Progress-Pega Integration

Leading Claims management provider uses PEGA platform to improve claim servicing and outcome optimization

One of the leading global providers of technology-enabled risk and benefits solutions.

The Client

The client is one of the leading global providers of technology-enabled risk and benefits solutions having over 200 offices in USA, Canada, United Kingdom and Ireland. The company takes care of various organizations and its employees by delivering cost-effective claims, productivity, managed care, risk consulting and other services.

Business Objectives

The client wanted a game changing solution from improved claim servicing and claim outcome optimization perspectives. From a delivery standpoint, expectation was to offer fast paced technical releases aligned with key business objectives through end to end traceability.

The Solution

JKT facilitated and supported the usage of Pega 7 to streamline the IT landscape through optimal leverage of the existing application landscape. Pega 7 was primarily used to automate ‘feather-touch’ claims and promote best in class Customer Service that allowed front-end CSRs to facilitate ‘intake’ and ensure smooth handover to examiners / specialized teams for processing ‘claims’. New Data Model was proposed to cater multiple claims across Lines Of Business for the same incident.
Existing claim cases were migrated smoothly from the legacy system of records to the new Pega workflow application. The end to end processes were welded together using Pega Progress integration aligned with best practices (e.g. using middleware to manage security aspects better). Dedicated UX Team was leveraged to ensure best in class user experience.

The Benefits

  • Substantial cost savings through application refactoring to facilitate improved claims processing.
  • Pega application acted as a one stop shop to stich all disparate systems together.
  • Improved and responsive user experience – less clicks, lesser page refreshes.
  • Flattened learning curve resulting in faster and easier user adoption.