Outsourcing for Insurance Industry
Outsourcing in the INsurance Industry
Oworkers connects insurance companies with skilled, insurance-trained professionals ready to support their operations.
From policy administration to claims processing and back-office support, our dedicated talents integrate seamlessly into your teams to improve efficiency, accuracy, and scalability. Explore how Oworkers helps insurers strengthen their operations with reliable, compliant, and high-performing talent.
insurance Industry Use Cases
01
Multilingual Claims Processing for a Global Travel Insurance Provider
Client Background and Challenges Faced
A leading global travel insurance company, providing coverage to millions of travelers across 150 countries, had been facing severe operational bottlenecks in its claims processing department.
Their customer base was inherently global and diverse, but their claims processing capabilities were centralized in a single, English-speaking location, creating significant challenges.
Language Barriers in Claims Submission
The company had been receiving claims in over 40 different languages, but their team of 200 claims adjusters was almost exclusively English-speaking.
This forced them to rely on slow and expensive third-party translation services, which added an average of 7-10 days to the processing time for each non-English claim.
Inconsistent Data and Documentation
Claims were submitted with a wide variety of international documents—medical reports from a hospital in Japan, police reports from Brazil, receipts from France.
The internal team lacked the expertise to efficiently validate these diverse document formats, leading to a high rate of back-and-forth communication with claimants and an average claims cycle time of 35 days.
Peak Season Scalability Issues
The company experienced predictable claims surges of up to 300% during peak travel seasons (summer holidays, winter breaks).
Their fixed internal staffing model had been unable to cope, leading to a claims backlog that would often exceed 10,000 cases and further extend processing times to over 60 days.
High Operational Costs
The combination of reliance on external translators, the inefficiencies of manual processing for international documents, and the need to pay overtime during peak seasons resulted in a claims processing cost that was 40% higher than the industry benchmark.
Implementation Strategy
oworkers.com was selected to overhaul the insurer’s claims processing operations. We implemented a multilingual, technology-driven solution focused on efficiency, accuracy, and scalability.
1. Multilingual Claims Hubs
We established two dedicated claims processing hubs staffed with native speakers in over 40 languages.
These teams were not just linguistically proficient; they were trained as certified claims processors with specific expertise in validating international medical and legal documentation.
2. Intelligent Document Processing (IDP)
Oworkers.com deployed an AI-powered IDP platform.
This system was trained to recognize, classify, and extract key information from thousands of different international document types. It could automatically flag missing information and inconsistencies, presenting a structured and pre-validated file to the human claims adjuster.
3. Flexible, Scalable Staffing Model
We created a flexible staffing model with a core team of dedicated adjusters and a cross-trained “flex team” that could be deployed within 24 hours to manage peak season surges.
This allowed the insurer to scale its processing capacity by 300% on demand, without the cost of maintaining a large bench of full-time employees.
4. Centralized Quality and Compliance Framework
A single, unified quality assurance framework was implemented across both hubs. This included standardized processing rules, a multi-level review process for high-value claims, and continuous performance monitoring to ensure consistency and compliance with international regulations.
Results Achieved
The transformation of the claims processing function delivered dramatic improvements
across the board.
- Radical Reduction in Processing Time: The average end-to-end claims processing time was reduced from 35 days to just 5 days. For claims submitted in non-English languages, the improvement was even more stark, dropping from an average of 45 days to 7 days.
- Significant Cost Savings: The new, efficient process, combined with the elimination of third-party translation fees, resulted in a 50% reduction in the cost per claim processed.This translated to annual savings of over $8 million for the client.
- Elimination of Backlogs: The scalable staffing model completely eliminated the seasonal claims backlog. Even during the busiest travel periods, processing times remained within the 7-day service level agreement (SLA).
- Improved Customer Satisfaction: The speed, accuracy, and ease of the new claims process led to a 40-point increase in the Net Promoter Score (NPS) related to claims experience. The company began receiving positive reviews for its claims handling, turning a traditional pain point into a competitive differentiator.
02
Multilingual Customer Services for a Health Insurance Company
Client Background and Challenges Faced
A large regional health insurance provider in the United States, with a rapidly growing membership in diverse urban areas, had been struggling to provide adequate support to its multicultural member base.
Their services were primarily offered in English and Spanish, which was no longer sufficient for their evolving demographics.
Growing Language Gaps
The insurer’s member base now included significant populations speaking Mandarin, Vietnamese, Haitian Creole, and Portuguese.
Lacking native-speaking support, these members had been facing significant barriers to understanding their benefits, finding in-network providers, and managing their healthcare, leading to lower utilization of preventive care and higher rates of emergency room visits.
Inconsistent Member Experience:
The company had been using a phone-based translation service to bridge the language gap, but this created a clunky, three-way calling experience that was slow and often led to miscommunication.
Member satisfaction among non-English/Spanish speakers was 50% lower than among their English-speaking counterparts.
Regulatory Compliance Risks
The lack of effective communication was creating significant regulatory risks related to providing equitable access to care and ensuring members understood their rights and responsibilities under the Affordable Care Act (ACA).
