Virtusa Transforms Long-Term Care (LTC) Process Across Multiple Countries for a Leading Multi-Line Insurer

The US Department of Health and Human Services and US Department of Labor have projected that by 2030 the population of the elderly will double in size. For insurers dealing with long-term care products, this is a great opportunity for growth. However, insurers also need to be aware of their product pricing and ability to provide service around these products.

Our client’s long-term care products focused on providing the best benefits in the market. Nevertheless, the cost of servicing these products challenged profitability targets. To prepare for this anticipated increase in volume, the client engaged Virtusa to improve systems and processes to handle this spike.

  • The Challenge

    We partnered with our client to build a solution that addressed would accomplish the following:


    • Replace an inflexible existing  legacy platform
      Reduce high error rate due to process complexity
      Automate manual and paper-based processes increasing the risk of temporary loss
      Reduce lengthy training curve due to process complexity
    • Improve Poor customer experience caused by time-consuming manual by introducing a new personalized Digital customer interface,
    • Ensure g systems are scalable and capable of handling a prolonged spike in policy service requests and new business
  • The Solution

    Virtusa’s consulting expertise supported the client’s transformation journey by identifying top functional areas for automation and delivering roadmaps for each. Details of the engagement include:

    • Collaboration with key client stakeholders through Accelerated Solution Design (ASD) workshops to establish the requirements
    • Delivery of solution roadmaps for call center processes and their major use cases which included: new business and benefits change, billing change, and termination/reinstatement processing
    • Automation of processing leveraging Pegasystems technology
    • Automation of call center process
  • The Benefit

    Virtusa helped to improve the client’s systems and processes in order to sustain the growth of their long-term care claims operation. We offered multiple benefits to the client:


    • 40% effort reduction due to reduced request processing time
      Automated tracking and work monitoring for nextgen reporting
      Eliminated policy servicing errors by reducing human intervention and manual calculations
      Customer satisfaction
    • Improved communication and reduced turnaround time among client, agents, and customers by developing an automated platform that drives complex business scenarios
    • Ability to handle volumes necessary to reach the client’s growth objectives and
      improved onboarding of new team members by consolidating and creating consistent processes
      Enhanced controls and processes to satisfy regulatory requirements

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