This client is a self-contained division of a large insurer and an industry leader in its niche, writing high-limit accident medical expense products for colleges, universities, K-12 schools, and sponsoring organizations and covering student-athletes in sponsored activities, games, and practices. Inside one operation it runs marketing, underwriting, policy servicing, premium collection, claims administration, and case management. Volume and complexity had grown, and the operation was feeling the strain.
A special-risk accident insurer cut its open-claims and correspondence backlog 70% and the cost to process each claim 30%, clearing the work it had been carrying rather than spending its way out of it.
Special-Risk Accident Insurer
Results at a Glance
70%
Claims Backlog Reduction
30%
Cost Per Claim
40%
Claim Processing Time
Executive Brief
A self-contained insurance division writing high-limit accident medical coverage for colleges, universities, schools, and student activities was carrying high processing costs, a persistent claims and correspondence backlog, and declining service, with no effective Management Operating System to run the work. POWERS set performance standards by position, trained frontline leaders and supervisors through workshops and train-the-trainer programs, and built the operating system the claims operation had been missing: central reporting, identified bottlenecks, time and performance standards, a claims-inventory tracking system, and daily and weekly reports. The backlog of open claims and correspondence fell 70%, the cost to process each claim fell 30%, and claim review and processing time fell 40%, on a 30% productivity gain and a 70% cut in overtime. The result was an operation running to standard with a platform to grow on.
The Situation
An industry leader that had outgrown its own controls: claims and correspondence piling up faster than the operation could clear them, with no system to see the work or run to it.
This client is a self-contained division of a large insurer and an industry leader in its niche, writing high-limit accident medical expense products for colleges, universities, K-12 schools, and sponsoring organizations and covering student-athletes in sponsored activities, games, and practices. Inside one operation it runs marketing, underwriting, policy servicing, premium collection, claims administration, and case management. Volume and complexity had grown, and the operation was feeling the strain.
The growing pains were structural, not seasonal. Claims processing costs were high, a backlog of open claims and correspondence had built up and would not clear, and service levels were declining. Underneath all of it sat the deeper problem: there was no effective Management Operating System and no performance standards by position, so leaders had no benchmark to manage against and no clear view of the work or the backlog.
Leadership wanted a fast-acting remedy that did more than catch up once. The operation needed to reduce its backlog, raise service levels, lower processing costs, and stand up a platform it could grow on, which called for an operating system and standards built into the daily routine rather than a one-time push that would erode the moment attention moved elsewhere.
The Diagnosis
Six structural gaps producing the same outcome from six directions.
High processing cost against a standing backlog
Claims processing costs ran high while a persistent backlog of open claims and correspondence kept building, so the operation paid more and still fell further behind.
No effective Management Operating System
There was no working system to run the claims operation day to day, leaving the work to be managed by reaction rather than by plan.
No performance standards by position
Without time and performance standards by role, output had no benchmark, so leaders could not tell normal from slow or manage productivity against a target.
Bottlenecks left unidentified
Process bottlenecks went undiscovered and uncleared, holding claims in queue and inflating the time and cost to process each one.
No reporting to see the work
With no central reporting, claims-inventory tracking, or daily and weekly reports, leaders could not see the work in flight or the size of the backlog they were carrying.
Thin frontline leader and supervisor training
Frontline leaders and supervisors had not been equipped to run the operation, and service levels declined as a direct result.
What POWERS Did
Gave the claims operation an operating system and the standards to clear its backlog and run to plan.
POWERS started with the standards the operation had never had, establishing performance standards by position so output finally had a benchmark to manage against. Frontline leaders and supervisors were trained to run to those standards through hands-on workshops and train-the-trainer programs, building leadership capability the operation could keep using after the engagement.
On top of that foundation, POWERS rebuilt the Management Operating System the division had been missing. A central reporting system was put in place, process bottlenecks were identified, time and performance standards were developed, a claims-inventory tracking system was implemented, and daily and weekly reports were created so leaders could see productivity, backlog, and claims cost as the work moved. Management systems tracked all three, and front-office tools were added to support the growth the division was preparing for.
Together, the standards, the leadership routines, and the reporting turned a reactive operation into a managed one. With the work visible and the bottlenecks cleared, the backlog came down, claims moved faster, and the operation began running to plan instead of constantly catching up.
The Full Result
Five measurable gains, all pulling cost and backlog down at once as the operation began running to standard.
70%
Claims Backlog Reduction
The backlog of open claims and correspondence fell as a claims-inventory tracking system and daily and weekly reporting surfaced the work and drove it down.
30%
Cost Per Claim
The cost to process each claim came down as productivity rose and rework and overtime fell away.
