ACCRA BUSINESS SCHOOL

STRATEGIC OPERATIONS MANAGEMENT

STUDENT NAME: BENNETT ATUOBI AMOAFO

STUDENT NUMBER: ABS0422071

COURSE CODE: MBA 555

WORD COUNT: 2570

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TABLE OF CONTENT

ITEM PAGE

1. INTRODUCTION……………………………………………………………...5

1.1 Brief Description of Starlife Assurance Company Limited (SACL)………5

2. StarLife Assurance Claims Settlement Process Design………………………6

2.1 SACL Claim Procedure………………………………………………………..6

1. Step One…………………………………………………………………………..7

2. Step Two………………………………………………………………………….7

3.Step Three………………………………………………………………………...7

4. Step four………………………………………………………………………….7

5. Step Five…………………………………………………………………………7

6. Step Six…………………………………………………………………………...7

7. Step Seven………………………………………………………………………..8

2.2 SACL Principles of Operations……………………………………………….8

a. Volume……………………………………………………………………………8

b. Variety……………………………………………………………………………8

c. Variation…………………………………………………………………………8

d. Visibility…………………………………………………………………………..9

2.3 SACL Operation Performance objectives…………………………………..10

a. Cost………………………………………………………………………………10

b. Speed/Time………………………………………………………………………10

c. Dependability.…………………………………………………………………...10

d. Flexibility………………………………………………………………………...10

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e. Quality……………………………………………………………………………11

3. Analysis On SACL Claim Settlement Process .………………………………..11

4. Evaluation on SACL Claim Settlement Process………………………………11

5. Conclusion and Recommendation……………………………………………12-13

6. Conclusion…………………………………………………………………….…13-14
7.References…………………………………………………………………………15

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1. INTRODUCTION

Operation management is able to make or break any organisation. Operation most of the time
encompasses the majority of the people and the bulk of the assets of the organisation. The critical
factor is that operation management gives the organisation the ability to compete by providing;

The ability to respond to customer feedback.

Develop capabilities to stay ahead of the industry.

Operation management previously called production management involves planning, organizing

and supervising processes and make necessary improvement for high profitability The
adjustment in the everyday operation have to support the company strategies goals, so they
preceded by deep analysis and measurement of the current processes.

The operations function is part of the organisation that produces products and services.

Processes also produce products and services but on a smaller scale.

However, the motive of this report describes how Starlife assurance claims process and how it
affects the company’s overall performance in the insurance industry. The report further uses
concept and tools of process design and analysis to critical evaluate and analyse the process and
providing recommendations on how it can be improved in terms of one or more performance
objectives.

1.1 Brief Description of Starlife Assurance Company Limited (SACL)

Profile
StarLife Assurance Company Limited is a life insurance company founded in October 2005 and
Incorporated as a limited liability company in compliance with the new Insurance Law 2006, Act
724. The company is the first Life Assurance Company to be separated as a composite Company.
The leading Life Assurance Company offering a wide range of need -based life assurance
products designed to meet the financial security needs of the insuring public.
Mission
To help people identify the most secured wealth creation opportunities and provide them with
unique financial security solutions.

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Vision
To be the pacesetters in creating wealth and a fulfilling life through personal relationships with
our partners.
Core Value
Integrity, Innovation, Leadership, Empathy, Passion for Excellence.
Service Provided
The company pursuit to satisfy and meet the financial needs of various market segments of the
insuring public, having designed unique and value-added life security solutions to cater for both
the formal and informal sector. The products are grouped into three different categories:
 Corporate products (Employee security plan, key man plan, loan protection and mortgage
protection plan)
 Individual products (cash builder plus, child lifeline plus, esteem home call
plus ,wealth master plus and ultimate protection plan)
 Special products (banc assurance, brand assurance, group welfare)

