With its chronic injury cases numbering 6,100 in 2008 and climbing steadily by 250 per year, Wellington, New Zealand-based Accident Compensation Corp. (ACC), which provides comprehensive, no-fault personal injury coverage for all New Zealand residents and visitors, needed to streamline claims management to help improve client outcomes, contain spiraling costs and meet government mandates to be fully self-supporting by 2019. "We were still using documents and spreadsheets for case management and purchasing interventions," recalls Denise Cosgrove, general manager for claims management, ACC (US$3.5 billion in annual levies). This resulted in multiple inefficiencies with no visibility into where, or how, improvements could be made, he says.
In particular, ACC's National Serious Injury Service -- a business unit responsible for about 500 spinal cord and brain injured claimants -- desired more functionality than provided by the previously implemented Fineos (Dublin, Ireland) claims system. "We wanted specialized features to meet the needs of our claimants," explains Cosgrove. "So in early 2010 we engaged with Fineos to find a solution."
After forming a cross-functional, joint ACC/Fineos team, high-level project requirements were hammered out. "By May 2010 it was clear the base Fineos platform wouldn't be upgraded soon enough to meet our timeline," comments ACC project manager Carl McLaughlin. "We needed a customized solution."
Divide and Conquer
To start, the team divided the initiative into two projects, planning and purchasing, Cosgrove reports. The former would impact the entire 2,000-user claims management division while the latter would focus on the specific needs of the 120-user serious injury department.
The requirements and design phases were completed by late 2010 and the build-out began. "Although Fineos maintains an onsite development team at ACC, they also brought in some expertise from Australia," Cosgrove explains. "Additionally, a number of the product features were developed at the Fineos headquarters in Ireland."
In late March 2011 the two tracks merged. "Although we began with the intention of designing purchasing features only for the National Serious Injury Service, we came up with a design that worked for the whole group," notes McLaughlin. "At that point, we merged the two projects and worked toward a single rollout."
As testing proceeded in April 2011, ACC focused on training its team across the country to smooth the transition. "In addition to using a 'train the trainer' model, we established a champion within each business unit," recounts Cosgrove. "A key component of our post-implementation plan was having those champions available for ongoing support."
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Indeed, when the new solution rolled out successfully in May 2011, positive user feedback immediately followed, according to Cosgrove. "My staff reported high levels of satisfaction," she reports. "In fact, the week after the rollout, we deliberately polled some of our most cynical users. They were absolutely amazed by the new functionality and how much easier it was making their jobs."
And the benefits have been plentiful. "For example, social rehabilitation costs are now 17 percent under budget," asserts Cosgrove. "In human terms, only about 18 percent of those with spinal cord injuries had meaningful employment before. Today, with improved care coordination and knowing what interventions work versus what doesn't, 22 percent participate in employment."
She adds, "With the ability to objectively develop and evaluate interventions, we anticipate an aggregate saving of US$35 million over the lifetimes of our group of serious injury clients."
More broadly, reducing government liabilities benefits New Zealand's society as a whole, Cosgrove points out. "When we began, ACC was running a US$9.4 billion deficit, which we've reduced by US$3.7 billion already. In the future, this means we can reduce the levies [taxes] on our population," she says. "Most important, individuals receive faster and higher quality interventions because our staff members are utilizing their client support skills rather than performing administrative tasks."
CASE STUDY SNAPSHOT
Institution: Accident Compensation Corp. (Wellington, New Zealand)
Assets: US$3.5 billion in annual levies
Lines of Business: Universal no-fault personal injury
Vendor/Technology: Dublin, Ireland-based Fineos's FINEOS Claims system
Challenge: Streamline case management and improve interventions for chronic serious injury claimants