1. Transform to the power of digital
Aligning the Claims Operating Model with
Enterprise Strategy
Discussion Guide
March 2015

2. The information contained in this document is proprietary. Copyright © 2015 Capgemini. All rights reserved
Contents
Insurance Business Challenges
Enterprise Strategy and the Claims Operating
Model
Aligning the Claims Operating Model
Calibrating Alignment Strategy – Claims
Diagnostic Review
Representative Profiles

3. The information contained in this document is proprietary. Copyright © 2015 Capgemini. All rights reserved
Five Key Insurance Enterprise Strategy Trends in 2014-2015
 New claims systems are a
top business and technology
priority
 Significant linkage between
customer retention and
customer satisfaction with
the claims process
 The claims process is the
most involved and
emotionally charged
interaction between insurers
and customers
 Use the data generated in a
claims process to improve
customer satisfaction and
profitability (claims analytics)
 Insurers‘ ongoing efforts to
improve their ability to
accurately price risk inherent
in the policies they issue
 Need to accurately assess
data and manage
underwriting in a fast, cost-
effective manner
 Pressure on insurers to
exercise more underwriting
discipline
 Improve insight into
customer data management
and analytics
 Development of a
multichannel integrated
platform to support cross-
channel interaction
 Need for investment in
business process monitoring
(BPM) solutions for
customer-facing channels
 Shifting the business model
to support electronic
channels, content, and
transactions
 Expanding CRM to align
processes, products,
channels, and brand to
match customer preferences
 Build the Customer-Centric
Insurance organisation
 Market differentiation to
find new sources of revenue
 Use of new tools for
product development and
delivery, e.g., mobile devices,
telematics, product
configurators
 Better alignment of
products with market needs,
reduce the time- and cost-to-
market
Source: Capgemini Competitive Intelligence Center, Gartner, Deloitte
1 2 3 4 5
Improving
Underwriting
Discipline
Claims
Transformation
Closer
Customer Experience
Digitization
and Automation
Product Innovation
and Mobile Solutions

4. The information contained in this document is proprietary. Copyright © 2015 Capgemini. All rights reserved
Establishing and maintaining alignment between the Claims Operating Model and
Enterprise Strategy supports Business Goals and drives Enterprise Value
Enterprise
Strategy
RISK MANAGEMENTCUSTOMER ACQUISITION
CUSTOMER RETENTIONOPERATING PROFITABILITY
 Claim costs (loss payments + loss adjustment expenses)
account for 70% to 75% of the combined ratio.
 Claims management is a major factor in operating
performance and results.
 Claims services are a major customer satisfaction criteria: the
customer experience represents the “moment of truth.”
 Effectiveness and efficiency of claims services are key differentiators.
 New customer acquisition costs are seven times the cost of
customer retention.
 Optimized claims costs enable competitive rates and
improved experience-based premiums.
 Accurate claims data supports risk segmentation and tight
underwriting rules.
 Claims service and ease of doing business support customer
acceptance and channel partners.
 Reserve integrity (case reserves, IBNR) has direct impact on insurer
ability to face its future obligations.
 Partnering on loss control and predictive modeling
 Risk-sharing via cost-effective reinsurance strategies
 Historical loss data is translated into actionable business
intelligence.
Claims Operating
Model

5. The information contained in this document is proprietary. Copyright © 2015 Capgemini. All rights reserved
Based on our experience, an effective Claims Operating Model encompasses the following
components
 Lays out the strategic imperatives: values, vision,
mission, and goals.
 The intelligent combination of management
processes and internal controls
 Defines the fundamental requirements for effective
leadership, organization and how actively the
corporate organization will monitor and manage the
Claims Organization
An effective Claims Operating Model is designed (and continuously refined) to balance and enhance aspects of effectiveness, efficiency, and Customer
Experience achieved through the Process, People, and Technology capabilities of the Claims organization.
Definition Rationale/Implications
 Includes the Claims Value Chain, including external
suppliers
 Defines the workflows linking individual claim activities
 Describes the high-level organizational structure,
knowledge, and expertise needed to process claims
 Identifies roles based on claims organization needs,
not on organizational structure
 Defines the interfaces for cooperation among
organizational functional areas
 Defines organizational and management structures
 Provides technology to support functionality used by the
department, including automation and other enablers
 Identifies the format, maintenance, and dissemination of
data and information
 The process model component will allow the Claims
Organization to understand the efficiency and
effectiveness of existing processes while defining
gaps.
 This component helps define at a high level the future
skills and level of knowledge integration.
 Helps management understand the level of change
needed to drive sustainable performance relative to
skills, behaviors, and metrics alignment
 Effective development of management processes will
define the business operational parameters and
measurement framework
 Technology enablement will identify the technological
roadmap and tools to support the flow of information
and activities across the Claims organization.
Management Processes
Process Model(s)
Technology
Enablement
People: Skills &
Competencies
Governance

6. The information contained in this document is proprietary. Copyright © 2015 Capgemini. All rights reserved
Aligning the Claims Operating Model with Enterprise Strategy helps drive
operational excellence
 What are the current and future needs of the business
units (and insurance products) serviced by the Claims
Operation?
 Who are our clients (internal and external) and
what are their needs and requirements?
 What are the implications for our operation, e.g.,
flexibility, responsiveness, quality, cost?
 What are the potential competitive advantages and
differentiators?
 What other considerations will impact the Claims
Operating Strategy, e.g., cultural, political, regulatory,
competitor offerings, org structure, existing skill sets?
 What are the gaps between current and required
capabilities and processes and what are the initiatives
required to fill those gaps?
 What capabilities and processes can be achieved
through third-party vendors?
 What is the initiative roadmap that drives change at a
pace the Claims organization can handle?
 How do we measure success, i.e., metrics?
1
2
3
4
5
6
To align the Claims Operating Model with the
Enterprise Strategy, a number of questions must be
answered:
6
 Industry Trends
 Competitive
Landscape
 Corporate
Objectives
 Org. Alignment
 Customer
Requirements
 Partner
Capabilities
 Physical
Infra-structure
 Current
Capabilities
Customer Needs
Governance
TechnologyProcess
External
Constraints
 Industry
Trends
 Competitive
Landscape
Internal
Challenges
 Corporate
Goals
 Org.
Alignment
Claims Operating Model Framework
Operating
Requirements
 Customer
Requirements
 Vendor
Capabilities
Operating
Capabilities
Service-level
Objectives
Service
Requirements
 Physical
Infra-
structure
 Current
Capabilities
People/
Management
ProcessesOperating Model supported
by Change Management

