daily
Prashant Gusain
As & When
NEFT Penetration
TAT –Before 3rd
of Every month
Checklist & Emails
Daily
Gurjeet Singh
As & When
Review and Meeting
Feedback/Followup
MOM’s &Concalls
Weekly
Gurjeet Singh
Prashant Gusain
As & When
Communication
Communication Calender
Tracker
As per Plan
Amrita Bhardwaj
As & When
Training
Adherence to TC
Training Calender
Quaterly
Pooja Goyal
As & When
✓ Project Team✓ Project Heir
Multiple actions were taken to ensure the continuity of changes in process/systems
Role of Project Heir
Apply Six Sigma methods and tools to sustain project results
Monitor and control improvements achieved during project
Present ongoing results monthly
Extend the improvements further
Who? Who?
3.Web based dashboards for real time monitoring
2.Process changes as per ISO Standards
4.Visual Management & Control through Charts
5.Monthly reports by project heir to Management Committee
83Max Life Insurance
84
What evidence showed that this became part of the organization’s culture / operating strategy? (Q2( (1/2)
• Company wide Emailer through a centralized process control unit• Replication of TAT improvement theme by other departments • Documenting of revised process & Sharing best practice on knowledge portal of Max Life – “E-cube”
Max Life Insurance
5.1.1
43
85
What was done to make sure the benefits obtained from the implementation(Item 4.2.1) were maintained? (Q1)
Project heir and Process ownersWho? DashboardHow?
Measurement & Control system designed for the projects
Dashboards & Control charts
5.1.2
Max Life Insurance
What evidence showed that this became part of the organization’s culture /operating strategy ? Q25.1.2
• Company wide Emailer through a centralized process control unit• Replication of TAT improvement theme by other departments • Documenting of revised process & Sharing best practice on knowledge portal – “e-cube”
• InstaClaim performance monitored at senior leadership levels – Part of Company wide update shared by Vice Chairman & MD in quarterly company town hall
86Max Life Insurance
44
What evidence showed that this became part of the organization’s culture Operating strategy?(2/2)5.1.2
• InstaClaim performance tracked and monitored regularly at operations leadership levels
87Max Life Insurance
How did the team communicate the results to the various stakeholder group? (1/2)5.2.1
StakeholderWho How Communicated
Steering Team
Quality Team
Field Operations Team
Operations Team
Training Team
Finance Team
Sponsors & Champions
Quality Experts & coordinators
Branch Offices
Service delivery TeamUnderwritingClaims
Training managers who support the training requirements
Finance Team to support in faster payouts
• Board meetings• Quarterly business updates• Monthly project updates through
dashboards & MIS
• Business quality councils• Monthly project team meetings• Program team meetings
For all system enhancements & automationsTechnology Team
• Monthly business reviews• Quarterly business updates• Monthly project updates through
dashboards
• Fortnightly conference calls• Monthly project updates through
dashboards
• Monthly project updates • Newsletter • Case Studies
• Monthly project updates through dashboards• Newsletter• Case Studies
• Monthly project updates through dashboards
• Newsletters88Max Life Insurance
45
InstaClaim launched on 24Oct2016 by Max Life Vice Chairman & MD and appreciated by Max Life Founder Chairman Emeritus Mr Analjit Singh
Launch EDM sent to all Max Life offices Launch Email sent to all policyholders
5.2.1
89Max Life Insurance
Max Life Top Management Key Note Messages on InstaClaim launch 5.2.1
90Max Life Insurance
Vice Chairman & MD Mr Rajesh Sud Message Chief Operating Officer Mr V Viswanand Message
46
InstaClaim Launch news was covered in major national dailies and insurance portals and had major impact 5.2.1
91Max Life Insurance
World Quality Congress Best Use of Six Sigma in Banking & Finance Sector
Max Group Best Black Belt Award
Project won “Best Black Belt of the year” award at Max Life & at Max Group level, Also won award at prestigious “World Quality Congress Awards” at National Level
Max Life Best Black Belt Award
92Max Life Insurance
47
Further way ahead…..
Can be replicated to other Line of businesses viz Group Claims, Health Claims
Can be replicated to Individual claims itself for “No Sum at Risk claims” in Early policy duration
Can be scaled to take up larger volumes post Merger as it has at its disposal technological and automated solutions including Uchit and Risk Scoring model