CPMI UserGuide V12

Customer Process Manager™for Insurance

User Guide

© Copyright 2008 Pegasystems Inc., Cambridge, MA

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This document is the property of: Pegasystems Inc. 101 Main Street Cambridge, MA 02142-1590 (617) 374-9600, fax: (617) 374-9620 www.pega.com Customer Process Manager™ for Insurance Document: User Guide Software Version: 1.2 Updated: June 2008

Contents

Chapter 1: Before You Begin .............................................................................................. 1-1 Who Should Read This Document .................................................................................. 1-2 Benefits of Customer Process Manager .......................................................................... 1-3

Optimized Interaction Management ......................................................................... 1-3 Smart Scripting and Guided Next-Step Processing ................................................. 1-3 Context-Sensitive User Interface .............................................................................. 1-4 “One-and-Done” Service Process Automation ......................................................... 1-4 Multi-Channel Support ............................................................................................. 1-4 Intelligent Sales and Marketing Campaigns ............................................................. 1-5 Value-Based Service Level Management ................................................................ 1-5 Quality Performance Management ........................................................................... 1-5 Real-Time Analytics and Reporting .......................................................................... 1-5

Structure of This Document ............................................................................................. 1-6 Documentation Set .......................................................................................................... 1-7

Education and Training ............................................................................................ 1-8 Chapter 2: Getting Started .................................................................................................. 2-1

Understanding Basic Terms ............................................................................................ 2-2 Accessing Customer Process Manager for Insurance .................................................... 2-3

Logging On ............................................................................................................... 2-3 Changing Your Password ........................................................................................ 2-5 Logging Off ............................................................................................................... 2-6

Portal Views .................................................................................................................... 2-7 Home Base .............................................................................................................. 2-7 Interaction Manager (Initiate Work) .......................................................................... 2-9 Interaction Manager (In Process) ........................................................................... 2-11

Understanding Icons and Controls in the User Interface ............................................... 2-14 Working with Other Windows ................................................................................. 2-14 Common Icons and Controls .................................................................................. 2-14 Entering Data ......................................................................................................... 2-18 Responding to Errors ............................................................................................. 2-20

Chapter 3: Working with CPM ............................................................................................ 3-1

iv Contents

Conducting Live Customer Interactions ........................................................................... 3-3 Identifying and Verifying the Customer .................................................................... 3-3 Search for a Customer ............................................................................................. 3-4 Verify the Customer ................................................................................................. 3-6 Processing Service Requests .................................................................................. 3-7 Queuing Processes .................................................................................................. 3-8 Interaction Goals ...................................................................................................... 3-9 Launching Business Processes ............................................................................... 3-9 Executing Processes .............................................................................................. 3-10 Standard Business Processes ............................................................................... 3-11 Accessing Customer Information ........................................................................... 3-14 Policy Composite Gadget ....................................................................................... 3-16 Contact Composite Gadget .................................................................................... 3-18 Policy Holder Composite Gadget ........................................................................... 3-20 Business Unit Composite Gadget .......................................................................... 3-22 Ending the Interaction ............................................................................................ 3-24

Using CTI Functions ...................................................................................................... 3-25 CTI Login and Availability ....................................................................................... 3-25 Screen Pops ........................................................................................................... 3-27 When You Are on a Call ......................................................................................... 3-28 Making a Call ......................................................................................................... 3-28

Conducting Non-Live Customer Interactions ................................................................. 3-29 Creating Non-Live Customer Interaction Cases ..................................................... 3-29 Selecting a Non-Live Interaction Case ................................................................... 3-32 Identifying the Customer and Processing Service Requests .................................. 3-33 Completing Non-Live Customer Interactions .......................................................... 3-35

Processing Service Requests Post-Interaction ............................................................. 3-36 Finding Service Cases ........................................................................................... 3-36 Researching and Completing Service Request Cases ........................................... 3-39

Using Reference Utilities ............................................................................................... 3-46 Using Supervisory Functions ......................................................................................... 3-47

Modifying Dialog Scripts ......................................................................................... 3-47 Reassigning Work .................................................................................................. 3-48 Conducting Quality Reviews .................................................................................. 3-49 Creating and Assigning Coaching Tips .................................................................. 3-56 Reviewing Customer Satisfaction Surveys ............................................................. 3-59

Contents v

Using Sales and Marketing Functions ........................................................................... 3-62 Campaign Management ......................................................................................... 3-62 Territory Management ............................................................................................ 3-70 Opportunity Processing .......................................................................................... 3-74

Chapter 4: Understanding CPM Business Processing .................................................... 4-1 Key Business Processing Flows ..................................................................................... 4-3 Adding a Business Unit ................................................................................................... 4-5

Add New Business Unit ............................................................................................ 4-6 Add Primary Communication .................................................................................... 4-9 Add Additional Details ............................................................................................ 4-10 Business Processing .............................................................................................. 4-10

Adding a Contact ........................................................................................................... 4-11 New Contact ........................................................................................................... 4-12 Enter Primary Contact Addresses .......................................................................... 4-14 Enter Contact Communication Options .................................................................. 4-15 Business Processing .............................................................................................. 4-15

Communicating a Message ........................................................................................... 4-16 Communicate Message ......................................................................................... 4-17

Entering Complaints or Compliments ............................................................................ 4-18 Complaint or Compliment ....................................................................................... 4-19 Business Processing .............................................................................................. 4-20

Diagnosing Issues ......................................................................................................... 4-21 Diagnose Issue ...................................................................................................... 4-22 Business Processing .............................................................................................. 4-23

Using Frequently Asked Questions ............................................................................... 4-24 Browse or Search Topics ....................................................................................... 4-25

Confirm Knowledge Topic ............................................................................................. 4-27 Business Processing .............................................................................................. 4-29

Creating a General Service Item ................................................................................... 4-30 Enter Request Details ............................................................................................ 4-31 Business Processing .............................................................................................. 4-32

Sending Material ........................................................................................................... 4-33 Select Material ....................................................................................................... 4-34 Select Distribution Method ..................................................................................... 4-35 Confirmation of Materials Fulfillment ...................................................................... 4-36 Business Processing .............................................................................................. 4-37

vi Contents

Modifying Business Unit Links ....................................................................................... 4-38 Search for Business Units to Link .......................................................................... 4-39 Link a New Business Unit to a Contact .................................................................. 4-40 Verify – Link a New Business Unit ......................................................................... 4-41 Business Processing .............................................................................................. 4-41

Entering a Sales Opportunity ........................................................................................ 4-42 Enter Opportunity Details ....................................................................................... 4-43 Confirmation of Opportunity ................................................................................... 4-44 Next Actions ........................................................................................................... 4-46 Attach a Note ......................................................................................................... 4-48 Resolve Opportunity ............................................................................................... 4-49

Overriding a Default SLA ............................................................................................... 4-50 Override SLA .......................................................................................................... 4-51 Business Processing .............................................................................................. 4-51

Adding a Contact using Quick Add Contact .................................................................. 4-52 Quick Add Contact ................................................................................................. 4-53 Business Processing .............................................................................................. 4-54

Scheduling Activities ..................................................................................................... 4-55 Schedule Appointment ........................................................................................... 4-56 Confirmation of Scheduled Activity ......................................................................... 4-57 Business Processing .............................................................................................. 4-57

Sending Correspondence .............................................................................................. 4-58 Create and Send Correspondence ......................................................................... 4-59 Business Processing .............................................................................................. 4-60

Sending Statement Copies ............................................................................................ 4-61 Select Statement .................................................................................................... 4-62 Statement Photocopy Details ................................................................................. 4-63 Confirmation of Statement Copy Request .............................................................. 4-64 Business Processing .............................................................................................. 4-64

Presenting Suggested Reviews .................................................................................... 4-65 Business Processing .............................................................................................. 4-66

Presenting a Suggested Offer ....................................................................................... 4-67 Suggested Offers Flow ........................................................................................... 4-67 Handle Opportunity Flow Diagram ......................................................................... 4-68 Get Offers Flow Diagram........................................................................................ 4-69 Process Offer ......................................................................................................... 4-70

Contents vii

Accept Offer ........................................................................................................... 4-71 Reject Offer ............................................................................................................ 4-72 More Information .................................................................................................... 4-73 Confirmation of Offer Presentation ......................................................................... 4-74

Processing a Transaction Dispute ................................................................................. 4-75 Start Dispute .......................................................................................................... 4-76 Select Dispute Reason ........................................................................................... 4-77 Confirmation of Transaction Dispute ...................................................................... 4-78

Updating Contact Communication Options ................................................................... 4-79 Update Contact Communication Options ............................................................... 4-80

Updating a Contact Name and Profile ........................................................................... 4-82 Update Contact Name and Profile .......................................................................... 4-83 Business Processing .............................................................................................. 4-83

Chapter 5: Understanding Insurance Business Processing ........................................... 5-1 Adding New Policy Applications ...................................................................................... 5-2 Changing Policy Endorsements ...................................................................................... 5-7 Filing a First Notice of Loss ........................................................................................... 5-10

Chapter 6: Reporting ........................................................................................................... 6-1 Reporting Gadgets .......................................................................................................... 6-2

Reporting Dashboard Gadget .................................................................................. 6-2 Reports ..................................................................................................................... 6-3

Drill-Down Reporting Capabilities .................................................................................... 6-5 Frequently Used Reports ................................................................................................ 6-8 Ad Hoc Reporting Capabilities ...................................................................................... 6-12 Creating a Custom Report ............................................................................................. 6-13

Step 1: Selecting the View ..................................................................................... 6-14 Step 2: Selecting the Data Source ......................................................................... 6-15 Step 3: Defining the Report Criteria ....................................................................... 6-16 Step 4: Defining Display Groups ............................................................................ 6-17 Step 5: Defining the Field Functions ...................................................................... 6-18 Step 6: Defining Drill-Down Capabilities ................................................................. 6-19 Step 7: Charting the Data ....................................................................................... 6-20 Step 8: Previewing the Report ................................................................................ 6-23

Appendix A: Workflow Descriptions................................................................................... A-1 Interaction Flows ............................................................................................................. A-2

viii Contents

Service Workflows ........................................................................................................... A-4 Customer Management Flows ........................................................................................ A-7

Appendix B: Default Portals ................................................................................................ B-1 CACSRPortal .................................................................................................................. B-2 CAManagerPortal ............................................................................................................ B-3 CASalesRepPortal .......................................................................................................... B-4 CASalesManagerPortal ................................................................................................... B-5

Chapter 1 Before You Begin

Customer Process Manager™ for Insurance is a process-oriented contact center application for managing and automating customer service across multiple customer touch points. This book describes how to use Customer Process Manager (CPM) for Insurance to guide CSRs in processing customer service inquires and requests from initiation through resolution.

Key features of CPM for Insurance include:

■ Optimized interaction management capabilities

■ Smart scripting and guided next-step processing

■ A browser-based, context-sensitive user interface

■ “One-and-done” service process automation

■ Integrated support for telephone, e-mail, and Web-based channels

■ Intelligent sales and marketing campaign management

■ Value-based service level management

■ Quality performance management

■ Real-time analytics and reporting

1-2 Customer Process Manager for Insurance User Guide

Who Should Read This Document This book addresses users who perform any of the following roles:

■ Customer service representatives (CSRs) responsible for handling customer calls, inbound correspondence, and front-office research and fulfillment tasks.

■ Contact center supervisors and managers responsible for ensuring service availability and quality.

■ Marketing personnel responsible for establishing and monitoring cross-sell and retention campaigns executed by the contact center.

■ Sales representatives and sales managers who work with the contact center to follow up on leads and to close opportunities.

■ Account managers needing access to customer interaction and service item information.

Before You Begin 1-3

Benefits of Customer Process Manager Customer Process Manager helps reduce service costs and improve customer satisfaction through a process-driven approach that helps to resolve customer issues quickly at the point-of-contact. With CPM for Insurance, your company has new capabilities to:

■ Improve service effectiveness

■ Increase operational productivity

■ Increase customer retention and cross-sell revenue

■ Reduce training time

■ Ensure an optimal customer service experience

Optimized Interaction Management The Customer Process Manager Interaction Driver helps optimize every customer interaction. Its built-in intelligence automatically queues business processes based on your company policies as well as on anticipated customer requests. As a result, you can act on service requests before your customers even ask — reducing your call-back frequency and increasing first-call resolution rate.

Smart Scripting and Guided Next-Step Processing With Customer Process Manager, smart scripting and next-step workflow guide you through every customer interaction — reducing training time and ensuring service consistency. Comprehensive dialog management facilities enable you to create dynamic scripts that are personalized for the customer within the context of the interaction.


Context-Sensitive User Interface Customer Process Manager employs an Internet Explorer-based user interface that dynamically presents information when and where you need it. By presenting information that is both relevant to the customer and to the task you are performing, Customer Process Manager gives you the smart way to handle customer interactions. The browser-based interface means that Customer Process Manager is easy to deploy across your organizations. Optionally, your company can integrate Customer Process Manager forms and windows into other application portals.

“One-and-Done” Service Process Automation Through automated best-practice service workflows that are directly integrated with your legacy and back-end systems in real time, you can resolve customer issues quickly — without transferring or calling back customers, and without passing service fulfillment to the back office. The result is more efficient and effective service. Other capabilities, such as automatic correspondence and service request audit trails, minimize manual work and reduce time-consuming work transfer.

Multi-Channel Support Customer Process Manager includes integrated, multi-channel support capabilities for managing telephone, e-mail, and Web-based service interactions. Using PegaCALL for PegaRULES, Customer Process Manager provides robust CTI support including adaptive screen pops, desktop telephony controls, and enhanced call-out facilities. By leveraging the business rules engine architecture, you can re-use your business processes and rules across channels — from the IVR to the Web.


Intelligent Sales and Marketing Campaigns With its intelligent campaign and offer management capabilities, Customer Process Manager helps you deliver the right offer to the right customer at the right time. Integrated campaign setup and tracking capabilities enable you to easily manage your company’s cross-sell, retention, reward, and restitution campaigns.

Value-Based Service Level Management To help you meet important performance objectives, Customer Process Manager provides sophisticated facilities for managing value-based service level agreements (SLA). You can assign and monitor work, ensuring that tasks are completed according to both business priority and customer value.

Quality Performance Management Customer Process Manager provides comprehensive capabilities for quality review management to evaluate and monitor employee performance against your company’s quality criteria. Dynamic coaching tips improve productivity and reduce training time by delivering real-time advice and instructions to individual employees while they are interacting with customers.

Real-Time Analytics and Reporting Customer Process Manager includes a wide variety of standard reports and graphs, providing real-time information about processes, work, assignments, and historical data for analyzing contact center performance over time. Powerful drill-down analysis capabilities enable you to travel from a summary view of your entire operation down to the details of a single service-request case.


Structure of This Document This book includes the following chapters and appendixes:

■ Chapter 2 describes what you need to know to start using CPM for Insurance.

■ Chapter 3 describes how to use CPM for Insurance to conduct customer interactions, process service cases, use CTI capabilities, and perform supervisory functions.

■ Chapter 4 describes the business flows in detail, explaining how you interact with the system and the business processing that occurs automatically.

■ Chapter 5 describes the insurance business processes provided by the framework

■ Chapter 6 describes how to access, review, and work with reports.

■ Appendix A provides descriptions of the Visio diagrams that illustrate standard business process flows.

■ Appendix B provides samples and descriptions of portal screens.


Documentation Set In addition to this document, the Customer Process Manager documentation set includes:

■ Customer Process Manager for Insurance Implementation Guide — describes how to install and configure CPM for Insurance for use in your environment. It is intended for developers, system architects, and solution architects.

■ PegaCALL™ for PegaRULES Configuration and Operations Guide — describes how to configure and operate PegaCALL in your telephony environment.

■ PegaCALL™ for PegaRULES Installation Guide — describes how to install PegaCALL to work in your telephony environment.

For information on installing the Customer Process Manager Framework, refer to the Customer Process Manager for Insurance Installation Guide included on the media.

All sources listed below are available on the Pega Developer Network (PDN) http://pdn.pega.com. In addition to the sources listed below, technical notes and tips for using PegaRULES Process Commander are also available on the PDN.

For Process Commander information, refer to the following sources:

■ PegaRULES Process Commander Introduction — provides an overview of the architecture, concepts, and features of Process Commander

■ PegaRULES Business Rules Engine Introduction — provides an overview of the business rules engine, the development portal, concepts, and features of rules and rule forms

■ PegaRULES Process Commander Developer Fast Start – Personal Edition v5.2 — describes a hands-on introduction to modifying an application built on PegaRULES Process Commander, and introduces terms and skills for application developers.