7. We have developed a strategy- and operations-driven program to guide you through the
process of aligning the Claims Operating Model with the Enterprise Strategy
Copyright © 2011 Capgemini Consulting. All rights reserved.
7
Claims Diagnostic Review Future Initiatives Future Initiatives
Develop a Target Claims Operating
STRATEGY and model
 Review current state
capabilities
 Compare to business needs
and requirements and leading
practices
 Identify gaps and opportunities
 Define target Claims Operating
Model
 Identify improvement
initiatives
Help you DESIGN
customized improvements
 Design governance,
process, organization,
technology
improvement initiatives
 Identify the technology
enablers
 Evaluate and select
third-party vendor
partners
Outline a path to IMPLEMENT the
improvement initiatives
 Build and test enabling technology
 Train and implement technology
and process changes
Enable you to SUSTAIN the
changes and improvements
 Manage ongoing
requirements
 Integrate changes and
upgrades
ONGOINGPHASE IIIPHASE IIPHASE I
Claim Diagnostic Review Future initiatives Future Initiatives
Organization Change Management (OCM)
The information contained in this document is proprietary. Copyright © 2015 Capgemini. All rights reserved

8. The information contained in this document is proprietary. Copyright © 2015 Capgemini. All rights reserved
Strategy calibration through the Claims Diagnostic Review (CDR) is the first part of the
program and is designed to clarify business strategy and develop and define the Target
Claims Operating Model
KeyObjectivesActivities
8
Implement
 Implement initiatives
 Build and test enabling
technology to align business
and technical capabilities
 Develop plan to sustain
changes
 Define training and manage
impact to Claims Operation
 Deploy future state
capabilities
 Build future state technology
solution(s)
 Roll out vendor initiatives
 Prepare and approve the
training strategy and training
deployment plan
 Execute training and change
management plans to support
delivery
12 - 36 Months
Sustain
 Manage future
requirements and
advances
 Manage organization and
people so that gains can
be maintained
 Resolve post-
implementation issues
 Confirm operational
effectiveness of
implementation
 Manage performance
improvement and future
requirements
 Implement governance
model to maintain
capability
Ongoing
Phase I (CDR): Strategy
 Understand stakeholders, including internal and external
customers, and business needs and requirements
 Define business operating environment and strategy
 Define and assess capabilities needed to enable the
strategy
 Develop prioritized initiatives supported by a high-level
financial impact analysis
 Prioritize initiatives for Design Phase
 Develop use cases and criteria for technology and
vendor selection
 Identify potential technology solutions and vendors
 Identify and assess stakeholders, business issues and
strategy, and current Claims Operating Model
 Perform gap analysis
 Define Target Claims Operating Model
 Develop improvement initiatives
 Develop vendor market research and technology use
cases
 Define roadmap to Design and Implement
4-6 Weeks
Design
 Review and decide on governance,
process, organization, and
technology initiatives
 Decide on technology and third-party
vendors
 Design organization & process
alignment, capability development,
culture development, and change
sustainability plan, i.e., change plan
and change agent network
 Prepare initiatives for
Implementation
 Define new processes, organization,
and management structures,
capabilities, and roles
 Conduct RFP or other equivalent
process for technology and vendor
selection; finalize selection
 Design change management plan,
program and processes
2 Months

9. The information contained in this document is proprietary. Copyright © 2015 Capgemini. All rights reserved
Approach: Strategy phase (Claims Diagnostic Review)
9
 Identify and interview key
stakeholders
 Identify key industry trends and
leading practices that may impact
business requirements
 Identify customer and business
requirements
 Catalog current capabilities and
ongoing initiatives
 Identify future capability needs
 Identify stakeholders for change
management activities
DeliverablesActivities
Project
Kick-Off
Assess External
Landscape,
Opportunities, and Value
Propositions
1
Assess Existing
Operations
2
Identify Capability Gaps
3
Define Initiatives
4
Develop Roadmap and
Use Case for Technology
5
 Stakeholder Interview Observations
 Industry Trend and Practices Snapshot
 Business Value Propositions
 Claim Sample Review Findings
 Operational Capabilities Catalog
 Assess current capabilities
and initiatives versus
requirements to realize
business value propositions
 Identify gaps between
current and future
capabilities
 Define nature, size and
impact of gaps
 Capability Gap Analysis
 Define effort required to develop
capabilities
 Identify dependencies between
planned initiatives and existing
efforts
 Prioritize initiatives based on
achievability, organizational
readiness, and financial impact
 Assess organization change
readiness and identify change
agents
 Capability Initiative Catalog
 Develop roadmap of
prioritized initiatives that
focuses on realizing value
 Identify technology and
vendor options
 Initiative roadmap
 Vendor research
 Use cases for technology
comparisons/testing
Organization Change Management (OCM)

