Get to Know Individual Policy Administration

Learning Objectives

After completing this unit, you’ll be able to:

• Identify the people who use Individual Policy Administration in the workplace.
• List jobs to be done for each user.

Who Uses Policy Administration?

Cumulus is in the midst of implementing Individual Policy Administration for Insurance. The whole team is excited about the new solution.

Justus Pardo, the star consultant spearheading the project, first identifies the key users of the policy system and how they use it. Why does he do this? Ultimately, how well the system meets their needs and expectations determines its actual value. 

Let’s dive into these users and what they seek to do. 

At Cumulus, Justus identifies the following key groups.

• Customers
• Brokers
• Underwriters
• Customer support representatives

Let’s take a quick look at each group. 

Customer Jobs to Be Done

Justus starts with the most important person, the customer. 

Increasingly, customers expect a modern, omnichannel experience in which they quickly complete all essential policy administration tasks, such as policy issuance, payments, modifications, renewals, and cancellations, from a central hub. They want a main hub that also provides all their policy and billing details.  

Before policy issuance, customers want to easily:

• Review and confirm the premium and coverages before purchasing.
• Review payment plans or options.
• Enter payment method details, such as bank account, debit/credit card, and statement address.
• Complete payment of the premium or initial installment.
• Receive notification of any documentation or inspection requirements necessary to issue the policy.
• Receive complete documentation of the policy by email, download, or good old-fashioned snail-mail.

Following policy issuance, customers expect to:

• Add, modify, or remove an optional coverage or rider on an in-force policy.
• Add, modify, or remove insured items and parties.
• Add, modify, or remove a payment method.
• View the price difference in the premium, based on the effective date of the modification.
• If an additional premium is owed, pay the incremental amount.
• If a refund is due, receive the refund.
• Generate renewal quotes for an expiring policy.
• Cancel an existing policy.

Naturally, customers want to complete these tasks in a simple, timely manner. And when they do need help, they want easy access to the appropriate support channels. Many customers work closely with a broker, who can complete policy administration tasks on their behalf. Let’s have a look at the broker’s key jobs next.

Broker Jobs to Be Done

Brokers, also known as producers or independent agents, sell the insurance policies of multiple companies. Essentially, they act as facilitators between carriers and customers. Customers often like to work with brokers because they research policies and rates across different carriers and find the best-fit plan for their clients. Brokers then receive commissions from the carrier for the policies they sell. Captive agents, on the other hand, work directly for a single insurer and only sell products for them. 

Before policy issuance, brokers complete the same customer jobs for their clients. In addition, they want to:

• View policy commissions activity, including pending and paid commissions.
• Review in-process applications with a carrier.
• Check their own credentials to confirm qualifications to sell a proposed product.
• View recent activity on an application.
• Check the underwriting status and review the underwriting tasks of a pending application.
• Complete electronic applications for their clients, including sending links for electronic signature and submitting follow-up documents.
• Receive alerts when an application is approved or moved to a new stage.
• Receive alerts when deadlines are approaching for underwriting submission.

Following policy issuance, brokers often complete key endorsement jobs for their clients. In addition, they expect to:

• Review all upcoming renewals with a carrier.
• Generate policy modification documentation, and send it to customers by email, mail, or download.
• View key statistics and charts regarding their relationship with the carrier.
• View retroactive commissions adjustments.

As you can see, brokers share many needs with the customer, but they also expect additional capabilities that allow them to better review and manage their entire book of business.

Underwriter Jobs to Be Done

Underwriters evaluate insurance applications and determine coverage amounts and premiums. They review new applications and renewals, and ultimately decide whether an insurer should provide insurance to the customer, and under what terms. 

However, underwriters don’t just use gut feelings to make these decisions. They use a variety of policy-administration tools to determine the specific risk in insuring each customer, and based on that, calculate their eligibility and premiums. Typically, underwriters work closely with product administrators to help define the models, rules, and workflow for implementing the underwriting requirements.

Before policy issuance, underwriters need to:

• Generate underwriting requirements, such as required documents, medical exams, or site inspections.
• Send correspondence to the applicant and broker.
• Review and resolve underwriting exceptions.
• Submit an application to a more senior authority for review and approval.
• Add an approval condition to a quotation, including an exclusion or underwriting requirement.
• Approve, approve with modification, or decline a quote.
• Review the customer’s prior relationship with the carrier.
• Review files, such as documents and images submitted by the applicant.
• Review policy exceptions generated according to system rules.
• Review trailing requirements for an issued policy.
• Review documents generated for a policy.

Following policy issuance, underwriters need to:

• Define rules to determine which modifications require additional underwriting review and approval.
• Review documents generated for the endorsement.

Underwriters are ultimately responsible for setting up and enforcing the conditions for approving or declining an application for insurance. Individual Policy Administration offers powerful underwriting tools to meet their needs at every step.

Customer Service Representative Jobs to Be Done

Customer support representatives assist brokers and customers as they work through the policy-administration lifecycle. Reps need to be ready when the phone rings or the chat pings to answer all questions related to the policy lifecycle. And they need to do it in a personalized and efficient manner.

Throughout the policy-administration process, customer service reps need to:

• See all the customer’s information in one place.
• Perform all policy transactions on behalf of a customer.
• Resolve customer queries about coverages and policy activity.
• Settle customer disputes around policy details and billing.

This gives you an idea of what key users expect from a modern policy-administration system. It’s quite a lot! Policy Administration for Insurance is there for every user at every stage.