Business Process and Modeling: Insurance Claim Process Improvement

This report, focusing on business process and modeling, analyzes insurance claim processes and proposes significant improvements. The student's work begins with a BPMN diagram illustrating the current claim process. The report then identifies four key areas for enhancement: data and technology management, customer-centric payment methods, incorporation of mobility, and improvements to the assessment system. The second part of the report delves into business process reengineering, defining its role in organizational strategy and outlining methodologies such as Hammer and Champy, Davenport and Short, and the Process Analysis and Design Method. The report emphasizes the importance of reengineering in adapting to changing market demands, enhancing customer satisfaction, and reducing operational costs. References supporting the analysis are also included in the report.

Running head: BUSINESS PROCESS AND MODELING
Business Process and Modeling
Name of the Student:
Name of the University:
Author Note

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Question 1
Answer to question number (a)
Figure: BPMN Diagram
Source: (created by Author)
Answer to question number (b)
The four areas in which the company can improve the overall procedures of claiming the
insurance are:
 Improvement in the Data and the Technology Management of the company: The
improvement in the management of the data and the technology that, are being used by
the company would help the company in improving the insurance claiming procedure
(Kui et al. 2017). In addition to this, it would also benefit the company to accelerate the

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process of evaluation of the insurance that is claimed. The main impact of this would be
that the customers of the company would be able to receive their claims in a very short
time and this would also make the customers happy and increase their overall satisfaction
level. In addition to this with the improved data and technology management, the staffs of
the company would be able to work faster and would be able to perform their tasks more
efficiently (Zhou, Fu and Yang 2016).
 Making the payment methods customer centric: The payment methods that are
preexisting in the company can be improved to a great extent and made customer centric
(Pham and Ho 2016). The company can look to implement methods such as online
transaction and can introduce net-banking options to the customers so that they can
receive their money easily and the company can make their payments very easily. This
would increase the satisfaction of the customers and make the work for the staffs a lot
easier. This is very important for the company to implement, as this would be enabling
the company to deliver the customers through various type of channels and also would
improving the customer experience largely (Zheng et al. 2017). Claiming of insurance
can be stressful task for the customers but this method would make the process customer
friendly and also would be reducing the stress of the customers to a great extent and as a
result would be increasing the reputation of the company hugely.
 Incorporating mobility to the existing systems of the company: The company should
also try and incorporate mobility for the customers and the staffs of the company so that
they would be having a very easy access to the systems of the company (Cohen and
Kietzmann 2014). This would also help them in working more efficiently for the
company and the overall procedures within the company would be bit faster. In addition

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to this, the people today are more reliable on electronic gadgets and online methods.
Thus, the implementation of these methods for the company would help the customers to
check their status and the details regarding their claims more conveniently (Durst et al.
2015). They can easily log in to the portal of the company and check their details and the
claiming procedures would be accelerated to a hugely. Hence, this would help the
company to highlight the improvement of the services provided by the company to their
customers. This would also make the claim procedures easy and hassle free.
 Improvement in the assessment system of the claims: The system of assessment in place
for the company should be improved (Christensen and Laegrid, 2015). This would affect
the efficiency of the company. The improvement in the evaluation system would result in
the customers being served more convincingly. This would help in accelerating the
processes by which the customers receive their claims. They will also be assured of the
obtaining their rightful claims. The company would also be relieved of the dishonest
claims made by the fraudulent customers(Darling Hammond and Haertel 2015). The
effectiveness of the business procedures would also be increased to a great level and the
company would be safe from the losses that they might face due to the false claims.
Question 2
Answer to question number (a)
The business process reengineering is a business management strategy (Chang 2016).
This helps the company to focus on the analysis and the basic structure of the workflow that
takes place within an organization. This is very important for the organization as this process is
helpful in the making the organizations rethink about their processes and this helps the

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organization in mitigating the risks and avoiding the possible threats towards the progress of the
company. The reengineering process also helps the company in various other sectors namely the
sectors operational costs and the customer services (Vom Brocke et al. 2014). They help by
improving the satisfaction level of the customers and they can cut down the operational costs of
the company to great extent. The process is very important for the companies that are dependent
on the age-old policies and organizational structures. Hence, the organization may feel the need
of implementing newer methodologies in their business procedures that can increase the profit in
business and increase the enthusiasm of the employees to great extent. The main areas for the
organization to focus during the reengineering process are the mission, strategy and the goal of
the organization (Harmon 2015). There might situations where the company would be
questionable on their operating procedures. The main area of consideration would be the
products, market and the customer, services. This process helps the organization to focus on
these areas and re-strategies the process of the company. They reengineering process aims at
governing the procedures that would help in creating the products for the market and providing
efficient services to their customers. There are two ways in which an organization can decide the
restructure of business procedures (Jetson and Nelis 2014). They might try to change the existing
systems within the organization or might eliminate the existing procedure all together. In case of
redesigning, the organization has to analyze the prevalent system within the business methods of
the organization. This would however be a steady process and will occur very slowly. But in
case of the organization needing a new plan altogether, they would be required to make a new set
up starting from scratch where the first phase would involve intense planning. The plan would
be constructed creating the future of the company in mind. The procedure recognizes that the
business processes of an organization is usually made up of several sub procedures that are