10. The information contained in this document is proprietary. Copyright © 2015 Capgemini. All rights reserved
Our approach uses tools and accelerators that can facilitate the rapid
development of the Strategy Phase (CDR) deliverables
10
Interview
Templates
Operational Capability Framework
Capability Gap Assessment
Approach
Initiative
Prioritization
Initiative
Roadmap
Sample Project Tools and Accelerators
22
DRAFT
Prioritising the e-Business Initiatives
Initiative
1. e-Buying (incl. leveraged catalogues)
2. Buy-Side Auctions
3. Collaborative Purchasing
4. Supplier CPFR
5. Supplier Inventory Management
6. Collaborative Product Development &
Introduction
7. E-Settlement (Buy-Side)
8. Content Management
9. Knowledge Management
10. HR Self-Service
11. E-Recruitment
12. eLearning
13. Statutory Compliance: Government
Returns
14. Logistics & Transportation Collaboration
15. Item Catalogue
16. Retail Exchange Participation
17. Private Exchange Participation
18. Customer Portal (eCRM)
19. Web-Enabled Call Centre & Email
Response Systems
20. Field Sales
21. E-Settlement (Sell-Side Customer)
22. Retailer Auctions
23. Sell Side Auctions
24. Promotions Management
25. Customer CPFR
26. Consumer Insight: Collaboration With
External Parties
27. Direct to Consumer Propositions (own /
participation in external props)
28. Investment in Buying Consortia
29. Investment in Retail Exchange
e-Business Initiatives and Prioritisation Scores:
Business Value Ease of Implementation
11 19
16.5 30
16.5 30
10 18
6 21
7 17
5 19
13.5 19
15.5 8
9 17
7 23
8 20
4 30
11 23
15 16
13 17
11 17
15.5 15
11 16
8 17
5 19
7 26
6.5 22
16 19
13 16
13 14
7 14
5 25
9 17
Ease of Implementation
BusinessValue&
StrategicImperative
Question/
Redesign
Accelerate/
Invest
Tactical/
Discretionary
Kill
High
High
Low
Low
5 17.5 30
2
10
18
1
2
3
19
4
5
6
7
21
8
9
10
29
11
12
13
14
15
17
18
20
2223
24
2526 16
27
28
Illustrative Framework
Prioritizing Supply Chain Initiatives
Supply Chain Initiatives and Scores
Detailed Approach to Value
Proposition Development
Step
1
Step
2
Step
3
Step
4
Step
5
• Production Schedule
• Inventory on hand
• Warehousing
• Logistics
• Customer Service
• Order Management
• Demand Management
Process Implications
MajorMajor
MilestonesMilestones
• 4Q04 – Online Channel Development
InputsInputs
• Product
Specifications
• Quantity
• Date Needed
• Ship To
Address
• Billing Address
• Customers
• Inventory On-
hand
• Production
Schedule
• Accounts
Receivable
• Shipping
Department
OutputsOutputs
Online retail channel
management
Management of online order from requisition to delivery to
the end consumer
Supply Chain Mgmt.Process AreaProcess Area
CapabilityCapability
CapabilityCapability
DescriptionDescription
Capability ElementsCapability Elements
1. Ability to provide two
way communications
for online customer
needs between end
customer and
Microsoft
• Receipt
• Bill of Laden
• Inventory
Update
• Delivery Date
• Production
Schedule
• Customers
• Email
communications
• Inventory on
hand
• Production Schedule
• Inventory on hand
• Warehousing
• Logistics
• Customer Service
• Order Management
• Demand Management
• Production Schedule
• Inventory on hand
• Warehousing
• Logistics
• Customer Service
• Order Management
• Demand Management
Process Implications
MajorMajor
MilestonesMilestones
• 4Q04 – Online Channel Development
InputsInputs
• Product
Specifications
• Quantity
• Date Needed
• Ship To
Address
• Billing Address
• Product
Specifications
• Quantity
• Date Needed
• Ship To
Address
• Billing Address
• Customers
• Inventory On-
hand
• Production
Schedule
• Accounts
Receivable
• Shipping
Department
• Customers
• Inventory On-
hand
• Production
Schedule
• Accounts
Receivable
• Shipping
Department
OutputsOutputs
Online retail channel
management
Management of online order from requisition to delivery to
the end consumer
Management of online order from requisition to delivery to
the end consumer
Supply Chain Mgmt.Process AreaProcess Area
CapabilityCapability
CapabilityCapability
DescriptionDescription
Capability ElementsCapability Elements
1. Ability to provide two
way communications
for online customer
needs between end
customer and
Microsoft
• Receipt
• Bill of Laden
• Inventory
Update
• Delivery Date
• Production
Schedule
• Receipt
• Bill of Laden
• Inventory
Update
• Delivery Date
• Production
Schedule
• Customers
• Email
communications
• Inventory on
hand
• Customers
• Email
communications
• Inventory on
hand
Copyright © 2011 Capgemini Consulting. All rights reserved.
Roadmap
FY10 FY11 FY12 FY13
Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4
A2: DP Stat. Forecasting (SKY) Visibility
B1: Trading Partner Seg. & Strategy Consistency
C3: Mfg. Standards Methodology Consistency
C1: Manufacturing Process
Decomposition
Consistency
C4: Mfg. & Qual. Actuals Integration Visibility
C2: Quality Process Decomposition Consistency
A1: Planning Effectiveness Consistency
D3: Lot Disposition Data & Controls Consistency
A7: Network Inventory Optimization Visibility
D1: Product Market Compliance Responsiveness
E3: Product Identification &
Improvements
Consistency
A3: DP System Replacement Visibility
E1: Advanced Int./Ext. Visibility (no
SNC)
Visibility
A6: Network Planning Enablement Visibility
A9: Value-Driven S&OP Flexibility
A11: Replenishment Model (STAR) Consistency
A17: Material Deployment Planning Responsiveness
B2: Trading Partner Relationship Mgt. Consistency
A13: TPM Replenishment (assumes
SNC)
Visibility
Enables E2: Mkt. Suitability
Enables D5: QA/QC Scheduling and C6: PO Visibility & Mgt.
Enables A8: Net.
Planning Org.
Realign
Enables B3: Trading Ptnr. Order Mgt. & Com. and
B4: Order Efficiency & Indirect Materials VMI
Enables C6: PO Visibility & Mgt. and C7: Shop Floor Schedule Visibility
Enables C7: Shop Floor Schedule Visibility
LEGEND: Scope, Plan and Design ImplementationIn Progress
Capgemini ASE Environment

