Compliance, complaints, and conduct: Challenges and opportunities for insurers

Tablets in a meeting

There are vital business areas that can greatly benefit from automation, but they present challenges for today’s insurers. These key areas include investigating and reporting on anti-money laundering (AML), handling customer complaints, managing employee training for business conduct and ethics, and ensuring regulatory compliance.

Today, the departments and individuals with responsibility for these areas typically use a variety of manual tools, spreadsheets, e-mails, and ad hoc methods to manage them. While there are software packages to assist in some of these areas (such as AML), there is a lack of automated solutions for case management and workflow management, as well as an inability to leverage the variety of unstructured digital content associated with each area.

Overall, these areas are often highly inefficient and frequently create problems with customers and regulators, resulting in fines, loss of licensure, customer dissatisfaction, or customer defections. Luckily, these are challenges you can overcome.

Utilizing technology to turn challenges into opportunities

Here is a quick review of the problems and opportunities in each of the previously mentioned areas:

1. Anti-money laundering case management

Insurers, like other firms that deal with large financial transactions, are required by the laws of various countries to identify, investigate, and report on money exchanges or transfers that are suspicious, including transactions from high risk countries or those involving politically exposed people.

The monitoring software of today will typically identify suspicious cases, but most insurers handle the ensuing investigation and reporting via manual approaches. Insurers benefit from solutions that generate a case, orchestrate and track the involvement of multiple individuals that may be engaged in the investigation, and provide an audit trail of decisions and actions.

Rather than performing all these actions ad hoc or manually, insurers benefit from a single, central solution to store, manage, and report on the wide variety of information collected during the investigation. With audit trails that detail who did what, when, and why, they’re empowered with a 360-degree view of the case.

2. Customer complaint management

Customer complaints come from many different sources, including web sites, contact centers, mobile communications, and letters, among others. Understanding the nature and severity of each complaint, engaging the right person to address it, and having the ability to report on the status of complaints is vital.

There is a great need to manage these complaints via a common platform throughout their lifecycles. An automated solution is required to manage the related information, orchestrate workflows, and support reporting for internal and regulatory purposes. Customer complaints are serious business, not only because of their impact on individual customers, but also because of the increased potential for swift reputation damage in the age of social media.

3. Code of conduct and ethics training

Insurers are required to train and test employees for business conduct guidelines and ethics during HR onboarding as well as on an annual basis. Many companies design and administer the tests via homegrown systems that are difficult to maintain, or in some cases, via manual forms. Tracking employees that have taken the tests, when they have taken them, how they scored, notifying or reminding them of the status, and managing the overall program is often done via spreadsheets.

Automating all of these tasks with a common solution can save valuable human resources, reduce costs, and result in a higher level of accuracy.

4. Governance, risk, and compliance

Keeping track of all the laws, regulations, and controls that an insurer must comply with is a daunting task, especially in light of the many legal jurisdictions that an insurer may operate in. Storing, locating, routing, and reporting on the vast number of logs, risk assessments, legal rulings, and advice from in-house counsel absorbs a great deal of human resources and money.

Managing these via a common, automated system is essential. In addition to managing the digital content and workflows, the ability to present a visual dashboard of risk by department, line of business, and geographic area is very important.

Ultimately, non-compliance can be far more costly than compliance. And the monetary implications are only part of the story.

Leveraging automated solutions to track and manage these areas also keeps insurers in the good graces of regulators, and contributes to satisfied employees, customers, and shareholders. These are challenges, to be sure. But with the right solution helping you decrease your dependence on paper and manual processes, you can decrease costs while you simultaneously turn them into huge opportunities to separate your company from the competition.

Mark Breading

Mark Breading is a partner at Strategy Meets Action. Mark is a recognized expert in advanced technologies and their implications for the insurance industry. He has exceptional knowledge of the customer experience, analytics, digital content management, and maturing and emerging technologies. You can follow him at @BreadingSMA on Twitter.

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