CIO Talk

Digitizing Documents: The Way Forward for Claims Processing

Cássio Vaquero, Regional Director, Information Management, Asia-Pacific and Latin America

Using new technology based on Artificial Intelligence allows for smart automation where communication is being interpreted via semantic understanding

A century ago people were happy to simply be insured, today many policies are easily replaceable with low barriers to switching insurers all together. Today’s customers have different expectations, driven by the service improvements they experience from other industries. They expect accuracy and responsiveness, 24/7. More importantly their experience must be satisfying and consistent across all channels of communication. The challenge for insurers is how to reduce costs, retain customer loyalty and sustain profitability in the short term, whilst keeping their eyes focused on long-term growth. Increased volume of communication, in both new and traditional channels, has resulted in an avalanche of structured, and even more challenging, unstructured data flowing into insurers day after day. At the best of times failing to process and respond will result in annoyed policyholders.

However, during catastrophes such as hurricane or the storms, flooding or personal medical emergencies brings processes to a breaking point and deficiencies in claims handling result in significant financial impact paired with serious customer satisfaction issues. Management of the emotionally involved claims process, particularly during these times, is critical to customer retention and satisfaction.

The need to reach and serve customers better

There is no doubt that in today’s marketplace, the customer is king. Policyholders, of all generations, have smartphones in their pockets, for them the speed of information is instantaneous and they are used to receiving quick and effective service. Wherever they go, they bring these expectations with them. These include, speedy claim processing, seamless communication across multiple channels, including phone, email and social media, as well as the ability to do their own research when desired and for someone to step in and show them the way when not. To achieve the policyholder retention they desire, insurers will have to work the way customers want – not the other way round. To rise to the challenge, all stakeholders in the claims process – like policyholders, carriers, independent agents, independent appraisers, lawyers and others – should be seamlessly integrated in the claims and associated streams. Improving information flow between these parties and incorporating various data sharing and communication channels including emails, faxes, letters, and other communication methods is essential to resolving claims in the timely manner that is expected by today’s customers.

These improvements are also necessary to achieve a 360° customer view, allowing everyone that communicates with policyholders from contact centre staff to claims agents, to have a complete picture of all previous communications and details of their case. After all when interacting with the insurance carrier regarding a claim, you do not want to get referred to multiple people who have partial information and cannot respond to your question or move your claim to completion. The consequences of not being able to meet customer expectations will have a far-reaching impact with loss of loyalty and dissatisfaction of a valued customer and the spread of their experience via social media to their friends, family and the wider world.

Efficiencies of automating processes

Today’s claims processing involves a significant amount of effort and includes many manual repetitive tasks tying up the valuable time of claims agents. The need is for end-to-end automation where each step seamlessly and automatically follows and the appropriate person is alerted when an exception is detected. Shortening the claims cycle not only enhances the customer experience but also presents opportunities for huge cost savings. Of course digitizing paper based documents as early as possible after they arrive at an independent agent, a subsidiary or the carrier headquarter, is key to facilitate process automation, speed up process and provide full transparency by making the information available instantly throughout the organisation. Too frequently workflows as well as policy and customer data are stored in ‘siloed’ systems, this presents a huge hurdle for automation. To eliminate slow and manual parts of the process it is essential to ensure integration of siloed processes across all communication channels and automate processes that are handled manually. Optimized automation of workflows combined with insight about customers and policies will go a long way to streamlining the claims process from the first notice of loss (FNOL) to settlement and subrogation. All whilst cutting claim transaction processing times and increasing employee productivity. Just as importantly, it will generate valuable cost savings and free-up staff to pursue new business.

The way forward

As outlined, the intersection of policyholders, claims staff and technology presents huge challenges, but at the same time, if mastered yields significant opportunities for carriers to position themselves for future growth and profitability. In order to ensure customer satisfaction and loyalty, policyholder responsiveness needs to be the highest imperative. To provide this optimal customer experience an integrated omni-channel communication process and optimized workflow management are key.

Advanced technology is coming to the rescue as it relates to automating the processes while integrating diverse communication and workflow expertise levels. Using new technology based on Artificial Intelligence allows for smart automation where communication is being interpreted via semantic understanding, the limitation of rules based process automation is overcome and the systems continues to leverage the experts in the organization. Of course the success of any technology deployment depends on the application of process optimization following best practices and a culture of innovation and customer experience.

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