High Support Costs for a Poor Experience:
The per-minute costs of the third-party translation service were high, and the longer call times associated with three-way communication meant the insurer was paying a premium for a substandard customer experience.
Implementation Strategy
ooworkers.com was tasked with creating a truly inclusive and effective multilingual member services center.
1. Dedicated Multilingual Pods
We established dedicated “pods” of customer service agents for each of the required new languages (Mandarin, Vietnamese, Haitian Creole, and Portuguese), in addition to bolstering their existing English and Spanish teams. These agents were native speakers and were also trained and licensed health insurance agents in the states the client served.
2. Omnichannel Communication in Native Languages
3. Cultural Competency Training
4. Integrated Technology
We integrated our systems with the insurer’s CRM and provider database, allowing our multilingual agents to not only answer questions but also to actively help members schedule appointments with in-network providers who also spoke their language.
Results Achieved
The implementation of a dedicated multilingual service center had a profound impact on member health outcomes and the insurer’s operational metrics.
- Improved Health Equity and Access: Utilization of preventive care services (like annual check-ups and cancer screenings) among the targeted language groups increased by 60%. Emergency room visits for non-emergency conditions decreased by 25%, indicating members were better able to navigate their healthcare options.
- Enhanced Member Satisfaction: Member satisfaction scores among the non-English/Spanish speaking populations rose to be on par with the English-speaking members, increasing by over 50%. The company received accolades from community organizations for its commitment to serving diverse populations.
- Reduced Operational Costs: Despite providing a much higher level of service, the new model delivered a 20% reduction in the average cost of a multilingual interaction by eliminating the inefficient third-party translation service and reducing call times.
- Increased Member Retention: The insurer saw a 15% improvement in member retention within the targeted demographic groups, who now felt understood and wellsupported by their health plan.
03
Underwriting Support for a Commercial Property & Casualty Insurer
Client
A mid-sized commercial Property & Casualty (P&C) insurer, specializing in complex risks for manufacturing and construction clients, had been facing a critical bottleneck in its underwriting department.
Their highly experienced (and highly paid) underwriters were spending a disproportionate amount of their time on administrative tasks rather than on their core function of risk assessment.
Administrative Overload
It was found that senior underwriters had been spending nearly 60% of their workday on administrative and data-gathering tasks.
This included manually entering data from submission forms, ordering and chasing third-party reports (e.g., loss runs, engineering reports), and preparing policy documentation.
Slow Quote Turnaround Time
The administrative burden was directly impacting the speed of quoting. The average time to deliver a quote for a new piece of business was 15 business days, which was 50% slower than their more agile competitors. This was causing them to lose out on desirable accounts.
High Underwriter Burnout
The focus on low-value administrative work was leading to frustration and burnout among the senior underwriting team, resulting in a costly 20% annual turnover rate in a field where talent is scarce.
Inconsistent Data for Risk Modeling
The manual data entry process was leading to inconsistencies and errors in the data used for risk assessment and pricing models.
This “dirty data” was undermining the accuracy of their pricing and potentially leading to unprofitable underwriting decisions.
Implementation Strategy
Oworkers.com implemented a specialized Underwriting Support solution designed to free up senior underwriters and bring efficiency and accuracy to the underwriting process.
1. Dedicated Underwriting
Assistant Team
We created a dedicated team of “Underwriting Assistants” (UAs). This team, composed of individuals with a background in insurance and finance, was trained specifically on the client’s P&C lines of business and underwriting guidelines.
2. Streamlined Submission
and Triage Process
The oworkers.com team took over the initial triage of all new business submissions. They used a standardized process to check for completeness, enter all relevant data into the underwriting workbench, and order all necessary third-party reports, ensuring the underwriter received a complete and validated file.
3. Data Cleansing and Preparation
Our team was responsible for cleansing and structuring all submission data before it was fed into the insurer’s pricing and risk models. This ensured the models were working with accurate and consistent information, improving their predictive power.
4. Policy and Endorsement Servicing
The oworkers.com team also handled the back-end servicing of policies, including preparing policy documents for issuance, processing endorsement requests, and managing renewal preparations. This allowed the underwriters to focus almost exclusively on new business and complex renewals.
Results Achieved
The introduction of the Underwriting Support team fundamentally changed the dynamic of the underwriting department.
- Increased Underwriter Productivity: Senior underwriters were able to shift their focus, spending 80% of their time on core risk assessment and decision-making, up from 40% previously. This effectively doubled their capacity for high-value work.
- Faster Quote Turnaround: The average quote turnaround time was slashed from 15 days to 5 days. This newfound speed allowed the insurer to compete for and win more business, leading to a 25% increase in new business written in the first year.
- Improved Underwriter Retention: With the administrative burden removed, underwriter job satisfaction soared. The annual turnover rate in the senior underwriting team dropped from 20% to less than 5%.
- Enhanced Data Quality and Profitability: The accuracy of the data entering the risk models improved to 99.8%. This led to more precise pricing and better risk selection, contributing to a 3-point improvement in the company’s loss ratio over two years, a direct boost to underwriting profitability.