■ PegaRULES Process Commander Administration and Security — describes how to perform the initial startup, setup, and day-to-day administration

■ PegaRULES Process Commander Integrating with External Systems — supports IT professionals who plan, design, build, and test the interfaces with other systems that can be used with a Process Commander application

■ PegaRULES Process Analyzer User Guide — describes how to install and use Process Analyzer, an optional component that provides online analytical process (OLAP) data for PegaRULES Process Commander

■ PegaRULES Process Commander Simulator User Guide — describes how to install and use Process Simulator, an optional component that provides simulation of PegaRULES Process Commander business processes

■ PegaRULES Process Commander Application Developer Help — provides contextual information about Process Commander. Access help by clicking the Help link on the Portal or on the toolbar

■ PegaRULES Process Commander Installation Instructions

■ PegaRULES Process Commander Release Notes

■ PegaDISTRIBUTION MANAGER™ (IOS) for PegaRULES Process Commander — Installation and Deployment Guide

For information on installing or working with third-party applications, such as Microsoft Visio, consult the vendor documentation.

Education and Training Pegasystems Educational Services delivers in-depth programs that are designed, delivered, and taught by certified experts for those who would like additional training. Through hands-on, role-based training, students receive critical knowledge from professionals skilled in the implementation of PegaRULES Process Commander solutions.


For more information about Pegasystems programs and schedules, visit us at http://pega.com/Services/EducationalServices/Education.asp.

Chapter 2 Getting Started

This chapter introduces CPM for Insurance, describes the basics of the user interface, and includes the following topics:

■ Understanding basic terminology

■ Accessing CPM for Insurance

■ Using the views of the CPM for Insurance Portal layout

■ Interpreting the icons and controls in the user interface


Understanding Basic Terms As you read this book, familiarity with the following terms is important:

■ Live customer interaction — a telephone inquiry or a walk-in visit from a customer. CPM for Insurance creates an interaction case to record all activities and service cases that result from live customer interactions.

■ Non-live interaction — an e-mail, fax, or mail inquiry from a customer. CPM for Insurance creates an interaction case to record all activities and service cases that result from non-live customer interactions.

■ CTI (Computer Telephony Integration) — capabilities combining data with voice systems to enhance your contact center operations. Using PegaCALL for PegaRULES, CPM for Insurance includes CTI capabilities such as screen pops, desktop telephony controls, and enhanced call routing.

■ Case (work object/service request) — a unit of work within CPM for Insurance. CPM for Insurance assigns a unique number called a Work ID to each case, whether an interaction or a service request case, such as an address change.

■ Workbasket — a centralized, shared pool of cases from which users can select work depending on their user role. As new cases are created, CPM for Insurance routes them to specific workbaskets for further processing, and then automatically retrieves the cases from workbaskets when users request work.

■ Worklist — a list of case items assigned to a specific user. CPM for Insurance routes appropriate work from workbaskets to the users most qualified to process that work. Users can also pull new case items to their worklist themselves.

■ Service levels — time interval to complete a request. CPM for Insurance assigns a service level rule to each piece of work within the system. A service level defines one or two intervals, known as goals and deadlines. The intervals indicate the expected or targeted turnaround time for the assignment, or time to resolve the case.

Getting Started 2-3

Accessing Customer Process Manager for Insurance Before using CPM for Insurance, you must obtain a Uniform Resource Locator (URL) for the application’s server from your system administrator. The URL has this form:

http://ssssss:9999/dddddd/PRServlet?

Logging On

To log on: 1. Start Microsoft Internet Explorer.

2. In the Address bar, type or paste the URL that your system administrator provides.

3. Press Enter. The logon window appears.

4. Enter your user ID and password, and click Log In. Remember that passwords are case-sensitive. The CPM for Insurance user portal displays on your desktop.

Automatic ActiveX Downloads Some features of CPM for Insurance may require the use of downloaded ActiveX controls. For example, if you are using the PegaCALL for PegaRULES CTI capabilities, you need an ActiveX control to support screen pops.


When you first require an ActiveX control you have not yet downloaded, Internet Explorer presents a security window (Figure 2-1).

Figure 2-1. Windows Download Security Warning

Click Yes to download the control. You need to download each control only once, when it is first required. If you select “Always trust content from Pegasystems” before clicking Yes, subsequent download operations occur without this security warning.

Note: If your Windows privileges or Internet Explorer settings do not let you download ActiveX controls, ask your technical staff for a temporary Windows Administrator or Power User sign on to enable downloads.

Getting Started 2-5

Changing Your Password A system administrator sets your initial password. You can change your password at any time.

To change your password:

1. From the Home Base, click the link associated with your name (top of the navigation panel). The Operator Profile Full Display appears (Figure 2-2).

Figure 2-2. Operator Profile Full Display


2. Click Change Password. The Change Password form appears (Figure 2-3).

Figure 2-3. Change Password Form

3. Enter your current password in the Verify Current field.

4. Enter your new password in the New field.

5. Enter the same password again into the New Confirm field.

6. Click Save to activate the new password.

Logging Off To log off CPM for Insurance, click the Log Off link at the top right left of the portal.

Caution: For security reasons, always log off before closing the browser window containing your application.

Whenever you remain inactive in the application for 20 minutes or more, you may be logged off automatically. You do not loose any completed work, but you must log on again to continue working.

Getting Started 2-7

Portal Views The CPM for Insurance portal has three main views:

■ Home Base

■ Interaction Manager (Initiate Work)

■ Interaction Manager (In Process)

Home Base Figure 2-4 shows the CSR Home Base, also known as the Dashboard view. This view is representative of what you see after you log on.

Figure 2-4. Home Base View of CSR Portal


Figure 2-5 briefly describes the gadgets that are available in each of the Task Bars, including Interaction Manger, Dashboard, and Analytics.

Note: Gadget functions are role-dependent and can vary. Appendix B contains examples of various portals and gadgets.

Task Bar Description

The Pega Logo or your company logo. Click the logo to return to the initial state of the portal from anywhere in the application.

Interaction Manager Click to perform CSR tasks (see Interaction Manager view section).

Dashboard Click to access the Home Base view containing the Reporting Dashboard. To monitor contact center activities, the dashboard provides statistical and tracking mechanisms in graphical form. For more information, see Chapter 6

Analytics Provides a comprehensive list of reports by category. For more information, see Chapter 6.

Manager Tools (not shown) Click to expose a set of tools that includes:

■ Quality Review Management — Supervisory functions that enable managers to evaluate and rate the quality of interactions and service items, and to use coaching tips to manage and improve employee performance.

■ Campaign Management — Supervisory functions that enable managers to view information and progress of cross-sell, retention, restitution, and reward campaigns.

■ Territory Management — Define and manage the ownership of policies, contacts, business units and geographic areas that drive assignments of opportunities.

Figure 2-5. Home Base Gadgets

Getting Started 2-9

Interaction Manager (Initiate Work) Figure 2-6 shows a representative view of the Interaction Manager after you click the Interaction Manager bar in the navigation panel.

Figure 2-6. Interaction Manager View (Initiate Work)


Gadget functions are role-dependent so can vary and be expanded. Figure 2-7 briefly describes the Interaction Manager gadgets in this view.

Gadget Description

Navigation Panel Two text areas, initially empty, appear in expanded format in the navigation panel:

■ Contact Information — displays a snapshot of the contact’s identity.

■ Interaction Log — displays step-by-step details of the current interaction and of additional steps left to perform. The log clears when the interaction ends.

My Work in Progress Displays a list of calls and other activities you are currently involved with. For more information, see Chapter 3.

Find Work Presents various ways of searching for specific case items. For more information, see Chapter 3.

My Group Provides access to other operators’ worklists and to workbasket contents. For more information, see Chapter 3.

Find a Contact or Policy Presents various ways of searching for a policy and contact information, for both live interaction and background research. For more information, see Chapter 3.

Enter New Work Enables you to create a new inbound correspondence case. For more information, see Chapter 3.

Figure 2-7. Interaction Manager Initiate Work Gadgets

Getting Started 2-11

Interaction Manager (In Process) Figure 2-8 shows a representative view of the Interaction Manager after you initiate some work, such as locating and verifying a customer.

Figure 2-8. Interaction Manager View (in Process)


Figure 2-9 briefly describes the Interaction Manager gadgets in this view.

Gadget Description

Interaction Manager Navigation Panel

Notice the effect on the navigation panel after locating and verifying a contact:

■ Contact Information — displays a snapshot of the contact’s identity.

■ Interaction Log — displays step-by-step details of the current interaction and of additional steps left to perform. The log clears when the interaction ends.

Dialog Manager Displays the script to use during customer interactions. The text changes to match the business process being performed. For information on how authorized users can customize dialog text, see Chapter 3.

Select Intent / Take Action Enables you to launch and execute business processes to respond to customer service requests. For more information, see Chapter 3.

Policy Holder Displays information about the policy holder including financials, recent transactions and interactions, and who is authorized to access the policy. The information appears in the Composite area.

Contact Displays information about the contact, including a personal profile, recent call history, and policy and business unit associations. The information appears in the Composite area.


Gadget Description

Policy Holder Displays information about the owner of the policy, including an SLA profile, recent call history, and business unit associations. The information appears in the Composite area.

Business Unit (not shown) Displays information about the business unit (if applicable), including a business profile, recent call history, and contact associations. The information appears in the Composite area.

Figure 2-9. Interaction Manager Gadgets


Understanding Icons and Controls in the User Interface This section describes icons and controls and shows you how to interact with these screen elements as you perform your tasks.

Working with Other Windows Depending on the activity, CPM for Insurance may open a separate window to display requested data. You can resize, move, and drag these windows. To close a floating window, click Submit, Close, or Cancel.

Click either the Pega logo or the Home link to return to your home base. (Your company logo may appear in place of the Pega logo.)

Common Icons and Controls Figure 2-10 lists and describes most of the common CPM for Insurance screen icons and controls that you use to enter or view data, or to take some action.

Buttons and Icons

Name

Description

Action button Click to send data on the form to CPM for

Insurance. For more information, see chapter 3.

Call Disposition Green

Indicates happy or satisfied customer interaction.

Call Disposition Red

Indicates unhappy or upset customer interaction.

Call Disposition Yellow

Indicates open issues that need to be addressed on an interaction.

Add or Edit Attachment

Presents selection of attachment options in a separate window.


Buttons and Icons

Name

Description

Calendar Click to select and insert a date from a calendar

into a date field. (You can also type in dates as explained on page 2-18.)

Close Closes everything displayed in the workspace.

Expand All Expands all currently unexpanded gadgets in

the workspace.

Collapse All Collapses all currently expanded sections in the

workspace.

Composite Area Bottom

Moves the composite data area to the bottom of the workspace and displays action frame at the top.

Composite Area Top

Moves the composite data area to the top of the workspace.

Split Action & Composite display

Sets the workspace to display the action frame at the top and the composite area on the bottom.

Refresh Composite Area

Refreshes the composite data area to provide up-to-date information.

View Content Indicates that the current work object is a

cover. Click to access the contents (associated work objects) of the cover.

Delete Click to delete an item from a list. Clicking the

icon deletes the item immediately. You are not prompted for confirmation.

Dialog Indicates a dialog script is displayed for this

interaction.

Dialog With Information

Indicates a dialog script is displayed with coaching tips available for the CSR.


Buttons and Icons

Name

Description

Help Displays help for a rule form.

View History Displays history of current interaction in a

separate window.

Image Viewer Indicates images are attached and accesses

the image attachments.

Add a Row Adds a row to the current form.

Location Finder Initiates search for geographic locations.

Lookup Initiates search.

Lookup Transaction

Initiates transaction search.

Open Rule Opens a rule instance.

Phone Displays desktop telephony functions.

Print Prints the current active gadget in the workspace.

Flag Alerts user that a Priority Note exists on an inquiry.

Reference Material

Displays window to initiate a search for reference materials.

Reopen Reopens a work object.

Display Current Customer Composite

Displays the customer composite area in a pop-up window.

Save Saves the rule instance.


Buttons and Icons

Name

Description

Show Prior Suggestion

Displays the prior suggestions made to a contact during an interaction.

Service Level Goal

Appears on the worklist when an assignment or case is not completed within it’s goal time.

Service Level Deadline

Appears on the worklist when an assignment or case remains incomplete past its service level deadline.

Spell Check Performs spell check on work object forms.

Transfer Initiates the transfer of a call.

Chart Indicates the report display contains a chart.

Expandable Gadget Indicator

Click the triangle pointing down to expand previously hidden information. The expanded gadget then becomes a collapsible gadget marked with a triangle pointing up.

Expandable Section Indicator

Click the right-facing triangle next to a gadget to expand the section to show previously hidden information. The expanded section then becomes a collapsible section, marked with the triangle pointing down.

Refresh Refreshes the information displayed in the workspace.

Where am I? On a worklist, pops-up an information box with basic details about a case. Also, opens a Visio flow diagram of the current workflow that pinpoints where you are in the process.

Figure 2-10. Workspace Buttons and Icons


Entering Data CPM for Insurance lets you enter data quickly with a minimum of keystrokes. The following sections contain instructions for entering:

■ Dates

■ Amounts

Dates CPM for Insurance supports multiple date display formats, known as locales, that are referenced in your operation profile. Your locale is the basis of the format of the date you see.. For example, if today is July 9, 2007, and your profile contains the:

■ en US locale, the date appears as 7/9/2007

■ en GB locale, the date appears as 9/7/2007

■ fr CA locale, the date appears as 2007-07-09


Some forms include a calendar icon ( ) to the right of date fields. You can type a date into the field or click the calendar icon to open a date selection calendar (Figure 2-11). Use the mouse to find the year, month, and day you need, and then click Close.

Figure 2-11. Pop-Up Date and Time Selector

Amounts The system displays dollar amounts with commas where appropriate. You can omit trailing zeros when entering amounts. For example, when you enter the disputed amount as 1234, CPM for Insurance displays 1,234.00. When you enter 1234.1, it displays 1,234.10.


Responding to Errors If you make an error completing a form, a red X ( ) indicates the field in error (Figure 2-12 shows an example). When you place your cursor over that icon, you are prompted with instructions about how to correct the error. (A common error is not entering data in a required field.) Correct the erroneous field(s) and submit the form again.

Figure 2-12. Error Indicator in the Workspace

Errors may also appear on forms to indicate a problem on the page. (Figure 2-13).

Figure 2-13. Error in Dialog area

Chapter 3 Working with CPM for Insurance

This chapter explains how to navigate the interface to perform the role of a Customer Service Representative (CSR) and covers the following topics:

■ Conducting a live customer interaction, such as a telephone call

■ Using CTI functions

■ Conducting a non-live customer interaction, such as ran e-mail inquiry

■ Processing service request cases (post-interaction)

■ Using reference utilities

■ Using supervisory functions

■ Using sales and marketing functions

For information about the:

■ Service flows, see Chapter 4, “Understanding CPM for Insurance Business Processing”

■ Insurance flow, see Chapter 5, “Understanding Insurance Business Process”

■ Sample flows, see Appendix A, “Sample Visio Flows”


■ CPM for Insurance portals, see Appendix B, “Default Portals”

Working with CPM for Insurance 3-3

Conducting Live Customer Interactions This section explains how to conduct a live interaction with a customer, for example, to respond to a telephone inquiry or a walk-in visit. It includes:

■ Identifying and verifying the customer

■ Processing service requests

■ Standard CPM business processes

■ Accessing customer information

■ Ending customer interactions

Identifying and Verifying the Customer A live interaction starts by identifying and verifying the customer. To start the interaction, select the Interact with a Customer option in the Find a Contact or Policy gadget located on the Interaction Manager view (see Chapter 2), as shown in Figure 3-1.

Figure 3-1. Find a Contact or Policy Gadget

Note: Your company may use PegaCALL for PegaRULES to provide CTI capabilities for your CPM for Insurance application. If it does, you may be notified of an incoming call via a screen pop. Depending on the information about the caller that your company’s interactive voice response (IVR) system captures, you may not need to perform search or verification processes. Refer to Using CTI Functions on page 3-25 for more information on CTI integration.


Search for a Customer The Dialog and Take Action gadgets change when you begin a customer search. Policy search options default into the display; however, the selection box also includes options to search for a contact, business unit, or work item (Figure 3-2). CPM for Insurance requires you, at minimum, to select a contact during a live interaction.

Figure 3-2. Customer Search Options


Enter search criteria and click Submit to initiate the search. The Take Action gadget changes to display search results. For example, Figure 3-3 shows results based on a search for a partial search for a policy number starting with FWW.

Figure 3-3. Policy Search Results List


Verify the Customer After you make a selection, the Take Action gadget changes to display caller verification information (Figure 3-4). The basis of verification data on the policy or contact information is defined by your company’s business rules.

Figure 3-4. Caller Verification

Verify the caller by asking one of the questions displayed in the Take Action gadget. After the caller provides the verification information, select the radio button next to the item and click Submit to continue. If you cannot verify the contact, select Contact Not Verified from the selection box, and click Submit to return to the original search form.


Processing Service Requests When you verify the caller, your view changes to display customer information and options for processing the caller’s service requests (Figure 3-5). Note that the contact information section on the left panel changes to reflect information about the caller. Likewise, the customer composite section of the view changes. The section now shows information about the policy, contact, and policy holder that was selected during search processing.

Figure 3-5. Interaction Manager after You Verify the Caller


Queuing Processes The Take Action area now displays options that let you select the business processes necessary to respond to the caller’s service requests. Figure 3-6 shows an example of the Select Intent screen.