11. The information contained in this document is proprietary. Copyright © 2015 Capgemini. All rights reserved
Approach: Strategy phase
Step 1 - Assess external landscape, stakeholders, opportunities, and value propositions
11
Purpose
Activities
 Provides understanding of industry current
state
 Identifies business requirements and customer
opportunities
 Establishes business Value Propositions as
basis to align Claims Operating Model with
Enterprise Strategy
Assess External Landscape, Stakeholders,
Opportunities, and Value Propositions
Provide external view of the industry, prioritize stakeholders, including internal and external
customers, and identify value propositions that align with the defined corporate strategy.
These define the aspirational capability requirements, which will be assessed against current
capabilities to identify and prioritize gaps to be addressed through future processes and
initiatives.
 Identify and interview key stakeholders to gain
understanding and buy-in
 Identify key industry trends and leading
practices that may impact business
requirements
 Interview/conduct focus groups with
stakeholders
 Identify business and customer requirements
Potential Benefits
Key Deliverables
Industry Trends
and Leading
Practices
Snapshot
 Overview of relevant industry-specific trends
and leading claim practices
Business Value
Propositions (10-15)
 Prioritized list of business requirements and
customer opportunities
 Value Propositions aligned with Enterprise
Strategy, including solution definition and
opportunities
© Copyright 2004 Archstone Consulting LLC
Confidential9
Requirement: Enhanced understanding and use of cost-to-serve leads to
improved cost and margins
11 Client Case StudyClient Case Study
22 Archstone Consulting 2003 Consumer Healthcare Supply Chain SurvArchstone Consulting 2003 Consumer Healthcare Supply Chain Surveyey
 More than 50% of customers typically don’t
contribute to profits
 Costs for supply chain activities associated with
different customers can vary by a factor of two
 Assessment of “who are the best customers” and
what it costs to serve them often changes dramatically
as understanding of cost to serve improves
FACT: Although manufacturers view cost to serve as a critical foundational capability, few have integrated it into their
business decisions.
 Poorly integrated into business decisions
 Rarely used as a multi-departmental metric
 Lack of agreement on cost-to-serve
components undermines strategic customer
understanding and profitability
Cost to Serve Capability is Needed to Effectively Tailor
Supply Chain Services for Profitable Growth
Customers
CumulativeProfit
-100%+ profit200%+ profit 0% profit
-Marketing Expense
-Sales Expense
-Order Processing & Admin
-Credit Check
-Price Confirmation
-Deduction
-Returns / Unsaleables
-Order Resolution
-Replenishment
-Distribution
-Special Packing
-Invoice & Collection
-Transportation
A Robust Cost to Serve Approach Can
Improve Supply Chain Performance2
Robustness of Cost to Serve Approach
SCPerformance
© Copyright 2004 Archstone Consulting LLC
Confidential10
Requirement: Metric and organizational alignment between retailers and
manufacturers will improve focus
FACT: CPG companies and retailers do not measure a common set of metrics1
11 Archstone Consulting 2004 Retail / Manufacturer Collaboration SArchstone Consulting 2004 Retail / Manufacturer Collaboration Surveyurvey
Category Development New Products Promotion Effectiveness Cost ManagementAssortment
Unique to
Manufacturer
Shared with
Retailer
Unique to
Retailer
• Sales Volume ($)
• Velocity (Rate Of Shelf Movement)
• Incremental Profit To Total
Category
• Sales Growth ($)
• Market Share
• Trial And Repeat Rates
• Order Fulfillment (E.g. On Time,
Complete)
• Category Profitability
• Out of Stocks
• Incremental Sales To Total
Category
• Sales Volume (Units)
• Slotting Fee Potential
• Sales Growth (Units)
• Sales Volume ($)
• Category Profitability
• Market Share
• Incremental Sales To Total
Category
• Sales Growth ($)
• Total Profit Dollars
• Customer Count
• Out Of Stocks
• Incremental Profit To Total
Category
• Same Store Sales Trend
• Incremental Lift
• Profit Dollars Per Linear Shelf Ft.
• Sales Per Linear Shelf Ft
• Sales Volume (Units)
• Velocity (Rate of Shelf
Movement.)
• Retailer Profit Margin)
• Promotion Dollars Earned
• Lift (Incremental Promotion
Volume)
• Incremental Profit To Total
Category
• Incremental Sales To Total
Category
• Out Of Stocks
• Lift For Other Products Or
Categories (Cross Promotions,
Link To Loyalty Programs)
• Sales Growth ($)
• Velocity (Rate of Shelf Movement)
• Same Store Sales Trend
• Cost Per Incremental Case
• Order Fulfillment (E.g. On
Time, Complete)
• Incremental Consumption (Vs.
Retailer Forward Buy)
• Sales Growth (Units)
• Total Profit Dollars
• Sales Volume ($)
• Sales Volume (Units)
• Retailer Penny Profit Per Unit
• Velocity (Rate Of Shelf Movement)
• Total Profit Dollars
• Category Profitability
• Retailer Penny Profit Per Unit
• Sales Per Linear Shelf Foot
• Profit Dollars Per Linear Shelf
Foot
• Out of Stocks
• Per Unit
• Retailer Profit Margin
• Manufacturer Gross Profit
Margin
• Trial And Repeat Rates
• Same Store Sales Trend
• Average Cash Register Ring
• Sales Growth ($)
• Incremental Profit To Total
Category
• Inventory Turns
• Sales Volume ($)
• Total Profit Dollars
• Return On Capital
• Retailer Penny Profit Per Unit
• Retailer Dead Net Product Cost
• Category Profitability
• Promotion Dollars Earned
• Lift (Incremental Promotion
Volume)
• Order Fulfillment (E.G. On Time,
Complete)
• Sales Volume (Units)
• Inventory Turns
• Store Operating Expense
• Profit Per Employee
• Cost Per Incremental Case
• Incremental Profit To Total
Category
• Sales Growth ($)
• Sales Volume ($)
… even in cases where common metrics exist, manufacturers and retailers define them differently
The information contained in this document is proprietary. Copyright © 2012 Capgemini. All rights reserved