A Sector at a Crossroads
The global insurance industry, a cornerstone of financial stability and risk management, is navigating a period of profound transformation. While the sector demonstrates resilience and growth, with the global insurance BPO market valued at USD 7.2 billion in 2024 and projected to grow at a CAGR of over 5% 1 , it faces a confluence of unprecedented challenges. From the escalating frequency of natural disasters and the complexities of a digital-first world to shifting customer expectations and stringent regulatory demands, insurers are under immense pressure to adapt and evolve.
In this dynamic environment, Business Process Outsourcing (BPO) has transcended its traditional role as a cost-saving measure to become a strategic lever for innovation, efficiency, and customer-centricity. This presentation will delve into the critical challenges confronting the insurance industry and illustrate how a strategic partnership with a specialized BPO provider like oworkers.com can unlock new opportunities and build a more resilient, agile, and competitive organization.
Key Challenges Redefining the Insurance Landscape
Insurers today are grappling with a complex array of internal and external pressures that impact every facet of their operations, from underwriting and claims processing to customer service and compliance.
Talent & Workforce
- The Talent Crisis
A significant shortage of skilled professionals, from underwriters to data scientists and claims adjusters 2 . - High Turnover
The repetitive nature of many administrative roles leads to high employee turnover and associated recruitment and training costs.
Regulatory &
Compliance Risk
- Evolving Regulations
A constantly changing landscape of regulations related to data privacy (like GDPR), consumer protection, and solvency. - Cybersecurity Threats
Increased digitization makes insurers a prime target for cyberattacks, necessitating robust security measures and compliance.
Operational
Inefficiency & Cost
- Administrative Overload
A heavy burden of manual, repetitive tasks in policy administration and claims processing 2 . - Rising Claim Costs
Inflation and increased severity of events are driving up the cost of claims, squeezing margins 3 . - Legacy Systems
Outdated IT infrastructure hinders automation, data integration, and the launch of digital products.
Customer Experience
& Retention
- The “Customer Worst” Perception The insurance industry has historically struggled with customer experience, particularly during the claims process, which is often seen as the The Strategic Imperative of Outsourcing
By outsourcing key business processes, insurers can not only address these challenges but also strategically reposition themselves for future growth. A modern BPO partnership offers far more than simple cost arbitrage. most critical touchpoint. - Digital & Omnichannel Demands
Customers now expect seamless, 24/7, and multilingual interactions across a variety of digital and traditional channels. - Lack of Personalization
A failure to leverage data to provide personalized advice, products, and services.
The OWorkers Advantage
Outsourcing for
Insurance Companies
Cost Optimization & Scalability
- Reduce Operating Costs
Significantly lower expenses related to staffing, training, technology, and infrastructure. - Flexible Scaling
Effortlessly scale operations up or down to manage seasonal peaks (e.g.,storm season) or to support new product launches and market entry.
Superior Customer Experience
- 24/7 Multilingual Support
Provide roundthe-clock, expert support in multiple languages for both sales and service, improving global reach and customer satisfaction. - Faster, More Transparent Claims
Leverage specialized teams and technology to accelerate claims processing, providing customers with faster resolutions and greater transparency.
Access to Specialized
Talent & Tech
- Plug the Skills Gap
Instantly access a global pool of certified claims processors, licensed agents, and data analysts without the overhead of direct hiring. - Leverage Advanced Technology
Gain the benefits of AI, machine learning, and advanced analytics for fraud detection, underwriting support, and customer insights without the massive capital investment.
Enhanced Operational Efficiency
- Automate and Streamline
Implement intelligent automation for claims intake (FNOL), data entry, and policy administration, drastically reducing processing times. - Focus on Core Competencies
Free up underwriters and senior claims adjusters from administrative tasks to focus on complex risk assessment and high-value claim settlements.
Improved Risk & Compliance
- Expert Compliance Management
Partner with a provider that has deep expertise in insurance regulations across multiple jurisdictions. - Robust Security
Ensure data is handled in a secure, compliant environment (e.g., SOC 2, ISO 27001 certified).
oworkers
Your Strategic Partner in Insurance Outsourcing
oworkers.com is a leader in providing specialized BPO services to the insurance industry. We understand the unique challenges and opportunities of the sector and deliver tailored solutions that drive measurable results.oworkers.com is a leader in providing specialized BPO services to the insurance industry.
We understand the unique challenges and opportunities of the sector and deliver tailored solutions that drive measurable results.
Our key service offerings for the insurance industry include:
- Multilingual Claims Processing: End-to-end claims handling, from first notice of loss to settlement, in multiple languages, ensuring accuracy, efficiency, and empathy.
- Multilingual Customer Services: A full suite of customer support services, including policy inquiries, billing support, and sales, delivered by licensed and trained professionals.
- Underwriting Support: High-quality support for underwriters, including data collection, risk analysis, and policy issuance preparation.
By partnering with oworkers.com, insurers can build a more efficient, customer-centric, and resilient operation, ready to thrive in the future of insurance.
Oworkers : Your Strategic Partner in Insurance Outsourcing
oworkers.com is a leader in providing specialized BPO services to the insurance industry.
We understand the unique challenges and opportunities of the sector and deliver tailored solutions that drive measurable results.