Figure 3-6. Queuing and Launching Business Processes

The Select Intent screen within the Take Action gadget contains the following sections:

■ Suggested Processes — list the processes that CPM for Insurance has determined you may want to be use during this interaction. The basis of the list is information on the caller, policy profiles, and recent history. The suggestions are based on your company’s business rules. To select a suggested process, click the check box next to the process name. The process is added to the Queued Processes section to the right of the screen. The following icons may appear next to suggested processes:

− Target or clock — to help you understand the reason why the process is being suggested

− Light bulb — to show that a suggestion was previously made to the contact during an interaction


■ Other Processes — selection of a business processes from categorized lists (see Standard Business Processes on page 3-11 for a list of processes available with CPM for Insurance). When you select a process from the list, it is added to the Queued Process section to the right of the screen. You can also double-click to automatically start the process.

■ Queued Processes — list of processes queued for this interaction. In some cases, the system may automatically queue business processes required during the interaction. For example, in Figure 3-6 on page 3-8, CPM for Insurance has automatically queued two business processes, a suggested review of a complaint, and Wrap Up (end interaction business process).

Interaction Goals CPM for Insurance may display an interaction goal in the dialog area during a customer interaction. This goal reflects your company’s business rules and can be based on prior customer interactions, customer profile, or other information. CPM for Insurance may use this goal to present different dialog scripts to you for the customer or may use it to present suggested processes.

Launching Business Processes A gold arrow appears next to the process that is first in the queue. Click Submit to launch this process. To launch a process that is not the first in the queue, double-click the name within the queue.

To delete a process in the queue, click the trash can icon to the right of the business process name.

Note: Trash can icons do not appear next to business processes that are required for the interaction.


Executing Processes After you launch a business process, the Take Action and Dialog gadgets change to display the information and options appropriate for that business process. In some cases, the system may present one or more screens to guide you through the process. For example, the General Service business process first prompts you to enter transaction information (Figure 3-7).

Figure 3-7. Prompt to Enter New Address Information

The process then prompts you to confirm the transaction (Figure 3-8).

Figure 3-8. Prompt to Apply Address Change to Other Policies

Note: This icon indicates that the dialog contains a coaching tip the CSR. See Creating and Assigning Coaching Tips on page 3-56 for more information.


When you complete the business process, the Take Action gadget displays the Select Intent process selection and queue screen again. Continue to launch business processes until the interaction is complete.

Standard Business Processes Figure 3-9 lists the standard business processes available with CPM for Insurance. Based on your company’s implementation, additional or alternate business processes may be available. More information about these processes is available in Chapter 4, “Understanding CPM for Insurance Business Processing.” Check with your system administrator to find out which business processes are available on your system.

Process

Description

Category within Business Processes Menu

Add Contact Add a new contact Accessible via search functions

Communicate Message

Access a specific communications script (such as a new customer welcome message) that applies to the contact

Suggested by CPM for Insurance, based on your business rules

Complaint/Compliment Record a complaint or compliment during an interaction and present system-determined restitution or reward offers to a customer

General

Diagnose Issue Diagnose a problem or situation based on your company’s knowledge rules

General

Frequently Asked Questions (FAQ)

Browse and search for your company’s knowledge base topics

General

General Service Request

Create a general service item. Use this process to capture and route work when an automated workflow has not been created

General


Process

Description


Materials / Literature Order materials (such as product collateral or company information) to be sent to a customer

General

Modify Business Unit Links

View and maintain a list of a business units associated with a contact or policy holder

Contact and Policy Holder

Opportunity Add, view, and modify sales opportunities

General

Override SLA Set SLA profile overrides to designate priority handling of customer requests

General

Quick Add Contact Add a new contact (similar to Add Contact, but with fewer fields)

Accessible via search functions

Schedule Activity Schedule a follow-up call, task, or appointment during an interaction

General

Send Correspondence Generate an e-mail, fax, or mail document to a customer, based on available templates

General

Statement Copy Submit a statement photocopy request on behalf of a caller

Policy

Suggested Item Review

Review prior work item for a customer, as suggested by the system

Suggested Processes

Suggested Offers Select and present cross-sell and other offers to a customer

Generally available

Transaction Dispute Create a dispute-transaction case, at the request of the caller

Policy

Update Business Unit Address Details

View and maintain address information associated with a business unit

Business Unit

Update Business Unit Communication Details

View and maintain communication information associated with a business unit

Business Unit


Process

Description


Update Contact Communications Options

Update contact communication options

Contact

Update Contact Name and Profile

Change the contact’s name, and edit the personal profile

Contact

Figure 3-9. Table of Business Processes


Accessing Customer Information The customer composite area (Figure 3-10) consists of individual tabs or sections that display information about the policy, contact, and policy holder. Depending on your selections during search processing, some of these tabs or sections may not appear For example, if you did not select a policy during search processing, the policy and policy holder tabs are not visible.

Figure 3-10. Customer Composite Area


Use the controls at the right of the top gadget to reposition the composite area (including all individual sections) within the workspace:

■ Click to move the composite area to the top of the workspace, so that it overlays the Dialog gadget.

■ Click to move the composite area to the bottom of the workspace, so that only the top gadget appears.

■ Click to return the composite area to its original position.

■ Click to refresh the composite data area to provide up-to-date information.

Information in the customer composite areas may come from your legacy processing systems, from the CPM database, or from other third-party applications and databases within your organization.


Policy Composite Gadget The Policy Composite gadget (Figure 3-11) displays information about the policy you selected during search processing. This information enables you to respond to customer inquiries on recent transactions and statement, interactions and open service items, research prior interactions and service items; and document notes and comments.

Figure 3-11. Policy Composite Gadget

Note: During an interaction, you may need to access information about a different policy for the caller. To update the Policy Composite Gadget, you can select a different policy from the Policy Number selection box, or you can double-click on the policy in the policy list section of the Contact Composite.

Figure 3-12 lists and describes the sections within the Policy Composite gadget.


Policy Composite Sections Description Policy Information Displays general and financial information about the

policy; and the policy address information. Recent Transactions and Statements

Displays recent policy activity. Click on a Txn ID to view additional details about a transaction. Click a statement start date to view additional details about a statement. Use the search buttons to search for other transactions and statements for this policy.

Recent Interactions and Open Service Items

Displays recent interactions and open service items for this policy. Click any item to view additional details. The icon to the left of interactions provides feedback on the satisfaction of the caller (green is favorable; red is unfavorable, etc.). A colored icon to the left of an open service item indicates whether the case is past its goal (orange) or deadline (red) date. Use the search icon to search for other interactions or service items related to this policy by type and status.

Opportunities Displays opportunities and previous offers for this policy. Click any item to view additional details.

Authorized Contacts Identifies contacts associated with the policy; and includes their respective roles.

Notes Keeps a log of notes for this policy. Click Add Note to make an entry.

Figure 3-12. Policy Composite Sections


Contact Composite Gadget The Contact Composite gadget (Figure 3-13) displays information regarding the caller to whom you are speaking. This information enables you to view address and communication options; research prior interactions and service items for this caller; view associations this caller has with other policies and business units; and document notes and comments.

Figure 3-13. Contact Composite Gadget


Figure 3-14 lists and describes the sections within the Contact Composite gadget.

Contact Composite Sections Description

Address/Phone/E-mail Displays address and communications options for the contact. A check box next to an entry indicates the primary communication method.

Profile Displays personal information, communications and marketing preferences, and verification options for the contact.


Displays recent interactions and open service items for this contact. Click any item to view additional details. The icon to the left of interactions provides feedback on the satisfaction of the caller (green is favorable; red is unfavorable, etc.). A colored icon to the left of an open service item indicates whether the case is past its goal (orange) or deadline (red) date. Use the search icon to search for other interactions or service items related to this contact by type and status.

Opportunities Lists opportunities and previous offers for this contact. Click any item to view additional details.

Policy Lists other policies and business units linked to this contact.

Notes Keeps a log of notes for this contact. Click Add Note to make an entry.

Figure 3-14. Contact Composite Sections


Policy Holder Composite Gadget The Policy Holder Composite gadget (Figure 3-15) displays information pertaining to the owner of the policy. The sections within this gadget vary depending on whether the caller is the owner of the policy selected during search processing or whether another individual is the owner.

Figure 3-15. Policy Holder Composite Gadget


Figure 3-16 describes the sections within the Policy Holder Composite gadget.

Policy Holder Composite Sections

Description

Address/Phone/E-mail Displays address and communications options for the policy holder. A check box next to an entry indicates the primary communication method. If the contact is the owner of the policy, this section is not \visible.

Service Level Profile Identifies the SLA in effect and the name and duration of overrides, if any.


Displays recent interactions and open service items for this policy owner. Click any item to view additional details. The icon to the left of interactions provides feedback on the satisfaction of the caller (green is favorable; red is unfavorable, etc.). A colored icon to the left of an open service item indicates whether the case is past its goal (orange) or deadline (red) date. Use the search icon to search for other interactions or service items related to this policy holder by type and status. If the contact is the owner of the policy, this section is not visible.

Opportunities Lists opportunities and previous offers for this policy holder. Click any item to view additional details.

Policy Lists other policies and business units linked to this policy holder.

Figure 3-16. Policy Holder Composite Sections


Business Unit Composite Gadget The Business Unit Composite gadget (Figure 3-17) displays only if a business unit is selected during search processing, or if a business unit is the owner of the policy selected during search processing.

Figure 3-17. Business Unit Composite Gadget


Figure 3-18 describes the sections within the Business Unit Composite gadget.

Business Unit Composite Sections

Description

Address/Phone/E-mail Gives detailed information on how and where to reach the business unit.

Profile Categorizes the business by industry and size; Identifies the SLA in effect, and the name and duration of overrides, if any.


Displays recent interactions and open service items for this business unit. Click any item to view additional details. The icon to the left of interactions provides feedback on the satisfaction of the caller (green is favorable; red is unfavorable, etc.). A colored icon to the left of an open service item indicates whether the case is past its goal (orange) or deadline (red) date. Use the search icon to search for other interactions or service items related to this business unit by type and status.

Opportunities Lists opportunities and previous offers for this policy. Click any item to view additional details.

Contact, Policy, and Business Associations

Lists other contacts, policies, and businesses linked to this business unit.

Figure 3-18. Business Unit Composite Sections


Ending the Interaction The last business process in every live interaction is the Wrap Up. This business process is automatically queued by the system. To launch this business process, click Submit from the Select Intent screen in the Take Action gadget, or double-click the name in the queue list.

The system automatically evaluates and displays information regarding the primary reason for the interaction and whether the interaction relates to a prior service inquiry (Figure 3-19). If this information is not accurate, you can override it. You can also enter customer satisfaction information in the disposition area, as well as any general comments about the interaction.

Figure 3-19. Ending the Interaction

If you want to review any service items you created prior to ending the interaction, select items from the Interaction Log section of the Interaction Manager panel on the left portion of the screen. A separate pop-up window displays information regarding the service item.

Click Submit on the Finalize the Interaction screen within the Take Action gadget to complete the interaction. You return to the Interaction Manager Initiate Work view.


Using CTI Functions If your company uses PegaCALL for PegaRULES to provide CTI capabilities for your CPM for Insurance application, you can make and transfer calls and conduct conference calls directly from your application. Additionally, you are automatically prompted for incoming calls that are transferred to you.

This section covers the following CTI topics:

■ Logging in to CTI facilities and making yourself available for calls

■ Screen pops to announce the arrival of incoming calls

■ Telephony controls while on a call

■ Making a call

CTI Login and Availability You must be logged in to the CPM for Insurance’s CTI facilities before you can receive incoming calls or use telephony functions.

Note: This login procedure is separate from logging into the CPM for Insurance application.

To log in to CTI:

1. Click the telephone icon ( ) from the top of the portal to open the CTI Login form (Figure 3-20).

Figure 3-20. CTI Login Form

2. Enter your user ID, password, and your phone extension, and click Login.


3. The system confirms your login and sets your status as available to take calls. At this point, incoming calls can be routed or transferred to you (Figure 3-21). Additionally, you can make a call as described in “Making a Call” on page 3-28.

Figure 3-21. CSR Logged In and Available

4. To change your availability status, select Not Available. Calls can no longer be routed or transferred to you.

5. To log out of CTI functions, click Logout. No telephony functions are available to you.


Screen Pops Screen pops announce the arrival of incoming calls. A screen pop occurs in a separate window and its contents vary depending on what information is available about the caller. Figure 3-22 shows a sample of a screen pop.

Figure 3-22. Sample of a Screen Pop

■ To accept a call, click Accept. The system automatically begins a telephone interaction to log activities during the interaction (refer to the Live Interactions section of this chapter). Depending on the information known about the caller and the activities the customer performed within your company’s IVR system, CPM for Insurance may bypass search and verification processes. For example, if the customer entered verification data in the IVR, CPM for Insurance bypasses additional verification processes.

■ To decline a call, click Decline. The call is routed back to your company’s PBX system to be transferred to another available CSR.


When You Are on a Call When you make or take a call, the telephony controls change to provide flexibility in call handling (Figure 3-23).

Figure 3-23. Telephony Controls While on a Call

While on a call, you can use any of the following buttons:

■ Hold/Retrieve to place a call on hold or retrieve a call from a hold status. The Retrieve button is not visible unless a call is currently on hold.

■ Warm Transfer to transfer the call, first speaking to the transferee, before dropping off the line.

■ Blind Transfer to transfer the call without speaking to the transferee.

■ Conference to add parties to the call.

■ Hangup to end a call.

Making a Call

To make a call within CPM for Insurance: 1. Select a phone line.

2. Enter the phone number to dial. To access a predefined set of calling parties, place your cursor in the input box and press the down arrow key.

3. Click Dial to initiate the call.


Conducting Non-Live Customer Interactions This section explains how to conduct a non-live interaction with a customer, for example, to respond to e-mail, fax, or correspondence inquiries.

This section covers the following topics:

■ Creating non-live interaction cases automatically and manually

■ Selecting a non-live interaction case to work

■ Identifying the customer and processing service requests

■ Completing non-live customer interactions

Creating Non-Live Customer Interaction Cases

Automatic Case Creation CPM for Insurance automatically creates non-live interaction cases for inbound e-mail, fax, or correspondence inquiries depending on your system implementation. In a typical implementation, CPM for Insurance will:

■ Listen for inbound e-mails and faxes that arrive at designated folders and automatically create inbound interaction cases. CPM for Insurance routes these cases to the Inbound Correspondence workbasket.

■ Automatically create cases for inbound mail correspondence through integration with your company’s imaging system. CPM for Insurance routes these cases to the Inbound Correspondence workbasket.


Manual Case Creation You can also manually create non-live interaction cases for inbound e-mail, fax, or correspondence inquiries.

1. Select the Create Inbound Correspondence Case option within the Enter New Work gadget on the Interaction Manager view as shown in Figure 3-24.

Figure 3-24. Create Inbound Correspondence Case

2. Complete the information on the entry form (Figure 3-25). The Channel Type selection box includes the following values:

− E-mail

− Fax

− Mail

− Other

Figure 3-25. Create Inbound Correspondence Input Screen


3. Click Scan Document. The system initiates your local scanning software

4. Scan the document you wish to attach. The system updates the input screen as shown in Figure 3-26.

Figure 3-26. Create Inbound Correspondence Input Screen

5. Click Create Case. The system displays a confirmation that includes the case reference number (Figure 3-27), and routes the case to the Inbound Correspondence workbasket.

Figure 3-27. Create Inbound Correspondence Confirmation Screen


Selecting a Non-Live Interaction Case To work on a non-live interaction case, select it from the Inbound Correspondence Workbasket (see the section “To use the My Work in Progress gadget:” on page 3-38). You may also receive a non-live interaction case to work on, resulting from a search or Get Most Urgent operation.

After you select the case, your view changes to display information contained in the e-mail, fax, or mail (Figure 3-28).

Figure 3-28. Inbound E-mail Inquiry


To view attachments associated with the inquiry, such as attachments sent by a customer with an e-mail inquiry, click the attachment name. A separate window opens displaying the attachment contents.

Note: Your PC must have the necessary software installed to display the attachment. For example, if a customer included a MS Word attachment with their e-mail inquiry, you must have a copy of MS Word on your desktop in order to display the document.

Identifying the Customer and Processing Service Requests To process the non-live interaction, you must first identify the customer. The Take Action gadget displays search information for you to enter search criteria.

After you select the customer and policy, your system view changes to include the customer composite gadget as described in the Live Interaction section of this chapter. Unlike live customer interactions, no verification step is necessary. If your site has implemented custom parsing functions, or if an policy number or contact ID was manually entered when the case was created, the system may bypass customer identification. In this situation, you do not need to perform search operations, and the customer composite information is already visible.

To respond to the customer’s inquiry, select the appropriate business process from the Take Action gadget (see “Processing Service Requests Post-Interaction” on page 3-36.).


You can create service items to respond to this inquiry as well as send correspondence to the customer confirming the inquiry (Figure 3-29). Note that unlike live interactions, no dialog scripting is provided to you and no suggested processes are presented.