12. The information contained in this document is proprietary. Copyright © 2015 Capgemini. All rights reserved
Approach: Strategy phase
Step 2 - Assess existing operations
12
Purpose
Activities
 Identifies current capabilities and ongoing
initiatives and maps them to business
requirements
 Aligns current capabilities and ongoing
initiatives with required capabilities
Assess Existing Operations
Assess existing capabilities and initiatives and identify future state capabilities required to
support Enterprise Strategy
 Conduct key personnel interviews
 Review process documentation and perform
process walkthroughs
 Catalog ongoing and planned Claims initiatives
 Review selected claim sample
 Identify future capabilities (governance,
process, organization & technology)
Potential Benefits
Key Deliverables
Interview
Observations
 Key observations collected during interviews
with implications for operating strategy
 Identify quick-hit initiatives based on high
value/low effort opportunities defined during
initial assessment
Operational
Capabilities
Definition
• Detailed description of each capability,
including:
• Required governance, process,
organizational, and technology elements
• Major milestones
• List of key stakeholders
• Production Schedule
• Inventory on hand
• Warehousing
• Logistics
• Customer Service
• Order Management
• Demand Management
Process Implications
MajorMajor
MilestonesMilestones
• 4Q04 – Online Channel Development
InputsInputs
• Product
Specifications
• Quantity
• Date Needed
• Ship To
Address
• Billing Address
• Customers
• Inventory On-
hand
• Production
Schedule
• Accounts
Receivable
• Shipping
Department
OutputsOutputs
Online retail channel
management
Management of online order from requisition to delivery to
the end consumer
Supply Chain Mgmt.Process AreaProcess Area
CapabilityCapability
CapabilityCapability
DescriptionDescription
Capability ElementsCapability Elements
1. Ability to provide two
way communications
for online customer
needs between end
customer and
Microsoft
• Receipt
• Bill of Laden
• Inventory
Update
• Delivery Date
• Production
Schedule
• Customers
• Email
communications
• Inventory on
hand
• Production Schedule
• Inventory on hand
• Warehousing
• Logistics
• Customer Service
• Order Management
• Demand Management
• Production Schedule
• Inventory on hand
• Warehousing
• Logistics
• Customer Service
• Order Management
• Demand Management
Process Implications
MajorMajor
MilestonesMilestones
• 4Q04 – Online Channel Development
InputsInputs
• Product
Specifications
• Quantity
• Date Needed
• Ship To
Address
• Billing Address
• Product
Specifications
• Quantity
• Date Needed
• Ship To
Address
• Billing Address
• Customers
• Inventory On-
hand
• Production
Schedule
• Accounts
Receivable
• Shipping
Department
• Customers
• Inventory On-
hand
• Production
Schedule
• Accounts
Receivable
• Shipping
Department
OutputsOutputs
Online retail channel
management
Management of online order from requisition to delivery to
the end consumer
Management of online order from requisition to delivery to
the end consumer
Supply Chain Mgmt.Process AreaProcess Area
CapabilityCapability
CapabilityCapability
DescriptionDescription
Capability ElementsCapability Elements
1. Ability to provide two
way communications
for online customer
needs between end
customer and
Microsoft
• Receipt
• Bill of Laden
• Inventory
Update
• Delivery Date
• Production
Schedule
• Receipt
• Bill of Laden
• Inventory
Update
• Delivery Date
• Production
Schedule
• Customers
• Email
communications
• Inventory on
hand
• Customers
• Email
communications
• Inventory on
hand
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13. The information contained in this document is proprietary. Copyright © 2015 Capgemini. All rights reserved
Approach: Strategy phase
Step 3 - Identify capability gaps
13
Purpose
Activities
 Identifies areas of focus required to develop
future capabilities
 Begins to define initiatives that can leverage
current capabilities
 Provides assessment of potential impact of
change on Claims Operation
Identify Capability Gaps
Compare current capabilities and initiatives to requirements and future capability needs to
identify gaps to be addressed by future initiatives
 Identify gaps between current and future
capabilities
 Provide details surrounding nature, size, and
impact of gaps
Potential Benefits
Key Deliverables
Capability Gap
Analysis
 Assessment of current capabilities
 Considers initiatives either planned or in
process during the gap assessment
Define a business process
to incorporate ad hoc
material requirements and
automatically
communicate and alert
suppliers
40Y-NP
(1b) Ability to automatically identify and
rapidly communicate material requirement
changes internally and to partners and
suppliers
Provide data visibility and
network integration to
automatically monitor
partner and supplier
inventory levels and build
schedules and evaluate
ability to support final
assembly schedule
40Y-NN
(2) Ability to monitor and automatically
communicate mismatches between partner
assembly completion dates and final
assembly need dates in single common view
Develop data model and
standard business
processes to automatically
communicate material
requirements and alert net
changes across critical
component suppliers
50Y-NP
(1a) Ability to automatically update and
communicate a rolling forecast of system
materials requirements across all partners
and suppliers
Define a business process
to incorporate ad hoc
material requirements and
automatically
communicate and alert
suppliers
40Y-NP
(1b) Ability to automatically identify and
rapidly communicate material requirement
changes internally and to partners and
suppliers
Provide data visibility and
network integration to
automatically monitor
partner and supplier
inventory levels and build
schedules and evaluate
ability to support final
assembly schedule
40Y-NN
(2) Ability to monitor and automatically
communicate mismatches between partner
assembly completion dates and final
assembly need dates in single common view
Develop data model and
standard business
processes to automatically
communicate material
requirements and alert net
changes across critical
component suppliers
50Y-NP
(1a) Ability to automatically update and
communicate a rolling forecast of system
materials requirements across all partners
and suppliers
Integrated Build Schedule
Visibility (1 of 2)
Timely communication of production schedule and corresponding
material requirements across partners and suppliers and
monitoring of progress to plan
Supply Chain Mgmt.Process AreaProcess Area
CapabilityCapability
CapabilityCapability
DescriptionDescription
Capability ElementsCapability Elements
InitiativeInitiative
MeetsMeets
Reqs.Reqs.
InitiativeInitiative
MeetsMeets
TimingTiming
NeedsNeeds
CapabilityCapability
CurrentlyCurrently GapGap Gap DescriptionGap DescriptionCapabilityCapability
ScoreScore
InitiativeInitiative
PlannedPlanned
N = No Y = Yes P = PartialN = No Y = Yes P = Partial
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14. The information contained in this document is proprietary. Copyright © 2015 Capgemini. All rights reserved
Approach: Strategy phase
Step 4 - Define initiatives
14
Purpose
Activities
 Identifies level of effort/cost required to move
from existing operating model to target model
 Prioritizes efforts to focus on areas where
change can have greatest impact
Define Initiatives
Define and prioritize the effort/investment required to develop future capabilities
 Define the effort required to develop future
capabilities given current capabilities and
existing efforts
 Identify dependencies between planned
initiatives and current initiatives
 Prioritize initiatives based on achievability,
organizational readiness, and financial impact
Potential Benefits
Key Deliverables
Capability
Initiatives
• Include relevant milestones/deadlines,
complexity definition, implications, and
dependencies
• Assess cost, complexity, benefits, risk, time,
change impact
BOM Creation and
Management
Process AreaProcess Area
CapabilityCapability
Product Development
Initiative IDInitiative ID # XXX
• Ability to define and maintain product
data attributes, manage their
associations with BOMs, and generate
Build to Package datasets as required
(1)
Capability ElementsCapability Elements
Initiative DescriptionInitiative Description
Existing Initiatives
• AF-1: Initial ability to construct and manage the
BOM 04Q1
• SE-3: 5700/SW logical PDM data model structure
403Q1
• AF-4: BTP workflows 03Q1
• AF-2: Ability to complete construction and mgmt of
a BOM 03Q1
Milestones
• (1) XXXYYY – Q203
Decision/Implications
• Assessment of plans is required as risk exists
in meeting need date and ensuring adoption
and use of PDM by all partners and suppliers
as significant resistance exists throughout the
program. (1)
Financial Impact Assessment
• Benefit Group Product Dvlp Collaboration
• XXX Impact $159M - $477M
• YYY Impact $219k - $656k
• Initiative Impact High
• Cost $2.0M
Initiative Dependencies
• BD1, BD3
• IT1, IT4
Complexity/Effort Assessment
• Process 5 - Intl. Design
• Technology 2 - COTS Config.
• Integration 5 - Intl. External
• Duration 4-6 months
Gap: Timing
• Gap exists as current initiative plans deliver
capability past timing need. Current
program plans have been defined to
accommodate delivery of this capability by
MM/DD/YY. For improved BOM mgmt,
integration is required between PDM and
manufacturing, support, and key partner
and supplier systems. Associations of BTP
datasets with BOMs and WBS are
required. (1)
• Although this is a capability that is primarily
enabled in the PDM system, data model of
all required program business objects is
required, and interfaces between the
systems that contain the relevant data
must be developed.(1)
Gap DescriptionGap Description
Focus: TechnologyFocus: Technology
1=low - 5=high
Description – The gap for this capability element is a timing gap as current initiative
plans deliver the capability past the timing need date (at MM/DD/YY); for improved
BOM management, integration is required between PDM and manufacturing,
support, and key partner and supplier systems; associations of datasets with BOMs
and WBS are required
Process – Assess process scope, implementation timing and resources
Technology – Assess technology scope, implementation timing and resources
Organization and Training – Assess organizational scope and impact
Initiative
Prioritization
• Prioritize initiatives to guide resource
allocation and timing
• Perform readiness assessment to determine
the achievability of the initiatives
22
DRAFT
Prioritising the e-Business Initiatives
Initiative
1. e-Buying (incl. leveraged catalogues)
2. Buy-Side Auctions
3. Collaborative Purchasing
4. Supplier CPFR
5. Supplier Inventory Management
6. Collaborative Product Development &
Introduction
7. E-Settlement (Buy-Side)
8. Content Management
9. Knowledge Management
10. HR Self-Service
11. E-Recruitment
12. eLearning
13. Statutory Compliance: Government
Returns
14. Logistics & Transportation Collaboration
15. Item Catalogue
16. Retail Exchange Participation
17. Private Exchange Participation
18. Customer Portal (eCRM)
19. Web-Enabled Call Centre & Email
Response Systems
20. Field Sales
21. E-Settlement (Sell-Side Customer)
22. Retailer Auctions
23. Sell Side Auctions
24. Promotions Management
25. Customer CPFR
26. Consumer Insight: Collaboration With
External Parties
27. Direct to Consumer Propositions (own /
participation in external props)
28. Investment in Buying Consortia
29. Investment in Retail Exchange
e-Business Initiatives and Prioritisation Scores:
Business Value Ease of Implementation
11 19
16.5 30
16.5 30
10 18
6 21
7 17
5 19
13.5 19
15.5 8
9 17
7 23
8 20
4 30
11 23
15 16
13 17
11 17
15.5 15
11 16
8 17
5 19
7 26
6.5 22
16 19
13 16
13 14
7 14
5 25
9 17
Ease of Implementation
BusinessValue&
StrategicImperative
Question/
Redesign
Accelerate/
Invest
Tactical/
Discretionary
Kill
High
High
Low
Low
5 17.5 30
2
10
18
1
2
3
19
4
5
6
7
21
8
9
10
29
11
12
13
14
15
17
18
20
2223
24
2526 16
27
28
Illustrative Framework
Prioritizing Supply Chain Initiatives
Supply Chain Initiatives and Scores
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15. The information contained in this document is proprietary. Copyright © 2015 Capgemini. All rights reserved
Approach: Strategy phase
Step 5 – Develop roadmap and use case for technology
15
Purpose
Activities
 Develops means to prioritize key investments
and initiatives going forward
 Creates a plan that allows company to
complete initiatives at a comfortable pace for
the organization
 Develops alignment across the organization to
enhance change acceptance
Develop Roadmap and Use Case for Technology
Develop prioritized and sequenced roadmap of initiatives to guide design and implementation
activities; create financial and strategic business case which shows alignment of Enterprise
Strategy and Claims Operating Model along with financial impact/benefits
 Develop roadmap of the prioritized initiatives
that focuses on realizing value
 Develop use cases for potential technology
solutions
 Identify vendor options
Potential Benefits
Key Deliverables
Roadmap
• Includes current projects and future initiatives, allowing
management of resources, costs and priorities through
implementation
• Identifies quick hit opportunities
• Highlights potential “breakthrough” opportunities
FY12 FY13 FY14 FY15
Value Cost Q3/Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Comments
Initiatives*
Automation of Payments (TradeCard) C $ 500K Automatepayments between Coach and SPs
JDA Manugistics Upgrade S $ 400K JDA technical upgrade
InventoryVisibility S $ 1.9M Providevisibility to inventory ownership
Visual Merchandising Planning Implementation S $ 1.5M Improveflow of VM through multiple DCs
Supply Chain Analytics (BI) S $ 3.0M Buildreporting environment for Supply Chain
Supply Chain Collaboration – Finished Goods G $ 10M BOM / Costing, PO tracking, samples, QA collaboration
WarehouseManagementProgram – HW/SW Upgrade S $ 2.6M WM hardware and applicationupgrade
29. ContactCenter Integrationand Management S $ 200K Processand staffingmodel to manage call routing & events
28. IntegratedStrategicTrade Management C $ 3.3M Systematicmanagement of trade information& updates
6. Total Cost of Ownership Model Developmentand Analysis C $ 200K Definitionand data to calculatecostsfor decisionsupport
19. Electronic invoice and shipment notificationenhancement S $ 800K ExpandEDI to support all internationalinvoicing
7. PurchaseOrder Assessment G $ 900K Document PO types and requirements, identifyoptions
1. ForecastingAssessment G $ 500K
Supply Chain requirementsand optionsto increasedemand plan
details
27. Logistics Strategic Sourcing C $ 100K Toolsand process to periodically resourceglobal logisticsservices
Global InventoryDeployment (DRP)
12. GlobalInventory Deployment
13. Enable Global Inventory Deployment
G $ 500K
$ 5.3M
Processto balancevariables to get product to right location
Tech.to executeright place, right quantity, first time process
2. Develop PreferentialSourcing Process and Integration C $ 200K Productplacement decision making process,integratingFTA and TCO
16. Network Wide Visibility S $ 1.8M Manage movements between Coach and all external partners
8. EnhanceMRP C $ 2.4M ExtendMRP to account for demand volume changes/enhance
RegionalInventoryDeployment (DOM)
14. RegionalInventory Deployment
15. Enable Regional Inventory Deployment
G $ 800K
$ 7.5M
Manage inventory consumptionacross orders from all channels
Systematicallyevaluate next best order for inventory consumption
Transportation
24. Transportation Management Process Development
25. Enable Transportation Management Process
G $ 500K
$ 3.95M
Process& org. to define/optimizeshipments& transit time
Rules led system to support shipment process
WarehouseOperations
20. GlobalWarehouse Operations
21. Warehouse Process Improvement
22. Value Added Services Improvement
S
$ 900K
$ 500K
$ 100K
EnterpriseWM with slotting,etc.
Efficiencythroughprocesses improvements& org. changes
Processto continuouslyevaluate value add services acrossnetwork
3. Rough-cutSupply CapacityPlanning and Optimization C $ 2.4M Criteria& processto technicallyenable supply plan/options
4. S&OP Process Development C $ 200K Escalationprocess& structurefor supply/demandconflicts
Totals $ 33.1M $ 10.7M $ 16.4M $ 3.6M
Malaysialive, Korea live,
Korea ICH
Move ADC
WC DC live
EDC live
LEGEND: Both, Technology & ProcessProcess Technology
Financial Quarter
GLS Roadmap: Wave I
*Italicizedinitiativesare current or planned;costs not
includedin totals
Value Key: C – Cost, G – Growth, S - Scalability
Use Cases  Key processes used to comparatively evaluate the fit of
potential technology solutions
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16. The information contained in this document is proprietary. Copyright © 2015 Capgemini. All rights reserved
Sample Strategy Phase (Claims Diagnostic Review) team structure
Please note: Capgemini staffing is subject to availability of consultants at project start and is considered in close coordination with the client
Key
Insurer Client
Capgemini
Professional profiles of key Capgemini resources are included on subsequent pages
Insurer Client
Project
Workstreams
Engagement
Oversight
Insurer Stakeholders
Consumer & Commercial
Claims and Operations
Business & IT
team members
Insurer Engagement Owner
TBD
Insurer Project Manager
TBD
CDR Project Lead
Engagement Executive
Mark Nobilio
Claire Louis
Identify Opportunities &
Initiatives/Create Roadmap
Assess Current
Operating Model
Gap Analysis & Target
Operating Model
Organizational Change Management Specialist, BTI Analyst, Business Analyst

