Today, many financial transactions occur in real time, andconsumers have come to expect the immediacy and real-time benefitsof online transactions, 24x7 connectivity and mobilecommunications. As a result, the claims industry has been forced torespond to consumer and market pressures to accelerate transactionprocessing.

What's ahead is a more modular, service-oriented architecturethat tightly integrates data, systems and people to speed upworkflow, improve productivity and enhance claims decisions.

Consider the key infrastructure and technology tools--such asWeb services, business rules and browser-based technology--that areenhancing straight-through processing, so claims organizations canachieve increased claims velocity.

An organization's unique claims management strategy is thecornerstone to its competitive advantage. In the past, policies andprocedures were hard-coded into claims systems. Changing a processmeant retooling the software--a task that required a programmer toperform.

With today's rapidly changing claims environment, organizationsneed to respond quickly, without waiting for IT assistance. Toadapt to market fluctuations, organizations are demandingbrowser-based systems that enable business users to implementprocess changes on their own and on the fly.

They must have the ability to continually rethink processes, andwhere appropriate, redesign claims workflow for optimal efficiencyand performance. A high-velocity solution provides both robustclaims functionality and powerful customization capabilities out ofthe box.

Ideally, claims organizations want to apply adjuster resourceswhere they are needed most. By leveraging sophisticated businessrule engines, organizations increase their rate of straight-throughprocessing. This means relatively simple and straightforward claimsare settled with little or no human intervention.

To achieve this type of end-to-end automation, organizationscustomize business rules to review incoming claims and identify"simple, straightforward" transactions--such as a workers'compensation claim with only one doctor's visit--to be routed forimmediate settlement and closure.

Business rules ensure consistent quality in an automatedclaims-handling environment, while also enabling claims adjustersto focus their time and attention on more complex claims thatrequire their expertise and personalized service.

Today, the vision of paperless claims processing is finallybeing realized. In its rudimentary stage, claims departmentsscanned documents but continued to use paper throughout theorganization.

To engage in a truly "paperless" paradigm, organizations arecompletely avoiding the generation of paper documents, relying onthe electronic submission and exchange of information. In thisdata-driven environment, information is inputted once and madeavailable to all parties via an enterprisewide electronicinfrastructure.

The paperless paradigm has expanded, as organizations useoptical character recognition and electronically attach digitalphotos, videos and audio to the claims file.

As an added benefit, a data-driven strategy means moreinformation is available for analysis, benchmarking and performancereports.

Prompt and accurate reporting of claims is critical to achievingthe best possible outcomes. Whether an organization employs anin-house claims department or a third-party call center, datareported on the front-end must feed directly into back-end claimssystems.

Seamless integration allows claims adjusters and otherloss-control specialists to quickly initiate their role in theclaims process, leading to optimal results. With the advent ofintelligent online claim forms, the use of Internet reporting hasincreased.

These smart forms use drop-down lists, auto-population of fieldsand threads of logic to navigate users quickly through theelectronic claims submission process. Due to their intuitive,user-friendly design, online forms are often faster than a typicalphone transaction.

Before claims velocity can be achieved, a modern ITinfrastructure is required. Maintaining legacy systems consumes asmuch as 80 percent of IT budgets, but these outdated systems lackcontemporary automation capabilities and result in inefficientoperations.

Rather than use a risky rip-and-replace approach, organizationsare leveraging service-oriented solutions as a means to rapidtransformation.

A more modular infrastructure allows organizations to quicklydeploy new claims functionality, management capabilities andautomation tools on a component basis. At the same time, theinfrastructure is highly interoperable and can work in conjunctionwith legacy systems, allowing organizations to control their rateof legacy replacement.

When building a modern claims infrastructure, a service-orientedarchitecture has many advantages. Organizations can bring togetherstandard, interchangeable components or "services," assembledaccording to their specific requirements.

SOA addresses an organization's need for speed-to-market withnew system developments. SOA also provides flexibility andintegration, creating one consolidated browser-based platform thatpulls together various system components, as well as multiplestakeholders, including claims adjusters, underwriters and riskmanagers.

To optimize functionality, SOA must be designed with anenterprise IT vision, as well as having each "service" embody amodule of claims functionality and value. As services are added,organizations orchestrate all services to work together and tosustain alignment with overall claims objectives.

Web services provide the process-accelerating promise of SOA.Web services offer cost savings through efficient IT development,integration and maintenance, but the greatest value is enablingorganizations to process claims at the speed of the Internet.

The challenge is developing an "analysis first" approach thatensures the greatest business value to claims departments.

Organizations reap the most benefit by first outlining anenterprise-level map of business processes and aligning Webservices to core claims functions. Many organizations have used Webservices to piece together a best-of-breed solution thatencompasses claims and risk management, as well as other insurancefunctions, such as policy administration and underwriting.

Claims leaders are continually striving to improve operations toachieve informational and transactional velocity. Organizationsmust ensure their IT infrastructure supports a highly automatedworkflow and has the ability to grow and expand with emergingneeds.

Today, the Internet and a service-oriented approach are the mainmeans to rapid process transformation. When evaluating new claimsystems, organizations must keep two considerations in mind--systemflexibility and service components, both of which will help aligntechnology to their overall claims strategy.