Figure 3-29. Responding to Inbound Correspondence


Completing Non-Live Customer Interactions Like live interactions, the last business process in every non-live interaction is End Interaction. The system automatically queues this business process. To launch the process, click Submit from the Select Intent screen in the Take Action gadget, or double-click the name in the queue list.

The system automatically evaluates and displays information regarding the primary reason for the interaction and the relationship of the interaction to a prior service inquiry. If this information is not accurate, you can override it.

If you want to review any of the service items you created prior to ending the interaction, you can select them from the Interaction Log section of the Interaction Manager panel on the left portion of the screen. A separate pop-up window displays information regarding the service item.

Click Submit on the Finalize the Interaction screen within the Take Action gadget to complete the interaction. You return to the Interaction Manager Initiate Work view.


Processing Service Requests Post-Interaction As a result of customer interactions, service cases are created that may require follow-up work or verification once the interaction is concluded. This section describes how you can find, research, and update service requests.

Finding Service Cases You can search for cases in the following ways:

■ Review your own worklist — My Work in Progress gadget

■ Provide search criteria — Find Work gadget

■ Review the worklists of other CSRs — My Group gadget

■ Review cases queued in workbaskets — My Group gadget

To use the My Work in Progress gadget:

1. From your home base, click Interaction Manager. The My Work in Progress gadget appears at the top of the workspace (Figure 3-30).

Figure 3-30. My Work in Progress Gadget

The My Work in Progress list displays your current assignments, sorted by urgency. Each row of the worklist describes one assignment for one case.


2. If your worklist contains more assignments than can be displayed, click the Expand link at the bottom of the list.

3. Click the row corresponding to an assignment you want to work on. The case opens in a form appropriate to its current status.

To use the Find Work gadget:

1. From your home base, click Interaction Manager. The Find Work gadget appears in the workspace (Figure 3-31). Click the triangle to expand the gadget, if necessary.

Figure 3-31. Find Work Gadget

2. Enter criteria as follows:

■ By ID — If you know the unique ID of the work object, enter it in the field and click Find. You can also open the work object in a separate window.

■ Search for work — If you don’t know a work object ID, use the Search for Work selection box to search for work through one of the following options:

− Entered by me

− Associated with me by a Party

− Resolved by me recently

− Assigned to me

− By workbasket

■ Get Most Urgent — This button opens the most urgent work object either from your worklist or from any of the workbaskets that typically feed your worklist.


To use the My Group gadget to review the worklists of other CSRs:

1. From your home base, click Interaction Manager. The My Group gadget appears in the workspace (Figure 3-32). Click the triangle to expand the gadget if necessary.

Figure 3-32. My Group Gadget for Other CSRs

2. Click the CSR whose worklist you want to review.

3. Select the case in the list to open it in a form appropriate to its current status.

To use the My Group gadget to review the contents of a workbasket:

1. From your home base, click Interaction Manager. The My Group gadget appears in the workspace (Figure 3-33). Click the triangle to expand the gadget if necessary.

Figure 3-33. My Group Gadget Workbaskets

2. Click the workbasket that contains the contents you want to review.

3. Select the case in the workbasket you wish to open. CPM for Insurance opens it in a form appropriate to its current status.


Researching and Completing Service Request Cases This section includes:

■ Reviewing a specific case summary and history

■ Adding notes and attachments to a case

■ Researching customer information

To review a case summary: 1. Select a case to review by selecting it from a worklist, using item

search facilities, or by selecting it from a customer composite gadget. A separate window opens, showing information about the item. The data contained in each display varies by the type of the item.


Figure 3-34 shows an example of a summary of a telephone interaction. In this example, you can see details about the call, the customer who made the call, and a list of all the service items created during the call.

Figure 3-34. Case Summary of a Telephone Interaction


2. To view case details, you can click any of the items created during the interaction. Figure 3-35 shows the case summary for an item changing the policy address.

Figure 3-35. Case Summary of a Policy Address Change


To review case history:

1. Click the View history icon on the upper-right portion of the case summary form. A separate window opens, showing the history of the call (Figure 3-36).

Figure 3-36. History Record for an Policy Change Item


2. To view the attachments listed, select the item from the list. A separate window opens, displaying the attachment (Figure 3-37).

Figure 3-37. Attachment to a Case


To add a note or an attachment to a work case:

1. Select the item you want to update.

2. Click the Add or edit attachments icon . The History and Attachments window opens (Figure 3-38).

Figure 3-38. Adding Notes or Attachments

3. Select the type of attachment you want to add. Your selection determines how the form changes.

4. Fill in the form with the information appropriate to your attachment choice.

5. Click Close.


To research customer information:

1. Open Interaction Manager and select the Perform Customer Research option from the Find a Contact or Policy section. You can search for a contact or policy without creating an interaction log for the activity.

2. Enter customer search criteria as described in the Live Interaction section of this chapter. Customer information displays in the composite gadget, as shown in Figure 3-39. From this view, you can view policy activity, recent interactions, and outstanding or completed cases for a customer or policy.

Figure 3-39. Research View

3. You can also initiate additional service item cases for this customer by selecting a business process from the selection box.


Using Reference Utilities The Reference Utilities give you access to your company’s reference information, accessed from icons at the top of your display.

■ — Location Finder

■ — Reference Materials

When you click the icon, a separate window opens

Location Finder 1. Click the Location Finder icon ( ) to search for a corporate location

Figure 3-40).

Figure 3-40. Location Finder Utility

2. Select a location type and enter additional search criteria if applicable, and then click Search. Results display below the search criteria area.

Reference Materials Reference Materials include your company’s product, service, and policy documentation and other informational resources you may want to consult during an interaction.

1. Click the Reference Materials icon ( ) to view available information (Figure 3-41).

Figure 3-41. Reference Materials Utility

2. Select a category and click an item to view the document.


Using Supervisory Functions This section describes functions and capabilities available to supervisors and managers. It covers the following topics:

■ Modifying dialog scripts

■ Reassigning work

■ Viewing campaign information and details

Note: Your role and access group must grant you authority to perform these functions.

Modifying Dialog Scripts The Dialog gadget displays suggested wording to use during customer interactions. The text changes to match the specific business process related to the interaction. To change the dialog script for a particular business process, select the text within the Dialog gadget. A separate window opens to enable you to update the dialog (Figure 3-42).

Figure 3-42. Update Dialog Gadget

Here, you can edit text, and add references to contact, policy, or CSR information. In addition to a default dialog section, the display includes a separate expandable section that enables you to create separate text for various CSR levels. To enter a reference to customer information, select the


category and field from the selection box, and click Append. To save the dialog, click Save.

Reassigning Work Use the Reassign Work gadget (Figure 3-43 ) to perform the following tasks:

■ Reassign work items from one CSR to another

■ Reassign work items from one workbasket to another

■ Perform specific actions on behalf of a selected CSR

■ Perform specific actions on a selected item class on behalf of a selected workbasket

Figure 3-43. Reassign Work Gadget

Note: Only authorized users (managers and supervisors) can reassign work. This gadget does not appear in your portal view if you are not an authorized user.


Conducting Quality Reviews CPM for Insurance enables authorized users to evaluate and rate the quality of interactions and service items for the purpose of managing and improving employee performance.

To select work to review: 1. From Manager Tools, open the Quality Review Management gadget.

Figure 3-44. Quality Review Management Gadget

2. Choose Select Work for Quality Review. Figure 3-45 appears.

Figure 3-45. Selecting Work for Quality Review


3. Enter the selection criteria for the work you want to review and click Next. Figure 3-46 appears.

Figure 3-46. Selecting Quality Sample Type

4. Choose random – to have the system select the items, or choose manual – to pick the items from a list; then enter the number of work cases to be chosen.

5. If you select a random sample, the system generates cases (up to the number you specified) that match the criteria you entered (Figure 3-47).

Figure 3-47. Random Selection of Work Items


If you choose a manual sample, the system presents you with a list of work items that match your criteria (Figure 3-48).

Figure 3-48. Manual Selection of Work Items

Check the work items to be reviewed and click Next. The detail information for the selected quality review appears (Figure 3-49).

Figure 3-49. Detail of Manual Selected Work Items


Your site’s rules determine the routing of the review. By default, the routing goes to the QualityReview workbasket.

To enter quality ratings: 1. Select the quality review item from the QualityReview workbasket. A

summary of the interaction or service item to review appears along with a survey rating form (Figure 3-50).

Figure 3-50. Enter Quality Review Ratings

2. Select the Work ID link. A pop-up window opens and displays the details of the work item.

3. Enter the quality ratings and reviewer comments and click Submit. The system calculates a total score and overall rating based on the ratings you enter (Figure 3-51).


Figure 3-51. Review Score and Determine Next Steps

4. Review the results, and indicate whether:

− A coaching session is recommended for this employee. If selected, the quality review is assigned to the employee’s manager to conduct the coaching session. If no manager is indicated in the system, the assignment gets routed to the CoachingSessions workbasket.

− A coaching tip should be assigned for this work type. See Creating and Assigning Coaching tips on page 3-56.

− The review is sent to the employee for comments. If selected, the quality review is assigned to the employee to review the ratings and enter comments.

− System enhancements are needed. If selected, the quality review is assigned to the SystemEnhancements workbasket for evaluation of suggested changes.

5. When you are finished, click Submit.


To view quality review results: Customer Process Manager allows authorized users to view rating information for quality reviews in several locations, including the following.

■ From the Manager Tools, click the Quality Review Management gadget (Figure 3-52) to display a list of Quality Review Reports. For more information about reports see Chapter 6, “Reporting.”

Figure 3-52. Quality Review Management Reports

■ When reviewing interactions or service objects, authorized users will see a Quality Review Summary section, if applicable (Figure 3-53). To see the Quality Review case, click on the Quality Review ID link (Figure 3-54).


Figure 3-53. Quality Review Listing

Figure 3-54. Quality Review Details Shown on Work Review


Creating and Assigning Coaching Tips Coaching tips help improve employee performance and reinforce best practices. Users with the appropriate privilege can create coaching tips for any screen that is available in a live customer interaction. Once created, you can assign the coaching tip to a user or to a workgroup. CPM for Insurance presents the tips appropriate for the user and the current process assignment (Figure 3-55).

Figure 3-55. Coaching Tips Displayed to Users

You can:

■ Create or modify coaching tips

■ Assign coaching tips to individual employees or work groups

■ Assign coaching tips during a quality review

■ Display assigned coaching tips


To create or modify a coaching tip:

1. From Manager Tools, open the Quality Review Management section and select Create or Modify Coaching Tips. Figure 3-56 appears.

Figure 3-56. Quality Review Management Gadget

2. Click Create or Modify Coaching Tips. Figure 3-57 appears.

Figure 3-57. Search for Coaching Tips

3. Enter the search criteria and click Next.

− If CPM for Insurance does not find a coaching tip, Figure 3-58 appears, letting you proceed with adding a new tip. Go to Step 4.

− If CPM for Insurance finds a coaching tip, Figure 3-59 appears. Go to Step 5.

Figure 3-58. Add New Tip, Select RuleSet and Version


Figure 3-59. Modify Existing Tip

4. Select the RuleSet and RuleSet Version in which you want to save the new tip and click Next.

5. Add new coaching information or update the existing coaching tip and click Finish. CPM for Insurance saves the coaching tip.

To assign a coaching tip:

1. From Manager Tools, open the Quality Review Management section and select Assign Coaching Tips. Figure 3-60 appears. You can search by user, workgroup, or coaching tip. The examples that follow show a search by Operator for a coaching tip.

Figure 3-60. Search for Coaching Tips


2. Based on your selection in Step 1, Figure 3-61 appears requesting additional information. Complete the form and click Next to continue.

Figure 3-61. Additional Search Criteria

3. Select the tips. Follow the on-screen instructions to add, delete, or modify a tip. Click either Delete or New (Figure 3-62).

Figure 3-62. Select Coaching Tip

3. When done, click Next.

4. Click close to exit this workflow.

Reviewing Customer Satisfaction Surveys Based on your site’s configuration, CPM for Insurance may send e-mail surveys to customers to measure how satisfied they were with their interactions. The system automatically scores these surveys. Completed surveys can be routed for review based on the overall survey ratings of your company.


1. Select the Customer Satisfaction Survey item from the Survey Review workbasket. A reference to the interaction type and overall survey rating as entered by the customer appears (Figure 3-63).

Figure 3-63. Review Customer Satisfaction Ratings

2. Select the Interaction ID link to open a pop-up window with details of the original interaction item.

3. Enter any review comments and click Submit.


To view customer satisfaction results: Customer Process Manager allows authorized users to view information on customer satisfaction surveys in several locations, including the following.

■ Click on the Customer Satisfaction Survey Reports gadget on their reporting view (Figure 3-64) to display a list of reports. For more information about reports, see Chapter 6, Reporting.

Figure 3-64. Customer Satisfaction Survey Reports

■ When reviewing interaction objects that have completed surveys, you can review the detailed information, by clicking the Survey Case ID link in the Satisfaction Survey Summary section. Figure 3-65 appears.

Figure 3-65. Customer Satisfaction Survey Detail


Using Sales and Marketing Functions The sales and marketing functions are:

■ Campaign Management

■ Territory Management

■ Opportunity Processing

Campaign Management

The Campaign Management gadget enables managers and supervisors to manage and monitor cross-sell, retention, restitution, and reward campaigns.

Note: The Reports gadget (described in Chapter 6, “Reporting”) includes a set of Campaign Reports that allow you to review the status of past, current, and future campaigns by type; review campaign statistics and scripts; and generate reports to examine campaign results.

To Add a New Campaign: From the Manager Tools bar, open the Campaign Management section and select Add New Campaign (Figure 3-66).

Figure 3-66. Campaign Management Gadget


The system initiates the Campaign wizard and automatically takes you through the steps required to create the campaign:

1. Entering rule data

2. Entering campaign data

3. Entering campaign criteria

4. Entering campaign scripts

5. Saving the campaign

6. Viewing the campaign summary

The following pages describe each of these steps.

Step 1: Enter Rule Data

1. Enter the appropriate rule data on the input form (Figure 3-67).

Figure 3-67. Enter Rule Data


− RuleSet — Contact your system administrator for the appropriate value to enter.

− RuleSet Version — Contact your system administrator for the appropriate value to enter.

− Class Name — Contact your system administrator for the appropriate value to enter.

− Campaign Name — Enter a name for the campaign (do not include spaces).

− Product ID — Select a product ID associated with the campaign. To access a predefined set of product IDs, place your cursor in the input box and press the down arrow key.

2. Click Next. The wizard moves to Step 2.

Step 2: Enter Campaign Data

1. Enter the appropriate campaign details (Figure 3-68).

Figure 3-68. Enter Campaign Data

− Campaign Name — is the name you entered in Step 1.

− Campaign Type — use the selection box to specify the campaign type.


− Start Date — select the date the campaign is to begin.

− End Date — select the date the campaign is to end.

− Offer Repeat Frequency — enter the number of days to elapse before an offer is repeated to a customer.

− Offer Priority — enter the priority ranking that the system is to use if the customer qualifies for multiple offers.

− Fulfillment Package ID — enter a reference number or the collateral ID number to identify the information you want sent to the customer.


Step 3: Enter Campaign Criteria

1. Enter the Intent — the rule that defines a selection criterion, as shown in Figure 3-69.

Figure 3-69. Enter Campaign Criteria

2. Optionally, click Add New Intent to add multiple intents.



Step 4: Enter Campaign Scripts

1. Enter the names of the campaign and objection scripts to use for this campaign (Figure 3-70).

Figure 3-70. Enter Campaign Scripts

− Campaign Script — used to describe the offer.

− Mail Template — select the mail template you want to use or click add/Update Mail Template to add a new or modify an existing template.

− Email Template — select the -mail template you want to use or click add/Update Email Template to add a new or modify an existing template.

− Objection Script — used to respond to an objection presented by the contact.

Note: If necessary, you can add multiple objection scripts.


2. Click Add/Update Script to enter or modify the text for the script. The system displays an input form (Figure 3-71).

Figure 3-71. Update Script Form

3. Enter the text and click Save. The system returns to the Enter Campaign Scripts screen (Figure 3-70).

4. Optionally, continue to add Objection scripts or click Next. The wizard moves to Step 5.

Step 5: Save Campaign 1. Indicate whether the campaign is to be available immediately

(Figure 3-72).

Figure 3-72. Save Campaign

2. Click Finish. The system saves the campaign and moves to Step 6


Step 6: View Campaign Summary

1. Review the campaign details summary (Figure 3-73).

Figure 3-73. View Campaign Summary

2. Click Done to complete the process.

To view an existing campaign:

1. From the Manager Tools bar, open the Campaign Management section and select View Campaign Details (Figure 3-74).

Figure 3-74. Campaign Management Gadget


2. The system displays a list of open campaigns (Figure 3-75). To see the details of a campaign, click on the Campaign. The details appear in the lower portion of the screen.

Figure 3-75. Campaign List and Detail

To maintain an existing campaign:

1. Select an existing campaign as described in the previous section.

2. From the Campaign Details screen, click Maintain Campaign The system displays the Enter Campaign Data screen from the Campaign wizard.

3. Modify the information as required, and complete the remaining steps as described in “To Add a New Campaign” on page 3-62.