17. The information contained in this document is proprietary. Copyright © 2015 Capgemini. All rights reserved
Key assumptions for Strategy Phase: Claims Diagnostic Review (CDR)
Key Assumptions
 Typical timeframe for execution of the Strategy Phase (Claims Diagnostic Review) is 4-6 weeks, however, engagement duration will vary
based on mutually agreed scope and data analysis required.
 The project work usually takes place at the client site four (4) days a week.
 While the project work will generally take place at the client site, certain project activities such as documentation and analysis of collected
information and project artifact and deliverable creation may be performed from a Capgemini Consulting office.
 From a project logistics standpoint, Capgemini Consulting assumes that the client is committed to the following responsibilities:
 The client will provide rooms with appropriate infrastructure and communication facilities (project office).
 The client will furnish a dedicated project team.
 The client will select the participants for the focus interviews and be responsible for timely arrangement of appointments with
people to be interviewed, providing their contact details (name, e-mail, phone number)
 The client will arrange for meeting rooms, invite participants to meetings, define the contacts in the client organization, and run the
global data collection process.
 Further, the client will be responsible for validating and aligning the project results throughout the course of the project.
 In the event that the client desires to leverage the Capgemini Accelerated Solution Environment (ASE), for visioning, there is an additional
daily charge for fees and expenses. If requested, Capgemini will provide fee estimate with and without optional ASE costs based on
expected number of participants and ASE days.
 A mutually agreed Statement of Work (SOW) will be signed prior to commencement of the engagement including all relevant Terms &
Conditions.
 This is not a complete list of Assumptions.