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linked with each other and sometimes the initiation of a sub process might be depending on end
product of a sub process (Braglia and Forsolini 2014). The main motive is to obtain a greater
profit for both the customers and the organizations. The organizations focus on the functions of
the business and improvement on the business procedures incrementally. The profit of the
company is also under consideration for the re- engineering methods. The mission of the
company is also redefined by this procedure and also the mission of the company is also
redefined to great extent in certain situations (Stadtler 2015). Conclusively, these are the main
factors that drive the companies to opt for the re-engineering procedure for the organization.
Answer to question number (b)
The methodologies that the organizations can adopt for the re-engineering process are:
Hammer and Champy methodology: The Hammer and Champy method was introduced by
Michael Hammer and James Champy around the 1990s (Wang 2017). The Hammer and Champy
method is concerned specially with the outcomes of the procedures and not the actual tasks of the
procedures. They generally include the areas that make use of the output of the process in order
to perform the process. They extract the information at the source only.
Advantages:
The main advantages of the method are:
 They merge the work of processing the information into the real work which provides the
information.
 They are concerned with linking the parallel activities instead of integrating all their
results.
 They focus on the point of decision where the actual work is performed.

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Disadvantages:
The main disadvantage in this method is that the organization might not be ready for the
business re engineering process and hence can result in a failure for the organization.
Davenport’s and Short’s methodology: The Davenport’s and Short's methodology was
formulated around the year 1990 (Kumar et al. 2016). The main procedures that organization go
through after adopting this method are the visioning and setting up their goal. After this, the
business process is being identified. The understanding and the process measurement are done.
The information technology procedures are performed in the next step. And finally the process
prototype is created and implemented.
Advantages:
The main advantages of the method are:
 The setting up of the re engineering is done at earlier stages of the method.
 A prototype is created before the implementation of the model.
 The planning of the process is done according to the business process of the organization.
Disadvantages:
The main disadvantage of this method is that the method might be time consuming and
there would be a steady balance before the organization can actually gain profit from the re
engineering process.
Process Analysis and Design Method: The Process Analysis and Design Method is basically a
systematic approach towards the towards the improvement of the understanding of the business
procedures of any type of organization (Montgomery 2017). The main aim is to reduce the costs,

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process the efficiency of the organization and manage the allocations made in human resources
effectively. The process analysis method can be conducted by the organization very easily. The
major steps that are present in the method are Planning, Analysis, Design and implementation.
The first stage is concerned with the definition of the project and development if the of scheduled
commitments. The second stage is the concerned with the understanding of the As-in state and
develops the concept for the To-be state. Next is the realization and the development of the
designing of the process. After the process is designed, the implementation of the process is
done. The testing of the process is also done in this stage.
Advantages:
 The main advantages of this method are that the process supports the organization
directly towards the journey of higher performances of the organization by the
combination of experience and talent.
 This method also helps in keeping track of all the methodologies and the process within
the business of the organization.
Disadvantage:
The main disadvantage in this process is that the organization would require a large
amount of time to ideate and implement the process.

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References
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Management, 32(1), pp.18-29.
Chang, J.F., 2016. Business process management systems: strategy and implementation. CRC
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Christensen, T. and Lægreid, P., 2015. Performance and accountability—A theoretical discussion
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Cohen, B. and Kietzmann, J., 2014. Ride on! Mobility business models for the sharing economy.
Organization & Environment, 27(3), pp.279-296.
Darling-Hammond, F., Haertel, E. and Pellegrino, J., 2015. Making Good Use of New
Assessments: Interpreting and Using Scores From the Smarter Balanced Assessment
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Durst, C., Durst, M., Kolonko, T., Neef, A. and Greif, F., 2015. A holistic approach to strategic
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Forecasting and Social Change, 97, pp.91-104
Harmon, P., 2015. The scope and evolution of business process management. In Handbook on
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Kiu, M.S., Riazi, M., Riazi, S., Nawi, M., Nasrun, M. and Esa, M., 2017. The roles, challenges &
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Montgomery, D.C., 2017. Design and analysis of experiments. John wiley & sons.
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