Territory Management Territory management enables authorized users to define the ownership of policies, contacts, business units, and geographic areas to drive the assignment of opportunities.

To access Territory Management, expand the Territory Management section and select Register/View Territories. You can register or view a territory assignment by using either of the following methods:

■ Named Customer Registration — to assign a representative to a specific customer

■ Territory Characteristics Registration — to assign a representative and broker to a territory such as a geographic area, a postal code, or an area code

To search for a named customer registration:

1. From the Territory Management wizard, select Register / New Territory Search type. Figure 3-76 appears.

Figure 3-76. Select Search Type


2. Select Named Customer Registration and click Next. Figure 3-77 appears.

Figure 3-77. Named Customer Search Options

3. Select Search for a Policy and click Next. Figure 3-78 shows the Named Customer Policy m,lk list and enables you to take other actions.

Figure 3-78. Named Customer Account List

4. Make your updates and click Submit.


To search for a territory characteristic registration:

1. From the Territory Management wizard, select Register / New Territory Search type. Figure 3-79 appears.

Figure 3-79. Select Search Type

2. Select Geographic Territory Registration and click Next. Figure 3-80 appears.

Figure 3-80. Territory Characteristics Registration Search


3. Enter the appropriate data on the input screen and click Next. Figure 3-81 appears showing the results of your search.

Figure 3-81. Territory Characteristics Registration Search

If the search yields no result, you can search again or choose add. If you choose add, Figure 3-82 appears.

Figure 3-82. Territory Characteristics Add a Territory

4. Complete the Add screen and click Submit.


Opportunity Processing You can create opportunities in the context of a live or non-live interaction, or as part of a research session. After you create the opportunities, sales representatives, sales managers, and other authorized users can continue to work with these opportunities.

To Add a New Opportunity: Instructions for adding a new opportunity are included in “Entering a Sales Opportunity” in Chapter 4, “Understanding CPM for Insurance Business Processing.”

Opportunity Assignment When an opportunity is created, the system routes the request to the worklist for the appropriate sales representative, according to Named Customer and/or Territory Characteristic registrations. For more information on routing logic, see Chapter 4, “Understanding CPM for Insurance Business Processing.”

If the system does not find named customer or territory registrations, it assigns the opportunity to the Opportunities workbasket where any authorized user can access it.

My Opportunities Authorized users can expand the My Opportunities gadget in their portal view to see a list of the opportunities assigned to them (Figure 3-83).

Figure 3-83. My Opportunities


To work on an opportunity, click on the individual item. You can perform activities including sending correspondence or material fulfillment, and schedule activities such as calls, tasks, and appointments. For more information, see Chapter 4, “Understanding CPM for Insurance Business Processing.”

Opportunity Reporting Refer to Chapter 6, “Reporting” for a list of available opportunity reports.

Chapter 4 Understanding Business Processing Flows

Business Processing in CPM for Insurance is controlled by flows. Many flows interact with each other to determine which screens you see and what processing occurs in the background. CPM for Insurance includes these types of flow classes:

■ Service flows process customer service requests during interactions.

■ Customer management flows are used to maintain links between customers, contacts, providers, and business units.

■ Interaction flows guide CSRs communication with customers or contacts as described in Chapter 3, “Working with CPM for Insurance.”

Appendix A, “Workflow Descriptions” lists the classes, names, and descriptions of all the flows.

This chapter provides information about key customer management and service flows that CSRs will frequently use when processing interactions. Figure 4-1 lists the flows in this chapter.


Chapter 5, “Understanding Insurance Business Processing.” provides information about insurance-specific flows that a CSR will use to add a new policy application, change a policy, or process a claim against a policy.

Understanding Business Processing Flows 4-3

Key Business Processing Flows

The following is a list of flows that are described in this chapter.

Process

Description


Page Number

Add Business Unit Add a new business unit Accessible via search functions

4-5

Add Contact Add a new contact Accessible via search functions

4-11

Communicate Message Access a specific communications script (such as a new customer welcome message) that applies to the contact

Suggested by CPM for Insurance, based on your business rules

4-16

Complaint/Compliment Record a complaint or compliment during an interaction and present system-determined restitution or reward offers to a customer

General 4-18

Diagnose Issue Diagnose a problem or situation based on your company’s knowledge rules

General 4-21

Frequently Asked Questions (FAQ)

Browse and search for your company’s knowledge-base topics

General 4-24

General Service Case Create a general service item. Use this process to capture and route work when an automated workflow has not been created.

General 4-30

Material Fulfillment Order materials (such as product collateral or company information) to be sent to a customer

General 4-33


Process

Description


Page Number

Opportunity Add, view, and modify sales opportunities

General 4-42

Override SLA Set SLA profile overrides to designate priority handling of customer requests

General 4-50

Quick Add Contact Add a new contact (similar to Add Contact, but with fewer fields)

Accessible via search functions

4-52

Schedule Activity Schedule a follow-up call, task, or appointment during an interaction

General 4-55

Send Correspondence Generate an e-mail, or fax, or mail document to a customer, based on available templates

General 4-58

Statement Copy Submit a statement photocopy request on behalf of a caller

Account 4-61

Item Review Review prior work item for a customer, as suggested by the system

Suggested Processes 4-65

Suggested Offers Select and present cross-sell and other offers to a customer

Generally available 4-67

Transaction Dispute Create a dispute-transaction case, at the request of the caller

Account 4-75

Update Contact Communication Options

Update contact communication options Contact 4-79

Update Contact Name and Profile

Change the contact’s name, and edit the personal profile

Contact 4-82

Figure 4-1. Flows Described in This Chapter


Adding a Business Unit The Add Business Unit flow lets you update external systems with a new business unit (Figure 4-2).

Figure 4-2. Flow Diagram for Add Business Unit Flow


Available actions include:

■ Add New Business Unit

■ Add Primary Communication

■ Add Additional Details

Add New Business Unit This action adds a new business unit. It is available when you search for business unit information. The AddBusinessDetails flow shape performs this step.

To create a new business unit: 1. Select Find a Business Unit from the Take Action Selection box.

Figure 4-3. Search Section

2. Enter your search criteria and click Submit.


3. From the search results screen, select the action Add New Business Unit from the Take Action selection box and click Submit.

Figure 4-4. Take Action Selection Box

CPM for Insurance displays a form for the business unit information (Figure 4-5).

Figure 4-5. New Business Unit Section


4. Enter the information for the business unit. The business unit name, status, industry code, customer type, and primary address fields are required.

Figure 4-6. Business Unit Details Section

5. Click Submit.


Add Primary Communication This action adds information about the communication options to the business unit record. This AddPrimaryCommunication flow shape performs this step.

1. CPM for Insurance displays a form to add the business unit’s primary communication options information.

Figure 4-7. Add Primary Communication Section

2. Enter the communication options for the business unit:

− Select a primary phone destination (home, business, mobile, emergency, pager, or Telex) and enter the number.

− Select a primary fax destination (home or business) and enter the number.

3. Click Submit.


Add Additional Details This action is optional and lets you add additional address or communication information to the business unit record. The AddAdditionalDetails flow shape performs this step.

1. CPM for Insurance displays a form for the business unit details (Figure 4-8).

Figure 4-8. New Business Details Section

2. Select Add Additional Business Address from the Take Action selection box. An Additional Addresses section appears. Enter address information, and click Submit. To add more contact information for this business, repeat this step.

3. Select a communication type, enter communication option information, and click Submit.

4. When you finish adding information, click Submit.

Business Processing CPM for Insurance updates the external system with the business unit information. This flow makes an entry in the interaction log, but does not create a separate work object.


Adding a Contact The Add Contact flow lets you add a new contact to external systems (Figure 4-10).

Figure 4-9. Flow Diagram for Add Contact Flow



■ New Contact

■ Enter Contact Communication Options

■ Enter Primary Contact Addresses

■ Enter Additional Contact Addresses

New Contact This action adds a new contact. It is available as a selection in the Take Action box when you review search results for a policy or contact. The NewContact flow shape performs this step.

To create a new contact: 1. From a search results screen, select Create New Contact from the

Take Action selection box (Figure 4-10).

Figure 4-10. Create New Contact Selection


2. Click Submit. CPM for Insurance displays a form for the customer’s contact information (Figure 4-11).

Figure 4-11. New Contact Section

3. Enter the information for the contact. The first name, last name, gender, communication preferences, and verification settings fields are required.

4. Click Submit


Enter Primary Contact Addresses This action adds address information to the contact record. This step is part of the AddContactAddress shape of the flow.

1. CPM for Insurance displays the customer’s contact information form (Figure 4-12).

Figure 4-12. Primary Contact Addresses Section

2. Select the address type — billing, business, home, secondary, service, or shipping.

3. Enter the address information and click Submit.


Enter Contact Communication Options This action adds information about the communication options to the contact record. The AddContactCommunicationOptions flow shape performs this step.

1. CPM for Insurance displays a form for the contact’s communication options information (Figure 4-13).

Figure 4-13. Update Contact Communication Options Section

2. Enter communications options for the contact. Information is optional except for the preferred communication option, which you specified on the previous screen:

− Select a primary phone destination (home, business, mobile, emergency, pager, or Telex) and enter the number.

− Select a primary fax destination (home or business) and enter the number.

4. Click Submit.

Business Processing CPM for Insurance updates the external system with the new contact information. This flow makes an entry in the interaction log, but does not create a separate work object.


Communicating a Message The Communicate Message flow lets you deliver a customer-specific message, selected according to your company’s business rules. For example, this could be a welcome message for new customers. The steps required to perform this task are included in a single action — Communicate Message. The Communicate Message flow diagram shows the steps to deliver a customer-specific message.

Figure 4-14. Flow Diagram for Communicate Message Flow


Communicate Message This action lets you deliver a message to a customer. The DisplayMessage flow shape performs this step.

To communicate the message: CPM for Insurance displays the text of the message (Figure 4-15). Click Submit to deliver the message to the customer.

Figure 4-15. Communicate Message Section

Business Processing This flow makes an entry in the interaction log, but does not create a separate work object.


Entering Complaints or Compliments The Complaint/Compliment flow is used when a complaint or a compliment is received from a customer. The flow processes the complaint and also retrieves applicable restitution or reward offers based on your company’s campaigns. Figure 4-16 shows the processing steps.

Figure 4-16. Flow Diagram for Complaint/Compliment Flow



■ Complaint or Compliment

■ Process Offer

■ Accept Offer

■ Confirmation of Offer Presentation

■ Confirmation of Complaint

Complaint or Compliment This action lets you specify the specific issue that the customer is reporting. The GetComplaint flow shape performs this step.

To specify the complaint or compliment:

1. Select the Complaint or Compliment action from the Take Action selection box. CPM for Insurance displays selection boxes for the category and reason (Figure 4-17).

Figure 4-17. Complaint Details Section

2. Use the selection boxes for Category and Reason to specify the type of issue that the customer is concerned about. Enter comments and any other information, if appropriate, and click Submit.


Business Processing CPM for Insurance checks to see if the customer meets specified campaign criteria for your company’s restitution and reward campaigns and displays the appropriate offers.

■ If there are offers, the Complaint/Compliment flow calls the Suggested Offers flow. If the customer accepts the offer, CPM for Insurance routes the request to the Opportunities workbasket for further processing. If the customer does not accept the offer, CPM for Insurance routes the complaint or compliment to the Complaints workbasket.

■ If there are no appropriate offers, the flow advances immediately to the Confirmation of the complaint.

Users with access to the Opportunities or Complaints workbaskets can later retrieve the item and edit it, cancel it, or attach a file, screen shot, or note. Depending on your site’s business needs and configuration, this flow may be further automated.

Note: For the detailed steps to Process, Accept, Confirm, or Reject the offer, see “Presenting a Suggested Offer” on page 4-79.


Diagnosing Issues The Diagnostic Issue flow prompts you with the questions needed to diagnose a problem or situation (Figure 4-18). These questions are based on your site’s business needs and configuration. More than one diagnostic process may be available on your system.

Figure 4-18. Diagnose Issue Flow Diagram


■ Diagnose Issue

■ Confirm Knowledge Topic


Diagnose Issue This action lets you diagnose problems or situations defined by your site’s rules. The Diagnose Issue flow shape performs this step.

To diagnose an issue: Enter the requested information as prompted by the system and click Submit. CPM for Insurance iteratively prompts with additional questions based on your site’s rules. If you change a previous entry, CPM for Insurance reviews the change and determines if you need to re-enter any questions. When the diagnostic procedure completes, click Submit a final time (Figure 4-19).

Figure 4-19. Diagnose Issue Section

Figure 4-20. Diagnose Issue Section – Additional Questions


Confirm Knowledge Topic This action lets you enter any additional research actions required to resolve this diagnostic process. You can also enter any suggested changes to the knowledge topic. The Confirm Knowledge Topic shape of the Wrap Up Knowledge Process flow performs this step (Page 4-27).

Business Processing Inquiries that require further research are routed by CPM for Insurance to the General Service workbasket. Users with access to this workbasket can later retrieve the item and update it, cancel it, or attach a file, screen shot, or note to it.

CPM for Insurance routes suggested changes to topics to the Knowledge Update workbasket. Users with access to this workbasket can later retrieve the item to review suggested changes and indicate if changes will be implemented.


Using Frequently Asked Questions The Frequently Asked Questions (FAQ) flow lets you browse and search your site’s knowledge topics that can include documents, web sites, and other content (Figure 4-21). More than one FAQ process may be available based on your site’s business needs and configuration.

Figure 4-21. Frequently Asked Questions Flow Diagram


■ Browse or Search for Topics

■ Confirm Knowledge Topics


Browse or Search Topics This action lets you browse or search for frequently asked questions and knowledge topics by category. The Identify Topic flow shape performs this step.

To browse topics: Select the topic category and click Submit. A list of topics for the category displays, sorted by the number of “hits,” which is the number of times the topic resolved FAQ inquiries for this category (Figure 4-22). To display the contents for a category, click the View Content link next to the topic.

Figure 4-22. Browse Topics Section


To search for topics: Select the Search Topics option from the Take Action selection box,. Enter search text and click Search to see a list of topics that include the text you entered (Figure 4-23). To display the contents for a category, click the View Content link next to the topic.

Figure 4-23. Search Topics Section


Confirm Knowledge Topic This action lets you enter any additional research actions required to satisfy the customer inquiry. You can also enter any suggested changes to the knowledge topic. The ConfirmKnowledge shape of the Wrap-Up Knowledge Process flow (Figure 4-24) performs this step. It is also called by Frequently Asked Questions (FAQ) flow and Diagnostic Issue flow.

Figure 4-24. Wrap-Up Knowledge Process Flow Diagram


To confirm the knowledge topic: Indicate whether additional research is required to complete the customer inquiry, and enter research notes shown in Figure 4-25. To suggest a change to the knowledge topic content, enter your suggestions, and click Submit.

Figure 4-25. Confirm Knowledge Topic Section

Click submit to proceed, the following screen appears Figure 4-26).

Figure 4-26. FAQ Confirmation of Search Topics


Business Processing Inquiries to CPM for Insurance that require further research are routed to the General Service workbasket. Users with access to this workbasket can retrieve the item and update it, cancel it, or attach a file, screen shot, or note to it.

Suggested changes to knowledge topics are routed to the Knowledge Update workbasket. Users with access to this workbasket can retrieve the item to review the suggestions and decide whether they are implemented.


Creating a General Service Item The General Service flow is used to create a general service item to capture and route work when an automated workflow does not exist (Figure 4-27). The steps required to perform this task are included in a single action — Enter Request Details.

Figure 4-27. Flow Diagram for General Service Case Flow


Enter Request Details This action lets you specify details about the type of service item you may want to create and are part of the Get Reason shape on the flow.

To enter request details: 1. Select the Enter Request Details action from the Take Action selection

box. CPM for Insurance displays an input screen (Figure 4-28).

Figure 4-28. Request Details Section

2. Enter the appropriate information and click Submit. CPM for Insurance displays a confirmation screen (Figure 4-29).

Figure 4-29. General Service Item Confirmation

3. Review the confirmation and click Submit.


Business Processing CPM for Insurance routes the item to the GeneralService workbasket for further processing. Users with access to the GeneralService workbasket can later retrieve the item and edit it, cancel it, or attach a file, screen shot, or note. Depending on your site’s business needs and configuration, this flow may be further automated.


Sending Material The Material Fulfillment flow is used to select material, such as marketing collateral, to be sent to a customer. The flow also lets you specify the distribution method.

Figure 4-30. Flow Diagram for Request Material Fulfillment Flow



■ Select Material List

■ Select Distribution Method

■ Confirmation of Materials Fulfillment

Select Material This action lets you select the specific material that the customer would like to receive. The CAMaterialFulfillment flow shape performs this step.

To select material:

1. Choose the Select Material List action from the Take Action selection box. CPM for Insurance displays a list of your company’s material (Figure 4-31).

Figure 4-31. List of Material Section

2. Enter the requested information and click Submit.


Select Distribution Method This action lets you specify the distribution method that the customer prefers. The SelectDistributionMethod flow shape performs this step.