2. StarLife Assurance Claims Settlement Process Design

Claims are a formal intimation to the insurance company about the receiving the sum assured
as per the policy terms. The insurance company after reviewing the validity of the claims
makes the agreed payment to the insured. In starlife claims occur fewer than two
circumstances, the maturity Claim the type of claim needs settlement once the policy
completes the term selected. The policies like the cash builder, wealth master or child lifeline
etc. fall under this category. And the death Claim this occurs in case of death of the
policyholder during the term of the policy. The death could either be due to illness or
accidental. The term plan is the biggest example.
The method, particularly when claims contain excessive face quantities, could require in-
depth examination by a service to make sure that the dying of the coated particular person
didn’t fall underneath any exclusion contained within the contract, equivalent to suicide or
dying ensuing from a prison act. The claims process takes about twenty-one working days or
three weeks without extenuating circumstances, affording beneficiaries the monetary
wherewithal to interchange the earnings of the deceased or just cowl the burden of ultimate
bills.

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2.1 SACL Claim Procedure
1. Step One
Customer Request; notification should be sent the insurer or advisor immediately or as soon
as practicable after loss has occurred or at maturity. It may be made through agent, broker or
directly to the customer service officer.
2. Step Two
Submission of Requirement; customer provides the required documents like Filled claim
form, a valid medical certificate of cause of death, death certificate and the original policy
document.
The Clients are advised to provide any of the following forms of identification during
payments:
Voter’s ID Card (OLD), Driver’s license, Passport, National Health Insurance Card
National Identification Card etc.
3. Step Three
Investigation: this is the stage of verification of records to ensure that the was cover at the
time of the loss, this involves an examination of records in the office to ascertain that the
relevant policy was in force at the material time and that the policy cover the event that led to
the loss or maturity then claim is Accepted.
If claim is rejected due to other reasons like unfulfilled requirements of document or further
information may be needed to assess the claim. The insurer will then let the client know what
the information they require and why it is important to the claim.
4. Step four
Calculate Claim Amount; this the process where the claims department check the
consistency of premium payments if there are any outstanding balance before maturity , if
it’s a life policy the waiting period is six month
5. Step Five
Approval: The Head of operations approves the claims for settlement.
6. Step Six
Process to Account department for payment.

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 7. Step Seven
SACL claim payment is being made to the client irrespective of the mode of payment the
clients opt or chooses. Example cheque payment, electronic transfer or bank transfer.

Contact
client
infnedd

N
Y
Submission Investiga Calculate Claim
Customer Request tion
of request Amount

Pay claims Process to Account Approval

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2.2 SACL Principles of Operations
a. Volume
This refers to the how much of a specific product is required to satisfy its demand. Processes
with high volume of output will have a high degree of repeatability and because task is
repeated frequently it often makes for staff to specialise in the tasks they perform. In relation
to the insurance industry both service and products are offered. The age range determines the
demand for a particular insurance products or policy being bought .The demand for wealth
master, cash builder and child lifeline plus is very high because is an investment policy and
secondly people age ranges between 20years to 45years turns to sign on more unlike the risk
policy where you find elderly age of 50 years to 75years signing on to esteem home call
(funeral policy).

b. Variety
The company has three categories of grouped products, under each category are diversifying
products with different specifications and benefits in pursuit to satisfy and meet the financial
need of the various market segment of insuring the public. Example under the corporate
products we have the mortgage protection, employee security, loan protection, keyman plan
they all have different benefits and conditions even though they are under the same category.

c. Variation
The insurance provide financial benefits, each type of policy has benefit and draw backs. A
number of options are available due to the varieties of the products or policies. What is right
for one may not reflect what is right for someone else. Taking time to learn what each type of
policy offer can ensure that you choose a policy that best suited to your need and financial
situation.

d. Visibility
The company has different platform reaching to its customer across the country
StarLife Assurance Company Limited (SACL) has acquired a new life insurance platform,
TurnQuest Life Insurance Management System to modernize operations, processes and also
increase efficiency and gain real-time visibility into its life insurance business operations.

