BlueDragon Use Cases
The insurance sector includes carriers providing coverage spanning life, health, property, casualty, automotive, liability, workers compensation and specialty policies. With evolving climate and cyber risks, pressures to control claims expenses, technology modernization needs and substantial assets under management, delivering positive policyholder experiences while maintaining fiscal stability carries immense complexity for insurers.
Typical challenges faced include:
- Improper claim denials, delays or confusion surrounding coverage decisions erode member trust, provoke complaints, and necessitate appeal settlements.
- IT project budget overruns limit resources available for advanced analytics, Internet of Things sensors, and machine learning tools needed to improve risk models and pricing plans.
- Ransomware attacks paralyzing systems used to process member claims during major catastrophic events like hurricanes and wildfires.
- Lawsuits or market conduct fines regarding non-compliance with state regulations, such as timely investigations for suspected fraud waste and abuse or required coverage for mental health services.
- Workforce talent gaps with experienced adjusters retiring faster than apprentices can be developed leading to claim backlogs.
- Inconsistent application of risk control standards across operating centers resulting in coverage gaps or exclusions unavailable when members attempt to file claims.
- Inferior third-party administration services resulting in slower claims processing, lacking sensitivity and higher appeals volume generating friction with members.
- Climate change exacerbating major losses from flooding, wildfires and extreme weather that outpace premiums collected.
- Diminished oversight into conflicts of interest with insurance brokers receiving kickbacks for steering members into products with opaque fees or sub-standard coverage.
- Gaps in data security defenses allowing hackers access to member health records, social security numbers and other sensitive information opening legal and PR liability.
The Bluedragon Value Proposition
BlueDragon IPS provides insurance leaders an advanced methodology to investigate the breakdowns surrounding denied claims, lawsuits and cyber incidents while enhancing risk controls and strengthening member experiences.
With climate and technology shifts disrupting traditional carrier models, insurers require resilience to reimagine customer-centric solutions while managing complex regulatory, fiscal and data security challenges emerging in the 21st century. With BlueDragon IPS, insurance providers can accurately diagnose root causes of systemic issues degrading member trust. Implementing targeted corrective actions balances legal, ethical and practical constraints with the imperative to smoothly guide members through life’s uncertainties. Our unique approach integrates critical thinking, risk management science and sharp focus on reliability gaps eroding positive policyholder experiences. With BlueDragon IPS as trusted partner, leading carriers can help insurers optimize underwriting profits, member retention and brand reputation through proactive identification and dedicated elimination of persistent barriers preventing teams from promptly assisting members in times of need.