To specify the distribution method:

1. Choose the Select Distribution Method action from the Take Action selection box. CPM for Insurance displays distribution information (Figure 4-32).

Figure 4-32. Distribution Details Section



Confirmation of Materials Fulfillment This step confirms the details of the request and displays the case number, fee charged, goal and deadline dates, and enables you to resolve the materials fulfillment request (Figure 4-33). The AssignToWorkBasket flow shape performs this step.

Figure 4-33. Flow Diagram for Resolve Material Fulfillment Flow


To confirm the request: CPM for Insurance displays the details of the request ( Figure 4-34). Review the details and click Submit.

Figure 4-34. Confirmation Section

Business Processing CPM for Insurance routes the request to the MaterialFulfillment workbasket for further processing. Users with access to the MaterialFulfillment workbasket can later retrieve the item and edit it, cancel it, or attach a file, screen shot, or note. Depending on your site’s business needs and configuration, this flow may be further automated.


Modifying Business Unit Links The Modify Business Unit Links flow is used to add or remove a link between a contact and an account (Figure 4-35).

Figure 4-35. Flow Diagram for Modify Business Unit Links Flow


■ Search for Business Units to Link

■ Link a New Business Unit to a Contact

■ Verify – Link a New Business Unit


Search for Business Units to Link This action lets you search for the business unit to which you want to link. This step is performed by the ModifyContactBUAssociations flow shape.

To search for business units:

1. Select the Search for Business Units to Link action from the Take Action selection box. CPM for Insurance displays a list of business units currently linked to the contact (Figure 4-36).

Figure 4-36. Search for Business Units Section

2. Enter the business unit name or business unit ID number and click Submit.


Link a New Business Unit to a Contact This action lets you specify the relation that the contact should have to the business unit. The SearchForBUsToLink flow shape performs this step.

To link a business unit to a contact:

1. Select the Link a New Business Unit to a Contact action from the Take Action selection box. CPM for Insurance displays a list of business units that match your search criteria (Figure 4-37).

Figure 4-37. Association Section

2. Select the account and the relation and click Submit.


Verify – Link a New Business Unit This action lets you verify the new link information. The VerifyAddNewLink flow shape performs this step.

To verify the link: CPM for Insurance displays the details of the link (Figure 4-38). Review the details and click Submit.

Figure 4-38. Verify Link Section

Business Processing CPM for Insurance updates the external system with new or updated link information. This flow makes an entry in the interaction log, but does not create a separate work object.


Entering a Sales Opportunity The Opportunity flow is used to enter and process information about a sales opportunity (Figure 4-39).

Figure 4-39. Flow Diagram for Opportunity Flow

Available actions (listed below) are described in this section.

■ Enter Opportunity Details

■ Confirmation of Opportunity


Enter Opportunity Details This action lets you enter initial information about the opportunity. The EnterDetails flow shape performs this step.

To enter opportunity details:

1. Select the Log Sales Opportunity action from the Take Action selection box. CPM for Insurance displays a blank screen similar to Figure 4-40.

Figure 4-40. Opportunity Details Section

2. Enter the requested information. Click the Insert a row icon . From the drop-down box, select products.

3. Click Submit. CPM for Insurance uses the Association Option to make routing decisions. See Business Processing on page 4-45 for more information about these routing decisions.


Confirmation of Opportunity This step confirms the details of the opportunity and displays the case number, fee charged, goal and deadline dates, and status. The ProcessOpportunity flow shape in Handle Opportunity Flow (Figure 4-64) performs this step. This flow is in the section for “Presenting a Suggested Offer” because both the Suggested Offers flow and the Opportunity flow use the Handle Opportunity flow for this confirmation section.

To confirm the opportunity: CPM for Insurance displays the details of the opportunity (Figure 4-41). Review the details and click Confirm.



Business Processing CPM for Insurance routes the opportunity to the worklist of an individual sales representative using this logic:

■ CPM for Insurance first attempts to find named customer registrations:

− If you selected the Association Option “Contact & Policy,” and the Policy has an assigned representative, CPM for Insurance routes the opportunity to the worklist of the assigned representative.

− If you selected the Association Option “Contact & Business Unit,” and the Business Unit has an assigned representative, CPM for Insurance routes the opportunity to the worklist of the assigned representative.

− If you selected the Association Option “Contact,” and the Contact has an assigned representative, CPM for Insurance routes the opportunity to the worklist of the assigned representative.

■ If there are no named customer registrations, CPM for Insurance next evaluates the territory registrations in the following order:

− If you selected the Association Option “Contact & Policy,” CPM for Insurance compares the policy characteristics with territory registrations. CPM for Insurance evaluates characteristics in the following order: postal code, area code, state, county, country. If CPM for Insurance finds a match, it assigns the opportunity to the representative with that territory registration. If it finds multiple territory matches, it assigns the opportunity to the one listed as primary.

− If you selected the Association Option “Contact & Business Unit,” CPM for Insurance compares the Business Unit characteristics with territory registrations. CPM for Insurance evaluates characteristics in the following order: postal code, area code, state, county, country. If CPM for Insurance finds a match, it assigns the opportunity to the representative with that territory registration. If it finds multiple territory matches, it assigns the opportunity to the one listed as primary.


− If you selected the Association Option “Contact,” CPM for Insurance compares the Contact characteristics with territory registrations. CPM for Insurance evaluates characteristics in the following order: postal code, area code, state, county, country. If CPM for Insurance finds a match, it assigns the opportunity to the representative with that territory registration. If it finds multiple territory matches, it assigns the opportunity to the one listed as primary.

If CPM for Insurance does not find named customer or territory registrations, CPM for Insurance assigns the opportunity to the Opportunities workbasket.

Authorized users can later retrieve the opportunity from their worklist or from the Opportunities workbasket. They can then edit the opportunity, cancel it, assign it to another user, resolve it as a won or lost sale, or attach a file, screen shot, or note. In addition, users can perform related activities such as Send Correspondence, Material Fulfillment, and Scheduled Activities (Call, Task, or Appointment).

Depending on your site’s business needs and configuration, this flow may be further automated.

Next Actions These actions are used after retrieving the opportunity from a worklist or the Opportunities workbasket. They let you further process the opportunity. The ProcessOpportunity flow shape performs this step.

Note: This flow is in the section for “Presenting a Suggested Offer” because both the Suggested Offers flow and the Opportunity flow use the Handle Opportunity flow for this process.


To select the next action:

1. Select Next Actions from the Take Action selection box. CPM for Insurance displays a list of possible actions (Figure 4-42).

Figure 4-42. Next Actions Section

2. Select the type of action that you would like to take and click Submit. CPM for Insurance calls the appropriate flow.


Attach a Note This action is used after retrieving the opportunity from a worklist or the Opportunities workbasket. It lets you further process the opportunity. The ProcessOpportunity shape of the Handle Opportunity flow (Figure 4-64) performs this step.


To attach a note:

1. Select the Attach A Note action from the Take Action selection box. CPM for Insurance displays fields for a subject line and note (Figure 4-43).

Figure 4-43. Attach a Note Section



Resolve Opportunity Use this action after retrieving the opportunity from a worklist or the Opportunities workbasket to resolve the opportunity previously created. The ProcessOpportunity flow shape shown in Figure 4-64 performs this step.


To resolve an opportunity: 1. Select the Resolve Opportunity action from the Take Action selection

box. CPM for Insurance displays fields for Resolve Opportunity (Figure 4-44).

Figure 4-44. Resolve Opportunity Section



Overriding a Default SLA The Override SLA flow is used to set an override SLA for a customer. The steps required to perform this task are included in a single action — Override SLA (Figure 4-45).

Figure 4-45. Flow Diagram for Override SLA Flow


Override SLA This action lets you select the specific SLA to change. The OverrideSLA flow shape performs this step.

To override the SLA: 1. Select the Override SLA action is from the Take Action selection box.

CPM for Insurance displays any SLA overrides in effect for the policy holder, the contact, or the policy (Figure 4-46).

Figure 4-46. Override SLA Section

2. To change or add an override, select the type, then use the SmartPrompt to select an override name from the list.

3. Enter a start date and an end date and click Submit.

Business Processing CPM for Insurance updates internal CPM for Insurance data with the new or updated override information. These overrides are used to determine the SLAs to use for subsequent items on behalf of the policy, the policy holder, or the contact.

This flow makes an entry in the interaction log, but does not create a separate work object.


Adding a Contact using Quick Add Contact The Quick Add Contact flow lets you update external systems with a new contact and associate that contact with an existing policy (Figure 4-47). This is similar to “Adding a Contact” on page 4-11, but requires only minimal data.

Figure 4-47. Flow Diagram for Quick Add Contact Flow


Quick Add Contact This action adds a new contact and lets you link the contact to an existing policy. It is available when you search for policy or contact information. The QuickAddContact flow shape performs this step.

To create a new contact:

1. From the search results screen, select the Create Quick Contact action from the Take Action selection box.

Figure 4-48. Create Quick Contact Section

2. Click Submit. CPM for Insurance displays a form for the customer’s contact information (Figure 4-49).

Figure 4-49. Quick Add Contact Section


3. Enter the information for the contact. The first name, last name, gender, security question and answer, and communication preference fields and contact information are required.

4. When you select a communication preference (mail, e-mail, phone, or fax), additional fields appear. Enter information in those fields.

5. Optionally, if you started this flow from an account listing, a list of accounts appears at the bottom of the form. Select a policy and make a selection in the Relation to Policy selection box to specify the role of this contact for the policy.

6. Click Submit.

Business Processing CPM for Insurance updates the external system with the contact information. This flow makes an entry in the interaction log, but does not create a separate work object.


Scheduling Activities The Schedule Activity flow is used to schedule a follow-up call, task, or appointment with a customer.

Figure 4-50. Flow Diagram for Schedule Activity Flow


■ Schedule Appointment

■ Confirmation of Scheduled Activity


Schedule Appointment This action lets you specify the details of the appointment. The ScheduleActivities flow shape performs this step.

Note: This section shows the Schedule Appointment activity. Use the selection box to schedule a task or call. The steps are the same.

To specify appointment details:

1. Select the Schedule Appointment action from the Take Action selection box. CPM for Insurance displays schedule information (Figure 4-51).

Figure 4-51. Schedule Details Section

2. Enter the information requested and click Submit.


Confirmation of Scheduled Activity This step confirms the details of the activity and displays the case number, fee charged, goal and deadline dates, and status. The Appointment flow shape performs this step.

To confirm the request: CPM for Insurance displays the details of the appointment (Figure 4-52). Review the details and click Submit.


Business Processing CPM for Insurance routes the request to the selected worklist or workbasket for further processing. Users with access to the selected worklist or workbasket can later retrieve the item and edit it, cancel it, or attach a file, screen shot, or note.

CPM for Insurance sets the overall SLA goal for this item to the date of the appointment, task, or call.


Sending Correspondence The Send Correspondence flow is used to create and send correspondence. The steps required to perform this task are included in a single action — Create Correspondence.

Figure 4-53. Flow Diagram for Send Correspondence Flow


Create and Send Correspondence This action lets you specify details about who is to receive the correspondence, the format of the correspondence, and the type of correspondence sent.

Note: CPM for Insurance includes correspondence templates. These templates contain predefined text, as well as fields for customer-specific information. Check with your system administrator to find out which templates are available for your company.

To create and send correspondence:

1. Select Send Correspondence action from the Take Action selection box. CPM for Insurance displays a Correspondence Details section (Figure 4-54).

Figure 4-54. Select Role Correspondence Details

2. Use the selection box to select the appropriate role for the receiver. Options include:

− Contact — the party initiating the interaction (such as the caller)

− Other Party — a third party associated with the interaction or the account

3. Using the selection boxes, make the appropriate choices to define the type of correspondence to be sent (such as e-mail or fax), and the appropriate template to use. Figure 4-55 shows a sample for selecting a correspondence template for e-mail to a contact. The selection boxes


that appear, and the choices within those selection boxes vary, depending on the template that you choose. For example, if you selected “Other Party” in the previous step, CPM for Insurance also displays fields for you to enter the name and address of the other party.

Figure 4-55. Correspondence Template Selection

4. Click Submit.

5. Click Submit again to send the correspondence.

Business Processing CPM for Insurance prints, e-mails, or faxes outbound correspondence items according to the type of correspondence you selected. If you selected a template that requires verification of the correspondence, CPM for Insurance routes it accordingly. After the correspondence item is verified, it is distributed based on the type chosen.


Sending Statement Copies The Statement Copy flow is used to select and send a copy of a past statement (Figure 4-56).

Figure 4-56. Flow Diagram for Statement Copy Flow



■ Select Statement

■ Statement Photocopy Details

■ Confirmation of Statement Copy Request

Select Statement This action lets you select the specific statement to send to the customer. The DisplayStatements flow shape performs this step.

To select a statement:

1. Choose the select Statement Copy from the Take Action selection box. CPM for Insurance displays a list of recent statements (Figure 4-57).

Figure 4-57. Select Statement Section

2. Click the statement that the customer requests. You can also use the Search for Additional Statements in the Take Action selection box to find other statements.

3. Click Submit.


Statement Photocopy Details This action lets you specify the distribution method for the copy of the statement. The DisplayPhotoCopyDetails flow shape performs this step.

To specify distribution details:

1. Select the Statement Photocopy Details action from the Take Action selection box. CPM for Insurance displays account address and communication information appropriate to the distribution method (Figure 4-58).

Figure 4-58. Statement Photocopy Details Section

2. Confirm the distribution method with the customer. Confirm the distribution details, such as postal address, e-mail address, or fax number. Enter new information if required.

3. Click Submit.


Confirmation of Statement Copy Request This step confirms the details of the request and displays the case number, fee charged, goal and deadline dates, and status. The SendToPhotcopyRequest flow shape performs this step.

To confirm the request: CPM for Insurance displays the details of the request (Figure 4-59). Review the details of the request and click Submit.


Business Processing CPM for Insurance routes the request to the PhotocopyRequest workbasket for further processing. Users with access to the PhotocopyRequest workbasket can later retrieve the item and edit it, cancel it, or attach a file, screen shot, or note. Depending on your site’s business needs and configuration, this flow may be further automated to distribute the statement without manual intervention.


Presenting Suggested Reviews CPM for Insurance can suggest reviews of prior work items for a customer during a customer interaction or when users search by a work item when starting an interaction. For example, CPM for Insurance may suggest you review an open complaint item with a customer the next time they call. Your site’s configuration determines which cases are suggested for review. The Review Item flow is shown in Figure 4-60.

Figure 4-60. Review Item Flow Diagram

Suggested Item Reviews are shown in the Suggested Process portion of the Interaction Driver (Figure 4-61).


Select the item to add it to the Interaction Driver queue and click Submit. This is a one-step process, unless you have the appropriate privileges, then you can continue processing the case.

Figure 4-61. Suggested Item Review

Once you open the item, you can review details of the case, select history or attachment buttons to view audit trail and other documentation.

Figure 4-62. Suggested Item Review

Business Processing Items reviewed via the Review Item process are included in the Interaction Log for the customer interaction (unlike items reviewed via the customer composite display). If a Review Item process is performed during an interaction, CPM for Insurance sets the Related to Prior Interaction flag to Yes. You can confirm this setting during call wrap-up (End Interaction).


Presenting a Suggested Offer The flows related to a Suggested Offer include:

■ Suggested Offers

■ Handle Opportunity

■ Get Offers

Suggested Offers Flow The Suggested Offers flow, is used when presenting an offer to a customer, and handles three outcomes — offer accepted, offer rejected, or more information requested (Figure 4-63).

Figure 4-63. Flow Diagram for Suggested Offers Flow


Handle Opportunity Flow Diagram The Handle Opportunity flow diagram shows the steps to manage a sales opportunity (Figure 4-64). You can enter an opportunity directly via the Opportunity flow, or it can arise from an accepted offer within the Suggested Offers flow.

Figure 4-64. Flow Diagram for Handle Opportunity Flow


Get Offers Flow Diagram The Get Offers flow is used during an interaction to retrieve current offers (Figure 4-65).

Figure 4-65. Flow Diagram for Get Offers


■ Process Offer

■ Accept Offer

■ Reject Offer

■ More Information

■ Confirmation of Offer Presentation


Process Offer This action lets you choose the offer to present to the customer. The GetOffers flow shape on the Suggested Offers flow (Figure 4-63) performs this step.

To process the offer:

1. Select the Process Offer action from the Take Action selection box. CPM for Insurance displays a list of offers (Figure 4-66).

Figure 4-66. Process Offer Section

2. Select the offer to present to the customer and click Submit.


Accept Offer This action lets you accept the offer presented. The GetPresentOffer flow shape on the Suggested Offers flow (Figure 4-63) performs this step. Select the Accept Offer action from the Take Action selection box and click Submit. CPM for Insurance displays offer details (Figure 4-67).

Figure 4-67. Opportunity and Accept Offer Section

Business Processing CPM for Insurance routes the request to the Opportunities workbasket for further processing. Users with access to the Opportunities workbasket can later retrieve the item and edit it, cancel it, or attach a file, screen shot, or note. In addition, users can perform related activities that are associated with the workflow, including Send Correspondence, Material Fulfillment, and Schedule Activity (Call, Task, or Appointment).

