Business Rules Management Adds Fleibility To Insurers IT Systems

A business rule is a statement that defines some aspect of the policy and is intended to control or influence the behavior of the policy management. For insurers, underwriting rules are an obvious example. All of the terms and conditions under which a person may be issued a policy make up a set of policy rules.

A BRMS provides a central repository for both those business rules and the application logic that governs the processes and people that manage them. By extracting the policy logic from the application, application maintenance is simplified and it is easier and faster to modify policy rules. All this also allows for more consistent decision-making across all applications.

BRMS technology offers insurers a number of business benefits that stem from this enhanced IT agility. Once business rules are stored in the BRMS, compliance updates, product rollouts or underwriting changes can be implemented in a fraction of the time. Insurers can reduce IT maintenance expense while achieving the flexibility to accommodate rapid policy changes, since responsibility for making the changes is shifted from programmers to policy administrators.

A BRMS also can automate the underwriting process, enabling real-time policy generation. Rules-based, automated decision-making streamlines the process and can remove underwriter intervention for routine policy requests. For more complex policies, rules-based exception processing maximizes underwriter productivity. That’s because underwriting automation reduces administrative and manual tasks, freeing up underwriting professionals to spend more time on complex underwriting scenarios and risk management tasks.

In addition, a BRMS can help customer service representatives resolve service requests more quickly and efficiently by storing rules that minimize the need for further contact and back-office processing. The BRMS can integrate with legacy and other back-end systems, allowing carriers to simplify complex interactions that formerly required access to multiple, disparate systems. A BRMS can enable business managers to add or modify workflows, offers or customer services to accommodate shifting requirements. This flexibility helps reduce operating costs while improving customer satisfaction.

One of the ways insurers deliver customer service is through information and referral hotlines, which many health care insurers operate. With growth and diversity in the subscriber populations, increasingly complex policy and rule sets can get too expensive for IT to maintain. Business rules let them empower business analysts to capture and maintain the rules that determine which referrals and reminders nurses access when serving customers on these referral lines. The net result of adding a BRMS to this scenario is delivering value-added health consultation and advice services at a much lower cost of service delivery.

A BRMS also can extend the return on investment of the ACORD XML standard for carriers by supporting pre-loaded ACORD vocabulary enabling the system to understand insurance terms and relationships out of the box. This allows business users to more easily author decision-making rules and policies that can be standardized across the enterprise, its agents and third-party partners.

For most insurers, the question of deploying business rules technology is not a matter of “if” but rather “when.” Providing an easier way to create, change and standardize policy rules quickly across the insurance value chain is a key driver for successfully improving customer satisfaction and reducing claims leakage.

Hans Witt is CEO and President of Haley Systems, based in Sewickley, Pa.

For most insurers, the question of deploying business rules technology is not a matter of ‘if’ but rather ‘when’