18. The information contained in this document is proprietary. Copyright © 2015 Capgemini. All rights reserved
Representative Profile: Mark Nobilio
Practice
Office
Role
Name
Consulting Competencies
 Digital Transformation
 Business Transformation
 Insurance Business Operations
 Underwriting Effectiveness
 Claims Technology & Process Innovation
 User Experience Design
 Policy Administration & Claims Re-architecture & Solutions
 Business Solution Delivery
 IT Strategy & Innovation
Industry and Project Experience (Selected)
Business Experience
 Senior Insurance industry executive serving various clients in a broad
range of services including business strategy, business operations,
transformation, and technology innovation
 Digital Transformation and Business Transformation services
 Extensive collaboration/partnering experience with large Insurance
clients to drive significant business transformation agendas to
reduce cost, improve efficiency, enhance product portfolio, devise
innovative business solutions, and provide seamless customer
experience
 Over 25 years top-tier professional services consulting with over 20 years of
Insurance industry expertise partnering with Insurance companies to inject
innovation and technology solutions to enhance business performance.
 Developed a multi-year transformation roadmap for a specialty insurer for
alternate customer transformation. Roadmap outlined a 4-5 year time horizon to
transform from low-volume, high-premium to high-volume, lower premium.
Implemented Automated Renewals based on Straight-Through Processing
technology and later leveraged for New Business low-touch policy quoting/direct
placement to improve operating costs and eliminate need for increased staff.
 Led in the development of Claim Reengineering strategy for a large Insurance
client including claims components, re-engineered features, claim workflow,
advanced assignment, user experience design for claims handling, re-architecture
of legacy system components, and addition of predictive analytics to drive
efficiency and proactive claim management and improved outcomes.
 Developed Next Generation Policy Administration re-architecture strategy and
roadmap for a large personal lines carrier. Roadmap included development of
new functions and features for policy servicing as well as roadmap costs for
development and enhancement of the business transformation.
 Facilitated Digital Transformation engagement for Customer Service Portal
solution for a major personal lines insurance carrier. The new User Experience
(UX) Design improved self-service capabilities and reduced operational costs.
 Implemented Predictive Analytics Scoring Engine for a major P&C insurance
carrier to support best practice U/W improving premium lift by 3% .
 Developed an International Digital Strategy and Roadmap for a large
international P&C insurance carrier to support a new B2C business model.
 Developed 3-year Digital Roadmap for large International Life company.
Mark Nobilio
VP, Insurance Industry Leader
New York, NY
Strategy & Transformation
18