Depending on your site’s business needs and configuration, this flow may be further automated.


Reject Offer This action lets you reject the offer presented. The GetPresentOffer flow shape on the Suggested Offers flow (Figure 4-63) performs this step.

To reject the offer:

1. Select the Reject Offer action from the Take Action selection box. CPM for Insurance displays offer details (Figure 4-68). If the customer accepts the offer or wants more information, select the appropriate action from the Take Action selection box.

Figure 4-68. Opportunity and Reject Offer Section


Business Processing CPM for Insurance closes the item with a Resolved-Rejected status. CPM for Insurance takes no further action.


More Information This action lets you request more information about the offer presented. The GetPresentOffer flow shape in the Suggested Offers flow (Figure 4-63) performs this step.

To request more information:

1. Select the More Information action from the Take Action selection box. CPM for Insurance displays offer details (Figure 4-69). If the customer accepts or rejects the offer, select the appropriate action from the Take Action selection box.

Figure 4-69. Opportunity and More Information Section


Business Processing CPM for Insurance routes the request to the MaterialsFulfillment workbasket for further processing. Depending on your site’s business needs and configuration, this flow may be further automated.


Confirmation of Offer Presentation This step confirms the details of the offer and displays the case number, fee charged, goal and deadline dates, and status. The ProcessOpportunity flow shape in the Handle Opportunity flow (Figure 4-64) performs this step.

To confirm the offer: CPM for Insurance displays the details of the offer (Figure 4-70). Review the details and click Confirm.



Processing a Transaction Dispute The Transaction Dispute flow is used when a customer wants to dispute a transaction. The flow retrieves recent transactions and accepts a dispute reason (Figure 4-71).

Figure 4-71. Flow Diagram for Transaction Dispute Flow


Available actions include.

■ Start Dispute

■ Select Dispute Reason

■ Confirmation of Transaction Dispute

Start Dispute This action lets you select the specific transaction that the customer is disputing. The DisplaySearchScreen flow shape performs this step.

To select a transaction:

1. Select the Start Dispute action from the Take Action selection box. CPM for Insurance displays a list of recent transactions for the account currently in view (Figure 4-72).

Figure 4-72. Start Dispute Section

2. Click the transaction that the customer is disputing. You can use the Account Transaction Search section of the screen to narrow the list of transactions to transactions that occurred during a specific time period or involved a specific amount of money.

3. Click Submit.


Select Dispute Reason This action lets you specify the reason that the customer is disputing the transaction. The GetReason flow shape performs this step.

To select a reason:

1. Select the Select Dispute Reason action from the Take Action selection box. CPM for Insurance displays the disputed transaction along with fields for details about the dispute (Figure 4-73).

Figure 4-73. Dispute Reason Section

2. Enter the details of the dispute and click Submit.


Confirmation of Transaction Dispute This step confirms the details of the request and displays the case number, fee charged, goal and deadline dates, and status. The AccountException flow shape performs this step.

To confirm the request: CPM for Insurance displays the details of the dispute (Figure 4-74). Review the details of the dispute and click Submit.


Business Processing CPM for Insurance routes the request to the AccountException workbasket for further processing. Users with access to the AccountException workbasket can later retrieve the item and edit it, cancel it, or attach a file, screen shot, or note. Depending on your site’s business needs and configuration, this flow may be further automated.


Updating Contact Communication Options The Update Contact Communication Options flow lets you update external systems with modified communication information, such as additional telephone numbers or e-mail addresses (Figure 4-75).

Figure 4-75. Flow Diagram for Update Contact Communication Options Flow


Update Contact Communication Options This action changes the communication options for a contact. The ChangeCommOption flow shape performs this step.

To update a contact communication option:

1. Select the Update Contact Communication Options action from the Take Action selection box. Figure 4-76 appears.

Figure 4-76. Update Contact Communication Option Section

2. Select the contact information to be changed and fill in the Number/Address field for the information that the customer would like to change.

− To make this entry the primary point of contact, check Make Primary.

− To remove a contact, check Remove Option. (To remove a primary point of contact, you must first designate another point of contact as primary.)


3. Click Update. The contact option is updated. If necessary, you can now change additional contact communication options.

4. Click Submit.

Business Processing CPM for Insurance updates the external system with the modified contact communication information. This flow makes an entry in the interaction log, but does not create a separate work object.


Updating a Contact Name and Profile The Update Contact Name and Profile flow lets you update external systems with modified name and profile information on a contact (Figure 4-77). The action that it displays is the Update Contact Name action.

Figure 4-77. Flow Diagram for Update Contact Name and Profile Flow


Update Contact Name and Profile This action changes the name and profile information for a contact. The ChangeName flow shape performs this step.

To update a contact name and profile:

1. Select the Update Contact Name action from the Take Action selection box. CPM for Insurance displays a form for the customer’s name and profile (Figure 4-78).

Figure 4-78. Update Contact Name Section

2. Fill in the information that the customer would like to change and click Submit.

Business Processing CPM for Insurance updates the external system with the modified profile information. This flow makes an entry in the interaction log, but does not create a separate work object.

Chapter 5 Understanding Insurance Business Processing

CPM for Insurance includes these insurance-specific flows:

■ Adding new policy applications

■ Changing policy endorsements

■ Filing a first notice of loss

The flow structure for each work type is similar. Each flow is controlled by a main flow that calls the appropriate subflows for the work type. The flows for each work type and the screens you see when processing occurs in the background are discussed in this chapter.

For more information about the main flows and subflows, see the Insurance Industry Framework Implementation Guide, Chapter 4.


Adding New Policy Applications This action lets you add new policy applications for an individual or for a business (Figure 5-1). The ApplicationMain flow shape performs this action.

Figure 5-1. Flow Diagram for ApplicationMain Flow

Available actions include adding applications for the following policy types:

■ Automotive (personal or commercial)

■ Business Owner’s Policy (commercial only)

■ Term Life

Understanding Insurance Business Processing 5-3

■ Variable Universal Life

■ Homeowner’s

To create a policy application: The following example illustrates the creation of a new homeowner’s policy application. The process is the same for all types of policies. If the contact is a business unit, the actions are limited to business-related policies (automotive and BOP). 1. Click Start Process to initiate creation of the new policy if New

Homeowners appears in the To Do section of the screen (Figure 5-2). Alternatively, double click the process in the Other Processes section.

Figure 5-2. Starting the Process

2. When the Pick Desired Product action appears, select the homeowners product from the dropdown list and click Submit (Figure 5-3).

Figure 5-3. Homeowners Product Selection


3. The Product Data Entry tree displays (Figure 5-4) for the homeowners product you selected. This screen initiates a process that walks you though the data capture process for the policy. Using the buttons on the screen, you can navigate though the entry of policy information step by step:

− Previous — brings you back to a previous entry screen

− Validate — validates the data entered on the screen without moving to another entry screen

− Next — brings you to the next entry screen in the process

Note: You also can select a data category directly from the tree rather than move through the entry screens. This displays the entry screen for that category.

Figure 5-4. Pick/Enter Product Details

4. Using the buttons, complete all entry screens to capture the policy information. Click Submit.


5. Review the policy information (Figure 5-5). If correct, click Submit.

Figure 5-5. Confirm Product Details

6. If the customer accepts the offer, select the Accept the Offer action and click Submit (Figure 5-6). If the decision will be made later, select Save the Application in the Take Action box and click Submit.

Figure 5-6. Accept the Offer

The new policy application service item (S-232 in this example) appears in the workbasket of the insurance underwriter who underwrites, binds,


and issues the application. When approved, it appears in the customer’s list of policies.

7. Click Confirm to finalize the new policy application transaction and return to the Select Intent form (Figure 5-7).

Figure 5-7. Confirmation of Service Items


Changing Policy Endorsements This action handles the process of changes (modify, create, or cancel) to policy endorsements. The ChgPolicy NewWork flow shape performs this action. (Figure 5-8).

Figure 5-8. Flow Diagram for ChgPolicy NewWork Flow


To change a policy endorsement: 1. Select Change a Policy in the Select Intent box (Figure 5-9) and click

Start Process.

Figure 5-9. Change a Policy

2. Select Create a New Endorsement in the Take Action box (Figure 5-10).

Figure 5-10. Create a New Endorsement


3. Select the Endorsement Effective Date and click Submit. The Take Action item Pick/Enter Product Details form appears (Figure 5-11).

Figure 5-11. Pick/Enter Product Details

4. Modify the data as necessary and click Submit. The Take Action item Confirm Product Details form appears.

5. Click Submit to continue the confirmation process. The Take Action item Approve appears.

6. Click Submit. The Confirmation of Service Items form appears.

7. Click Confirm to finalize the transaction.


Filing a First Notice of Loss This flow handles the filing of a first notice of loss (FNOL). The InsClaimDataEntry flow in the class of the specific LOB initiates the main flow process (Figure 5-12) following the verification of the contact.

Figure 5-12. Flow Diagram for FNOL Property Flow


The first step in processing the processing of a claim against an insurance policy is the filing of a First Notice of Loss (FNOL). The FNOL is the initial collection of information data regarding a loss event and is part of the official record for the entire lifecycle of the claim. The content and structure of the FNOL process varies based on the Line of Business (LOB) of the policy that the loss is filed against.

The FNOL solution provided by the framework supports the following LOBs:

■ Personal Auto

■ Homeowners Property

■ Commercial Auto

■ Commercial Property

■ Workers Compensation

■ General Liability

To file a First Notice of Loss

The following example illustrates a typical LOB flow (Homeowners Property) that collects FNOL information from a contact. The caller could be the insured on the policy, a representative of the insured or a third party claimant. The caller interaction is structured to accomplish the following:

■ Identify the caller — The FNOL is, by definition, a legal document. It is a requirement that the person calling be identified by name and address. The caller is added to the list of contacts for any future claims that may result, as well as for the system of record.

■ Establish the caller’s relationship to the claim — The extent of information shared with a caller regarding the insured is dictated by their relationship to the event. The maximum amount of information would be shared with the insured. A representative of the insured, (an agent, for example) may or may not have full access to all information. A third party claimant would have no access to the insured’s information.


■ Find the insured and policy — An FNOL is filed against a policy. A search by the insured’s name or the actual policy number will validate coverage. It will also determine the form to be used in the recording of the loss.

■ Date of Loss — the date of the loss is used as a way to narrow the search for the insured’s policy.

1. Filing begins as an interaction with a caller that is launched from the link labeled Enter a Loss located on the First Notice of Loss tab in the user's workspace (Figure 5-13).

Figure 5-13. FNOL Entry Link

2. When the contact has been verified, the Report A Loss screen is displayed (Figure 5-14). Answer the questions and Click Submit. Complete the next displays screen(s) to select the policy holder and the policy from display lists — which screens are determined by the amount of information previously gather regarding the contact and the policy.

Figure 5-14. Report a Loss Entry Screen

3. Once the policy type and the policy information has been collected, the system automatically queues the loss process for that type as the recommended process on the Select Intent screen (Figure 5-15). Click Start Process to begin the data collection process for the loss.


Figure 5-15. Starting the Loss – Homeowners Process

4. The data collection process is structured based on the type of loss. The flow walks you through the data that must be collected and the questions that must be answered to file the loss. Figures 5-16 to 5-18 provide samples of some of the collection screens.

On the left side of the collection screens, a tree structure indicates the data categories for the loss type as well as your location in the process. A check mark indicates completion of that data entry screen.

When all of the data has been entered on a screen, click Next>> to move to the next collection screen in the process. Click <<Back to return to the previous screens to update/review previously entered information. Icons also appear to allow you to add elements such as buildings and drivers as well as delete those elements.

Figure 5-16. General Loss Collection Screen


Figure 5-17. Collection Screen for Specific Building/Location

Figure 5-18. Collection Screen for Individual Building Damage

5. When the final entry screen is displayed and all information has been collected, click Finish. A screen containing all of the loss data you have collected is displayed for review (Figure 5-19). Click Submit to accept the information or select the Cancel action to cancel the process.


Figure 5-19. Review Screen

6. A Confirmation of Service Items form appears (Figure 5-20). Click Confirm to finalize the transaction, provide the contact with reference information, and return to the Select Intent screen where you can Wrap-Up the call or initiate another process.

Figure 5-20. Confirmation Screen

Chapter 6 Reporting

CPM for Insurance includes a wide variety of standard reports and graphs providing real-time information about processes, work, assignments, and historical data for analyzing contact center performance over time. This chapter describes the reporting capabilities available with CPM and includes these topics:

■ Reporting gadgets

■ Drill-down report capabilities

■ Frequently used reports

■ Ad hoc reporting capabilities


Reporting Gadgets The following Reporting gadgets can appear in your portal view depending on your user role:

■ Reporting Dashboard — displays key metrics about contact center activity

■ Reports — provides a list of interaction, productivity, quality, ageing, campaign, and opportunity reports available with CPM for Insurance

Reporting Dashboard Gadget The Reporting Dashboard presents information about contact center activity and performance in graphical form (Figure 6-1).

Figure 6-1. Reporting Dashboard

The slide control lets you adjust which categories are visible on the graph. Clicking the graph changes the view to display a summary report that lists the data included in the graph. See “Drill-Down Reporting Capabilities” on page 6-5 for more information on this topic.

Reporting 6-3

Reports The Reports gadget provides users with access to the comprehensive list of CPM reports presented by category.

■ Interaction reports — analyze interactions by channel, determine first-call and one-touch resolution rates, and evaluate the primary reasons your customers contact you

■ Throughput reports — understand the quantity of work received, resolved, and remaining within your operation

■ Quality reports — understand the timeliness of work completion, and analyze achievement of service level goals and deadlines

■ Ageing reports — understand the time required to process work within your operation

■ Campaign Reports —provide insight into campaign effectiveness and productivity

■ Opportunity Reports — analyze current opportunities, pipeline activity and lost sales

■ Quality Review Management Reports —analyze and manage employee quality reviews — only visible to services and sales managers

■ Customer Satisfaction Survey Reports —understand and analyze the factors that impact customer satisfaction — only visible to services and sales managers

■ Knowledge Management Reports — provide insight into knowledge topic usage and suggested changes — only visible to service managers


Figure 6-2. Reports Available to Customer Service Managers

Reporting 6-5

Drill-Down Reporting Capabilities Reporting includes powerful drill-down functions for report data. These capabilities enable you to travel from a summary view of your entire operation to the details of a single service request case.

1. Start by selecting a graph from the dashboard or a report from a reporting gadget. In Figure 6-3, the Satisfaction Summary Report is selected from the Interaction Reports gadget.

Figure 6-3. Satisfaction Summary Report

2. To drill down to the case detail, select a row in the list below the graph to display a list of cases included in the category. The list displays in a separate window. In Figure 6-4, the Concerned – Open Requests to be Resolved category is selected.

Note: You can also export report data to an Excel spreadsheet by clicking the Export to Excel button at the top of the report window


Figure 6-4. Satisfaction Detail Report for the Selected Category

3. Highlight a row to view summary details for a case in the list. A basic information frame displays at the bottom of the screen. Use the buttons at the top right of the form to export this view to an Excel spreadsheet, and to return to the summary list.

Reporting 6-7

4. Click Review to review the case details (Figure 6-5).

Figure 6-5: Case Details as Selected via Drill-Down Reporting


Frequently Used Reports Figure 6-6 lists many of the frequently used reports included with CPM for Insurance. A check mark indicates which reports include graphs, and whether a report appears in the view of each user role.

Report Name

Graph

Service Mgrs

CSRs

Sales Mgrs

Sales Reps

Interaction Reports

Interaction Channel, by Primary Reason

Interaction by Channel

Interaction by Reason

Interaction by Operator, by Channel

One-Contact Analysis by Channel

One-Touch Analysis by Channel

Resolution Detail by Operator

Satisfaction Summary

Satisfaction by Operator

Throughput Reports

Throughput Summary by Work Type

Throughput by Operator, by Work Type

Throughput in Past Week by Work Type

Weekly Process Creation by Work Type

Open Cases by Work Type

Open Cases by Assign Operator

Throughput Trend by Operator, by Day

Reporting 6-9

Report Name

Graph

Service Mgrs

CSRs

Sales Mgrs

Sales Reps

Throughput Trend by Operator, by Month

Throughput Trend by Operator, by Year

Throughput Trend by Operator, by Quarter

Throughput Trend by Operator, by Week

Estimated Application Savings

Quality Reports

Quality Summary by Work Type

Quality Summary by Resolve Operator

Timeliness by Work Type

Timeliness by Workbasket

Timeliness by Operator

Timeliness by Operator and Work Type

Ageing Reports

Ageing Summary by Work Type

Ageing Summary by Assign Operator

Campaign Reports

Campaign Summary

Campaign Effectiveness by Operator

Operator Effectiveness by Campaign

Offers Rejected by Reason


Report Name

Graph

Service Mgrs

CSRs

Sales Mgrs

Sales Reps

Opportunity Reports

Active Pipeline by Product and Stage

Forecast by Rep, by Sales Cycle Stage

Annual Closed Opportunity Summary

Annual Lost Sales, by Rep, by Reason

Pipeline Ageing by Product

Annual Customer Opportunity Summary

Active Pipeline, by Broker, by Rep

Forecast Expect Close, by Sales Cycle Stage

Annual Closed Opportunities, by Rep, by Month

Lost Sale Report, by Product and Reason

Pipeline Ageing Report by Rep

Quality Review Management Reports

Quality Review Summary by Employee and Overall Score

Quality Review Summary by Work Type and Overall Score

Quality Review Summary by Overall Rating

Coaching Sessions by Employee

Coaching Sessions by Work Type

Quality Reviews In Progress by Work Type

System Enhancement Request Summary

Reporting 6-11

Report Name

Graph

Service Mgrs

CSRs

Sales Mgrs

Sales Reps

Customer Satisfaction Survey Reports

Customer Surveys by Interaction Type

Customer Surveys by Overall Rating

Customer Surveys by Interaction Reason

Customer Surveys One-Contact Analysis

Customer Survey Response Rate

Customer Surveys In Progress

Knowledge Management Reports

Knowledge Process Summary by Topic

Knowledge Processes Requiring Research

Knowledge Update Request Summary

Figure 6-6. Frequently Used CPM Reports


Ad Hoc Reporting Capabilities The report wizard extends the system’s predefined report capabilities by providing an intuitive tool for creating customized reports. Reports generated through the wizard can be saved for easy access during future sessions.