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With over twenty one branches across Ghana, the third largest Life insurer in Ghana employs
multiple distribution channels including sales agencies, banks and brokers. As a leading
insurer, the objective was to acquire a platform that is best placed to ensure that the company
meets and surpass our aspirations

2.3 SACL Operation Performance objectives

To achieve its objectives and optimise the decision making through process design and
layout, Operations Management relies on five interrelated performance objectives. The levels
of trade-offs between cost, dependability, flexibility, quality and speed impacts the decision
making differently.
SACL has committed itself to making every customer’s encounter a pleasant experience.
As part of the commitment to client, the company will;
 Deliver quality services with courtesy, sensitivity
 Not only satisfy the customers but work hard to delight them
 Provide customers with accurate information on the products and services
 Meet customers at the appointed time and be helpful in all our dealings
 Ensure that reception and meeting facilities are clean, comfortable and safe
 Handle complaints professionally and revert promptly
a. Cost:
The cost is unique to each individual and depends on the type of policy the customer or client
chooses or opts for, the amount of coverage you want and factors age and overall health.
b. Speed/Time
The turnaround time (time taken to fulfil request) in SACL is twenty four hours or fourteen
working days. The life insurance industry has long history in Ghana but has operated with a
business model that well at a specific time .There is a need for innovation to add value but
also to remove the pain point that policyholder experience along the client journey.
c. Dependability:
SACL is able to settle or process claims within expected time.so as to keep delivery promises
to their client.

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d. Flexibility
The policy offer provision or riders that allow you to access benefits while you are living
under conditions such as a terminal illness, temporary disability, and financial security for
people you love after death.

e. Quality:
A company that handles claims promptly will be perceived by its policyholders as offering a
better quality product than a company that takes a long time to settle claims.
Well documented claims submitted under the terms of the contract, can usually be settled
fairly quickly. Complex claims however, may require considerable time .Poorly documented
claims that have a sound basis are sometimes submitted by contractors with limited
experience in providing the necessary documentation. SACL are fair and reasonable in such
cases and allow the client the opportunity to provide additional information to permit a
proper evaluation of the claim this will generally enable settlement to occur fairly quickly.

3. Analysis On SACL Claim Settlement Process

When claims are not paid within the turnaround time (twenty four hours or fourteen working
days) from the date the client submitted all the necessary document to the company meaning
the claim may be considered delayed.
For starlife to delay a claim settlement there could be dozens of reasons like;

i. The beneficiary may not be updated after a major life change when people divorce,
marry or have children etc. they usually want to change beneficiary on their policy, if
they fail to do so several people may have claims to the same policy proceeds after
death if cases as such occurs a claim may be delayed because the company will
prepare to file an interpleader.

ii. If the primary life beneficiary is not available .The proceeds are usually paid to a
contingent (secondary) beneficiary and if there’s no contingent beneficiary is named,

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 the company may delay paying the claim while determining who should receive the
pay-out.

iii. Failure to disclose relevant personal information. The most reasons insurers give or
deny life benefit is if the client fail to disclose information needed to accurately
measure the risk of a policy pay out.

iv. Failure to keep up with policy premiums; insurers strictly hold policyholder to the term
policies, one way to avoid having policy lapse is to pay premium consistently.

v. Provide required document as a beneficiary to expedite the claim; client should submit all
documents to make claim .document related to the policy and document to prove that the
death does not fall under exclusion mentioned in the policy contract .The claimant is
expected to obtain certified copies of all document. It is good to submit all required claim
document together because delay in submission may lead to delay in claim decision.

4. Evaluation on SACL Claim Settlement Process

National insurance commission (NIC) researchers are of the view that ,a long process of
evaluation of claim document is necessary as life policy is a high risk and as such effective
measures should be put in place minimizing risk .However it should not be unduly delayed
since some of the settlement needed are time bound example those who insured child lifeline
plus, esteem homecall plus policies .Customers assess performance based on claims
settlement ratio and if the claim settlement is not paid prompt it affects the clients
expectations .Currently SACL are doing well in the claim settlement process compared to
some competitors on the life insurance market .Claims are being processed within time line
or the company’s turnaround time. In processing complex claims may delay for two weeks or
fourteen days as stated in the above analysis, but the processing simple claims is settled
within twenty four hours. The standard TRT from regulators (NIC), claims processing
should not exceed four weeks.