40%
Claim Processing Time
Review and processing time shrank as process bottlenecks were identified and time and performance standards set the pace.
30%
Productivity Increase
Productivity climbed as performance standards by position and a working operating system replaced an operation without effective management systems.
70%
Overtime Reduction
Overtime hours dropped as the backlog cleared and the operation ran to standard rather than constantly catching up.
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Frontline Leadership · MOS
A special-risk accident insurer cut its open-claims and correspondence backlog 70% and the cost to process each claim 30%, clearing the work it had been carrying rather than spending its way out of it.
Special-Risk Accident Insurer
Executive Brief
A self-contained insurance division writing high-limit accident medical coverage for colleges, universities, schools, and student activities was carrying high processing costs, a persistent claims and correspondence backlog, and declining service, with no effective Management Operating System to run the work. POWERS set performance standards by position, trained frontline leaders and supervisors through workshops and train-the-trainer programs, and built the operating system the claims operation had been missing: central reporting, identified bottlenecks, time and performance standards, a claims-inventory tracking system, and daily and weekly reports. The backlog of open claims and correspondence fell 70%, the cost to process each claim fell 30%, and claim review and processing time fell 40%, on a 30% productivity gain and a 70% cut in overtime. The result was an operation running to standard with a platform to grow on.
Results at a Glance
70%
Claims Backlog Reduction
30%
Cost Per Claim
40%
Claim Processing Time
The Situation
An industry leader that had outgrown its own controls: claims and correspondence piling up faster than the operation could clear them, with no system to see the work or run to it.
The growing pains were structural, not seasonal. Claims processing costs were high, a backlog of open claims and correspondence had built up and would not clear, and service levels were declining. Underneath all of it sat the deeper problem: there was no effective Management Operating System and no performance standards by position, so leaders had no benchmark to manage against and no clear view of the work or the backlog.
Leadership wanted a fast-acting remedy that did more than catch up once. The operation needed to reduce its backlog, raise service levels, lower processing costs, and stand up a platform it could grow on, which called for an operating system and standards built into the daily routine rather than a one-time push that would erode the moment attention moved elsewhere.
The Diagnosis
Six structural gaps producing the same outcome from six directions.
High processing cost against a standing backlog
Claims processing costs ran high while a persistent backlog of open claims and correspondence kept building, so the operation paid more and still fell further behind.
No effective Management Operating System
There was no working system to run the claims operation day to day, leaving the work to be managed by reaction rather than by plan.
No performance standards by position
Without time and performance standards by role, output had no benchmark, so leaders could not tell normal from slow or manage productivity against a target.
Bottlenecks left unidentified
Process bottlenecks went undiscovered and uncleared, holding claims in queue and inflating the time and cost to process each one.
No reporting to see the work
With no central reporting, claims-inventory tracking, or daily and weekly reports, leaders could not see the work in flight or the size of the backlog they were carrying.
Thin frontline leader and supervisor training
Frontline leaders and supervisors had not been equipped to run the operation, and service levels declined as a direct result.
What POWERS Did
Gave the claims operation an operating system and the standards to clear its backlog and run to plan.
POWERS started with the standards the operation had never had, establishing performance standards by position so output finally had a benchmark to manage against. Frontline leaders and supervisors were trained to run to those standards through hands-on workshops and train-the-trainer programs, building leadership capability the operation could keep using after the engagement.
On top of that foundation, POWERS rebuilt the Management Operating System the division had been missing. A central reporting system was put in place, process bottlenecks were identified, time and performance standards were developed, a claims-inventory tracking system was implemented, and daily and weekly reports were created so leaders could see productivity, backlog, and claims cost as the work moved. Management systems tracked all three, and front-office tools were added to support the growth the division was preparing for.
Together, the standards, the leadership routines, and the reporting turned a reactive operation into a managed one. With the work visible and the bottlenecks cleared, the backlog came down, claims moved faster, and the operation began running to plan instead of constantly catching up.
The Full Result
70%
Claims Backlog Reduction
The backlog of open claims and correspondence fell as a claims-inventory tracking system and daily and weekly reporting surfaced the work and drove it down.
30%
Cost Per Claim
The cost to process each claim came down as productivity rose and rework and overtime fell away.
40%
Claim Processing Time
Review and processing time shrank as process bottlenecks were identified and time and performance standards set the pace.
30%
Productivity Increase
Productivity climbed as performance standards by position and a working operating system replaced an operation without effective management systems.
70%
Overtime Reduction
Overtime hours dropped as the backlog cleared and the operation ran to standard rather than constantly catching up.
POWERS|+1 678-971-4711|info@thepowerscompany.com|1801 Peachtree St NE, Suite 200, Atlanta, GA 303091 / 1