Case Study
Situation
- Small, single product A&H carrier with rapid growth in challenging regulatory environment
- Exponential growth outpaced service capability resulting in long claims processing delays and overwhelmed service organization
- Poor compliance controls caused multiple state DOI investigation and fines
- Slow claims processing masked deep fundamental Underwriting (UW) control, product design and pricing issues
SMA Services
Strategic Review
Product Review
Pricing Optimization
Technology Alignment
Business Transformation
Actions & Impact
- Created new operating infrastructure that included enrollment and claims processing, agent licensing, customer service and financial reporting, strengthening internal controls, enabling scalability with added functionality, all with $0 SG&A increase
- Performed in-depth underwriting and pricing analysis and created new UW manual and pricing with proper controls
- Worked with actuaries to design customized reserve calculation to properly reflect emerging liabilities
- Did in-depth study on product design and isolated problematic features that drove significant losses