Title: Improving the insurance claim processing process using Six Sigma methodology

Authors: Boby John; Pragati Parikh

Addresses: SQC & OR Unit, Indian Statistical Institute, Bangalore, Karnataka, 560 059, India ' JP Morgan Chase & Co, Bangalore, Karnataka, 560 087, India

Abstract: This is a case study on reducing the daily backlog % of accident and injury claims of an outsourced insurance claim processing process. The analysis showed that the fluctuations in claim volumes and ineffective utilisation of executives and processing time are the major causes of the high backlog. The solution developed is to forecast the daily claim volumes using dynamic regression and optimise the utilisation of processing time of executives using integer programming. The implementation of the solution improved the Cpk of accident claim processing from 0.21 to 1.18 and that of injury claims from 0.322 to 1.44. The solution also enabled in redeploying some of the highly skilled executives to other assignments during Thursdays and Fridays of the week. The methodology can be used for optimising any multiple task processing process by executives of varying skill levels.

Keywords: business process outsourcing; insurance claim processing; service level agreements; dynamic regression; integer programming; Microsoft excel solver.

DOI: 10.1504/IJSSCA.2020.112368

International Journal of Six Sigma and Competitive Advantage, 2020 Vol.12 No.4, pp.348 - 368

Received: 04 Sep 2019
Accepted: 13 Jul 2020
Published online: 12 Jan 2021 *

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