To access the report wizard, click the Analytics tab in the navigation panel and expand a reports gadget (Figure 6-7).

Figure 6-7. Reports Gadget

Click the icon associated with the report function you wish to perform. The available functions shown in Figure 6-8.

Icon Name Function

Custom Report Links

Displays a list of previously created custom reports

Browse Category

Displays a full list of previously created custom reports

Create Custom Report

Launches the Report wizard

Figure 6-8. Custom Report Functions

Reporting 6-13

Creating a Custom Report Click the Create Custom Report icon ( ).The wizard automatically takes you through the steps required to create the desired report:

1. Selecting the view (summary or list)

2. Selecting the data source

3. Defining the report criteria

4. Defining display groups

5. Defining the field functions

6. Defining drilldown capabilities

7. Charting the data

8. Previewing the report

Each step is described in detail on the following pages.


Step 1: Selecting the View The wizard lets you decide how you want the information displayed.

1. Click the radio button associated with the appropriate report view (Figure 6-9):

− Summary View — to include summary information such as totals and averages

− List View — to include a list of items including detail for each item

Figure 6-9. New Report Wizard Step 1 — Select Summary View

The wizard mode defaults to Simple, which is the mode described in this chapter. Contact your system administrator if you wish to create reports using the Advanced mode.


Reporting 6-15

Step 2: Selecting the Data Source

The wizard displays a list of available data sources (Figure 6-10).

1. Click the appropriate description.

Figure 6-10. New Report Wizard Step 2 — Select Data Source



Step 3: Defining the Report Criteria The wizard lets you define the criteria you want included in the report.

1. Choose a value from the Field selection box.

2. Select the appropriate condition and enter the required field value (Figure 6-11).

Figure 6-11. New Report Wizard Step 3 — Define Criteria

3. Repeat steps 1 and 2 to include additional conditions. When you include more than one condition, the one in the first row always takes precedence.

− To add a row above a specific row, click the Insert Row icon ( ).

− To add a row below the last row, click the Add Row icon ( ).

− To delete a row, click the Trash Can icon ( )

4. Click the click here to preview count link. The wizard determines the number of items that meet the criteria you defined and displays the

Reporting 6-17

results in a separate window. This information can help you determine if the report you are creating captures the right data. Click Close.


Step 4: Defining Display Groups The wizard lets you define how you want the criteria grouped.

1. Select the desired grouping criteria from the list of available fields (Figure 6-12).

− Use the Add and Remove buttons to create and modify your list.

− Use the Move Up and Move Down buttons to define the appropriate hierarchy.

Figure 6-12. New Report Wizard Step 4 — Define Display Group

2. Optionally to define a field caption, highlight an entry in the Group By These Fields list, and enter the caption text in the Field Caption input field at the bottom of the screen. Click Apply to set the field caption.



Step 5: Defining the Field Functions The wizard includes arithmetic functions (count, sum, average, minimum and maximum) that you can apply to the columns of your report.

1. Use the Function and Field selection boxes to define the function to apply to each field you selected for your report.

2. Click the Insert Row ( ) and Add Row ( ) icons to insert additional functions and fields in the desired order (Figure 6-13).

Figure 6-13. New Report Wizard Step 5 – Define Fields

3. Enter the caption text in the Caption field (or accept the default).

4. Repeat steps 1 and 2 as necessary.

− To add a row above a specific row, click the Insert Row icon ( ).

− To add a row below the last row, click the Add Row icon ( ).

− To delete a row, click the Trash Can icon ( ).


Reporting 6-19

Step 6: Defining Drill-Down Capabilities The wizard displays a list of fields that are available for drill-down analysis. You can define the fields you want displayed.

1. Select the desired display fields from a list of available fields (Figure 6-14).

− Use the Add and Remove buttons to create and modify your list.

− Use the Move Up and Move Down buttons to define the appropriate hierarchy.

Figure 6-14. New Report Wizard Step 6 — Define Drilldown Capabilities

2. Optionally, to define a field caption, highlight an entry in the Drill-down on These Fields list, and enter the caption text in the Field Caption input field.

3. Define the display order for the drill-down by highlighting and selecting the appropriate entry in the Sort selection box. Click Apply to set the sort order.



Step 7: Charting the Data The wizard prompts you to indicate whether you want to include a chart in the report. Then use the following steps to create an interactive chart.

1. Select the check box Use a chart for the view? (Figure 6-15).

2. Select Interactive as the chart output type. The button labeled Configure Interactive Charts appears to the right of the field.

3. Click the button to display the Interactive Chart Definition screen. Complete the Type, Data, Text, Options and Color Tabs (Figure 6-16 to Figure 6-20), and Click Apply.

Figure 6-15: New Report Wizard Step 7: Charting the data

Reporting 6-21

Figure 6-16. Interactive Chart Type Tab

Figure 6-17. Interactive Chart Data Tab

Figure 6-18. Interactive Chart Text Tab


Figure 6-19 Interactive Chart Options Tab

Figure 6-20. Interactive Chart Color Tab

4. Click Next. The Wizard moves to Step 8.

Reporting 6-23

Step 8: Previewing the Report The wizard displays a description of your report definition actions in the Usage field (Figure 6-22). Click on the options you want to use with your report.

Figure 6-21. Preview of report definition


Figure 6-22. New Report Wizard Step 8 — Finish and Preview

1. Click Finish to preview the report you have created.

2. Click Save View to save the report. The wizard prompts you to enter a purpose and title, and select a RuleSet and version (Figure 6-23).

Figure 6-23. RuleSet Information

Reporting 6-25

5. Click Save. The system saves the report and displays a confirmation screen, as shown in Figure 6-24. To create a link to the report, enter a label for the report and click OK. The wizard displays the following message: “OK: View delegated successfully.” The report is added to your Custom Reports workspace.

Figure 6-24. Delegate View Input Screen

6. Click Home.

For more information about reporting capabilities and the Report Wizard, see Application Development Help and the PDN.

Appendix A Workflow Descriptions

This appendix provides descriptions for flows in the following categories:

■ Interaction flows — used when CSRs are interacting with customers or contacts

■ Service flows — used to process customer service requests during an interaction

■ Customer Management flows — used to maintain links between customers, contacts, providers, and business units

You can view these flows through the Member Services application using the class and flow names listed.

Note: Some interaction flows have variations for the three types of interactions. These variations can be found in the -Call, -InCorr, and -Research classes.

A-2 Customer Process Manger for Insurance User Guide

Interaction Flows Class / Flow Name Description

Class: PegaCA-Work

AppReview Enables CSRs to review an existing service item, enter comments, and log the review as part of the interaction.

Class: PegaCA-Work-Interaction

AppGetAccount Used to select a contact from a list of accounts and contacts that are displayed as results of an account search.

AppGetContact Used to select a contact. The contact search flow calls this flow after performing a search by contact.

AppGetWorkItem Used to select a contact and an account resulting from a work item search.

AppVerifyContact Used to present contact data for customer verification.

AppVerifyAccount Used to present account data for customer verification.

CACommMessage Shows the steps to deliver a selected customer-specific message based on your company’s business rules. For example, this could be a welcome message for new customers.

CAGetOffers Used during an interaction to retrieve current offers.

CAInteractionDriver Drives the task workflow during a customer interaction.

CASetOverrideSLA Shows the steps to set an override SLA for a customer.

CAWrapUp Used to perform housekeeping tasks at the end of an interaction, such as logging the interaction and resolving the work item.

Class: PegaCA-Work-Interaction-Call

CAInteraction Used during an interaction.

Class: PegaIns-Work

IIFAppContactSearch Used to search for a contact.

Class: PegaIns-Work-CPM-Interaction

AppContactSearchCTI Initiated by a call arriving through Computer Telephony Integration (CTI) and is used to search for a contact.

Workflow Descriptions A-3

AppContactSearch Used during an interaction to search for contacts by business unit, contact, account, or work item.

AppGetAccountDetails Used during an interaction to retrieve account details. The contact search flow calls this flow after an account is selected

AppGetBusinessUnit Used to select a business unit. The contact search flow calls this flow after searching for a contact by business unit.


Service Workflows Class / Flow Name Description

Class: PegaCA-Work-Compliant

CAComplaintOrCompliment Used when a complaint or compliment is received from a customer. The flow processes the complaint and retrieves any applicable restitution or reward offers, based on your company’s campaigns.

Class: PegaCA-Work-Correspondence

CASendCorrespondence Used to create and send correspondence.

Class: PegaCA-Work-DisputeTransaction

CADisputeTransaction Used when a customer wants to dispute a transaction. The flow retrieves recent transactions and accepts a dispute reason.

CAGeneralService Used to create a general service item to capture and route work when an appropriate automated flow does not exist.

Class: PegaCA-Work-MaterialFulfillment

CARequestMaterialsFulfillment Used to select material, such as marketing collateral, to be sent to a customer. The flow also lets you specify the distribution method.

CAResolveMaterialsFulfillment Used to resolve the materials fulfillment request.

Class: PegaCA-Work-Opportunity

CAGetPresentOffer Used when presenting an offer to a customer, it handles the three outcomes — Offer Accepted, Offer Rejected, or More Information Requested.

CAFulFillOffer Used to completes the fulfillment process by requesting materials be sent to the customer.

CAHandleOpportunity Used to manage a sales opportunity. You can enter an opportunity directly through the Opportunity flow, or it can arise from an accepted offer within the Suggested Offers flow.

CAOpportunity Used to enter and process information about a sales opportunity.

Class: PegaCA-Work-StatementCopy

CAStatementCopy Used to select and send a copy of a past account statement.

Class: PegaCA-Work-TerritoryLink


Class / Flow Name Description

CAUpdateLink Used to update a territory link within the system.

Class: PegaCA-Work-SatSurvey

CAGenerateSurveyEmail Used to generate customer satisfaction survey emails.

CASSatisfactionSurvey Used to process customer satisfaction surveys following an interaction.

Class: PegaCA-Work-KM-SampleDiagnostic

CASampleDiagnostic Using a sample process shows how to diagnose a problem or situation.

Class: PegaCA-Work-KM-SampleFAQ

CASampleFAQ Using a sample process show how to respond to frequently asked questions.

Class: PegaCA-Work-CM-

CAWrapUpKnowledgeProcess Used to resolve FAQ and diagnostic processes.

Class: PegaIns-Work

BindPolicy Used to run processes that support binding a policy.

IssuePolicy Used to run processes that support issuing a policy

Class: PegaIns-Work-Application

ApplicationMain Used to run the main flow that controls processing for applications.

ApplicationQuote Used to secure quote approvals.

ApplicationUnderWrite Used to support underwriting for applications

BackOffice Used to process back office functions specific to applications, such as, underwrite, bind, and issue.

EnterApplicationData Used to run the main subflow that handles the processes to enter the application data.

EnterPartyData Used to run the main subflow that handles entering the party data for an application.

ProcessApplication Used to run the main subflow that handles process the application once the data has been entered.

ProductSelection Used to run the main subflow that handles selecting a product.

Class: PegaIns-Work-Application-Indiv-VarUnivLife


ApplicationQuote Used to handle the quote processing specific to Variable Universal Life application

NewWork Used to start the flow for a new Variable Universal Life application.

Class: PegaIns-Work-Application-Pers-Automotive

ApplicationQuote Used to handle the quote processing specific to Personal Auto

NewWork Used to start the flow for a new Personal Auto application.

Class: PegaIns-Work-Application-Pers-Household

NewWork Used to start the flow for a new homeowners application

Class: PegaIns-Work-ChgPolicy

BackOffice Used to process back office functions specific to ChgPolicy such as underwrite, bind, and issue.

EnterEndorsementData Used to run the main subflow that handles entering endorsement data.

EnterPartyData Used to run the main subflow that handles entering party data for an endorsement.

NewWork Used to start the flow for a ChgPolicy process.

PerformEndorsement Used to run the main subflow that handles processing the endorsement once the data has been entered.

PolicyReUnderwrite Used to support the underwriting process for endorsements.

ProcessPolicyChanges Used to support the processing of changes made to the policy.

ReQuote Used to handle the processes required to requote the policy.

SelectPolicy Used to handle the process of selecting a policy to be changed from a list of policies.


Customer Management Flows Class / Flow Name Description

Class: PegaCA-Work

CAAcctContactLinks Used to add or remove a link between an account and a contact.

CABUContactLinks Used to add or remove a link between a business unit and a contact.

CAContactAcctLinks Used to add or remove a link between a contact and a policy.

CAContactBULinks Used to add or remove a link between a contact and a business unit.

CAOwnerAcctLinks Used to add or remove a link between an owner and a policy. An owner can be a contact or a business unit.

CAOwnerBULinks Used to add or remove a link between an owner and a business unit. An owner can be a contact or a business unit

CAUpdateBusinessUnit Used to update external systems with a new business unit.

CAUpdatBusinessCommunication Used to update the business communication information in the system for a customer or contact and refreshes the composite screen.

CAUpdateBusinessDetails Used to update information about a business in the system and refreshes the composite screen.

CAUpdateContactCommOption Used to set a contact’s communication preference (e.g., mail, fax, phone).

CAUpdateContactName Shows the steps for updating external systems with modified name and profile information on a contact.

Class: PegaCA-Work-NewContact

AppAddContact Used to add a new contact to external systems.

Class: PegaCA-Work-NewContact-Quick

CAContactQuickAdd Used for updating external systems with a new contact.

Appendix B Default Portals

This section includes the portal layouts and a list of gadgets in those layouts that users in different CPM roles see as their home page when they log in to the application. Layouts are defined by the access group:

■ CACSRPortal — Customer service representative

■ CAManagerPortal — Customer service manager

■ CASalesRepPortal — Sales representative

■ CASalesManagerPortal — Sales manager

B-2 Customer Process Manager for Insurance User Guide

CACSRPortal

Figure B-1. CSR Portal

CACSRPortal Gadgets Task Bar Gadget Portal Icons

Interaction Manager My Work in Progress Reference Materials Find Work Location Finder

My Group CTITookit Find a Contact or Account Print Enter New Work

Dashboard Reporting Dashboard Analytics Interaction Reports

Throughput Reports Quality Reports

Default Portals B-3

CAManagerPortal

Figure B-2. Manager Portal

CAManager Portal Gadgets Task Bar Gadget Task Bar Gadget

Interaction Manager My Work in Progress Analytics Interaction Reports Find Work Throughput Reports My Group Quality Reports Reassign Work Ageing Reports Enter New Work Customer Satisfaction Survey Reports Find a Contact or Account Knowledge Management Reports

Dashboard Reporting Dashboard Portal Icons Manager Tools Quality Review Management Reference Materials

Campaign Management Location Finder Territory Management CTI Toolkit Print

B-4 Customer Process Manager for Insurance User Guide

CASalesRepPortal

Figure B-3. Sales Representative Portal

CASalesRepPortal Gadgets Task Bar Gadget Task Bar Gadget

Interaction Manager My Activities Analytics Opportunity Reports Find Work Throughput Reports My Group Quality Reports Enter New Work Portal Icons Find a Contact or Account Reference Materials

Dashboard Reporting Dashboard Location Finder My Opportunities CTI Toolkit Print

Default Portals B-5

CASalesManagerPortal

Figure B-4. Sales Manager Portal

CASalesManagerPortal Gadgets Task Bar Gadget Task Bar Gadget

Interaction Manager My Opportunities Dashboard Reporting Dashboard My Activities Manager Tools Territory Management Find Work Campaign Management

My Group Portal Icons Reassign Work Reference Materials

Analytics Opportunity Reports Location Finder Campaign Reports CTI Toolkit Throughput Reports Print Quality Reports Ageing Reports Customer Satisfaction Survey Reports

CPMI UserGuide V12

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