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5. Conclusion and Recommendation

Underwriting and claims settlement are the two most important aspects in the functioning of
an insurance company. In the present highly competitive insurance industry and
economically challenging environment, claims settlement can serve as a market differentiator
that puts insurance companies at the forefront of industry leadership and innovation.

To be successful, insurers need to improve the operational efficiency of their claim

organisations and build an operating model that can minimise claim costs as well as eliminate
the unnecessary expenses associated with claims handling.

The most important service that an insurance company gives to its customers is the claim
settlement to its policyholders. The speed and promptness which the claims are settled and
paid within the framework of stipulated rules and regulation of NIC is important.

In light of the findings above long processing of claims the company can be reduced through
educating potential customers or insured about documents or requirement needed for claims
assessment. SACL can award their customers or policyholders for loyalty price discount s or
extra value, free policy of their choice for a year etc.

SACL prolife can improvise communication channel placed between the broker, agents,
sales persons and managerial level employees of the company with the customers in regard
of claim settlement process as well as policy matters. For both the companies in order to
maintain and gain better position in life insurance market, speedy and hurdle free settlement
of claims will attract the new customers for the company. You cannot simply overlook
product quality and successfully stay in business over the long term. In order to provide
quality customer service insurers should critically look at improving on their financial
strength, human resource capacity building and systems development.

Furthermore, focus on best practices is a common misconception that all claim processes are
unique. While final execution of the process may be highly customised, most process
elements first notice of loss, segmentation and assignment, adjudication, investigation,
subrogation and so on are actually very similar when you break them down to their core
processes.

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6. Conclusion

Claim settlement process need to be as per requirement of the customers, so that at the

time of need, no customer should be suffered due complexity of the claim settlement process.

Faster claim settlement process reduces the cost of processing any claim whereas multiple

stages in the process should be avoided since it increases the cost of claim settlement. For

Increasing the speed, policyholders should be provided proper information on regular bases.

Adaptability is one of the major strengths of this organization. In order to make claim
settlement process more transparent and customer oriented, stress should be given on that.
NIC is also committed to ensuring a sound regulatory and supervisory framework that
maintains an efficient, safe, fair and stable insurance market and thereby promotes growth
and fair competition in SACL had acquired a new state-of -the –art application software that
was equipped with important features that included effective customer profiling, out of office
business transactions, quick customer service delivery, well-defined work process flow and
ease of deployment for intermediaries, to improve service delivery for the company.

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 REFERENCES
Buzacott, J.A., (2000). Service system structure. International Journal of Production Economics
68 (1), 15–27.

Gartner “MarketScope for North American Life Insurance Policy Administration Vendors”,
Steven Leigh, June 23, 2010. alter N. Miller

Joseph Oscar Akotey, Frank G. Sackey, Lordina Amoah, Richard Frimpong Manso, (2013) "The
financial performance of life insurance companies in Ghana", The Journal of Risk Finance, Vol.
14 Issue: 3, pp.286-302, https://doi.org/10.1108/JRF-11-2012-0081

Nigel Slack, Alistair,Brandon-Jones,Robert Johnston ,Alan Betts,Operation and process

management ;principles and practice strategic impact fourth edition

Slack, N., Brandon-Jones, A. and Johnston, R. (2013) Operations Management (7th Ed.) Harlow:
Pearson Education Limited.

The Journal of Risk and Insurance

Vol. 38, No. 4 (Dec., 1971), pp. 527-542

Published by: American Risk and Insurance Association

www.starlifeassurance.com

www.turnkeyafrica.com

www.nicgh.org

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