19. Representative Profile: Claire Louis
Practice
Office
Role
Name
Consulting Competencies
 Insurance Business Operations
 Business Strategy and Transformation
 Claims Process Innovation
 Claims Re-architecture & Solutions
 Claims Cost-Containment, “leakage”
 Litigation management
Industry and Project Experience (Selected)
Business Experience
 Senior insurance executive with extensive insurance claims
experience in direct claims, reinsurance, corporate risk
management, brokerage, third-party claims administrator,
accountancy, and consultancy domains
 Developed, implemented, and evaluated policies, procedures,
processes, controls, and client services standards for ins. claim ops.
 Designed and oversaw claim programs for large commercial
accounts, including vendor selection, monitoring, and performance
measurement
 Insurance claim processes, internal controls, service standards
 Collaborated with policyholders and insurers to develop and enhance
claim programs, including claim administrator selection and oversight,
claims handling best practices, performance metrics, and performance
monitoring tools
 Redesigned claim processes, policies, and procedures for large, self-
administered municipality
 Performed regulatory compliance readiness/alignment review for public
entity and educational institution insurer
 Claims cost-containment
 Developed, helped implement, and managed the insurance claims
programs of a multi-billion self-insured organization, resulting in reduced
loss costs
 For TPA of legacy Lloyd’s, AIG, and CNA long-tail claims, developed,
oversaw, and managed policyholders’ national litigation programs
 Performed claims leakage study for mutual insurer
 High-severity commercial claims
 As Head of Claims for a construction insurance brokerage, collaborated
with clients to develop and enhance claim programs, including TPA
selection and oversight, claims best practices, performance metrics, and
performance scorecards
 As Claims Manager for a multi-billion dollar global petrochemical
manufacturer, developed a performance management and incentive
program to help improve TPA claim outcomes for worker’s compensation
and general liability claims through more focused litigation management
and settlement efforts
Claire Louis
Managing Consultant
New York, NY
Strategy & Transformation
19The information contained in this document is proprietary. Copyright © 2015 Capgemini. All rights reserved

20. Contact:
Claire Louis
Managing Consultant, Insurance NA
508-415-7628 mobile
claire.louis@capgemini.com
623 5th Avenue, 33rd Floor
New York, NY 10022
Mark Nobilio
Vice President, Insurance NA
908-229-9553 mobile
mark.nobilio@capgemini.com
623 5th Avenue, 33rd Floor
New York, NY 10022