Filed Under:Claims, Claims Technology

Collaborating in Claims

A Conversation About Technology and Training

Even for insurers that have attained high levels of efficiency, claims management and processing remains a complex, difficult endeavor. Each claim requires the involvement of different professionals, many of them in varied locations, and many with widely varying degrees of technological sophistication. At many insurers, there are deep pockets of expertise within the claims workforce, but finding and accessing that expertise may not always be easy.

At first glance, the claims workplace might seem to be fertile ground for the application of collaboration technology. However, a number of obstacles stand in the way for insurers seeking to improve communication and increase efficiency in claims management. First and foremost is the state of the systems supporting claims professionals. Although insurers do not like to admit it, some claims management operations are still in the “green screen” era, using outmoded technology to obtain, organize, analyze, and process claims information. Even companies that present a modern face to the public─touting the latest mobile applications, for example, or using social media to initiate conversations with potential customers─may rely on decades-old systems to handle and document claims. Such systems are often stitched together in ways that discourage communication, let alone true collaboration.

Training, Technological Sophistication

The second obstacle is the training and technological sophistication of the claims workforce. Most of the claims workforce is more than 45-years-old and, while these older workers have a great deal of knowledge about specific types of claims, they tend to be less avid users of such collaboration tools as instant messaging, wikis or social media (Facebook, Twitter, LinkedIn) than their younger counterparts. Unfortunately, one of the biggest challenges in claims processing is in tapping older workers’ knowledge and expertise, a task for which collaboration technology is uniquely suited.

The third obstacle, ironically, is technology itself. Technological advances in mobile, streaming video, tablet computing, and other areas present insurers with a bewildering array of choices. It often seems easier and cheaper to string together a series of point solutions rather than take a comprehensive approach to communications and collaboration.

In claims management and processing, however, insurers do not have the luxury of waiting for “the next big thing.” A flood of claims arrives every day. Each claim presents the insurer with the opportunity both to minimize losses and to please the customer through speed and superior handling. The question for insurers is not, “What is the perfect system?” but rather, “How can we make the best of what we have, or of what we can afford right now?”

The stakes are quite high, not only in terms of cost savings but also for customer satisfaction. It is generally accepted that customer’s loyalty depends upon his or her most recent claims experience with a given carrier. Since collaboration can improve both the speed and the precision of claims processing, it can make a significant contribution to enhancing the customer experience as well.

Claims management is an inherently collaborative activity. Claims adjusters must gather information, obtain and review evidence, and, in many cases, interview claimants, witnesses or other parties. Claims staff must be in contact with underwriters, in-house and external legal counsel, and sometimes with investigators. At the most basic level, technologies such as meeting schedulers and data sharing (including desktop sharing) can make it easier to exchange information and review claims documents as a group (quickly) rather than sequentially (slowly). Instant messaging, as well as basic conferencing applications such as audio and Web conferencing, can be implemented or upgraded in most cases without overburdening existing IT systems.

Enhancing Claims Productivity

A 2009 study by Accenture showed that claims adjusters spent almost half of their time on non-core activities. To optimize performance in claims, insurers must increase the amount of time these professionals spend on value-added activities leading to claims resolution. Through collaboration, lower-cost resources can be trained to handle tasks formerly handled by higher-cost people, with further improvements to the company’s bottom line. A solution incorporating contact center, instant messaging, expert locator, and videoconferencing can reduce the claims cycle time while improving decision-making and recovery. More advanced solutions–using team spaces, document sharing, and immersive teleconferencing, such as Cisco Telepresence─offer similar returns and can also enhance the work experience for claims professionals.

Collaborative tools have their most immediate impact in key areas including first notice of loss (FNOL); incoming call routing; remote review of management files; damage reviews; and customer communications. Collaboration can also improve the customer experience. During a FNOL call, for example, if a call center agent discovers that an adjuster’s assistance is required, then advanced call center technology enables an immediate transfer to the appropriate person. Before transferring the call, a conversation via instant messaging or an audio conversation with screen sharing allows the call center agent to fully brief the claims adjuster on the case, making it unnecessary for the customer to repeat any information he or she already provided. Depending on the type of loss a customer reports, software prompts the call center agent to ensure that the customer provides all needed information– for example details about the police reports. In turn, this exchange enables the call center agent to relay important information to the customer (such as preferred repair shops) while facilitating one-click access to experts when assistance is required.

Collaboration also enables claims adjusters to obtain immediate input from managers (as necessary) during a call. Adjusters can quickly find an available claims executive, review the case with and secure approval, even if that executive is physically located in a different office, or perhaps even in a different country.

Web conferencing also enables adjusters to more quickly obtain accurate damage assessments by discussing estimates with body shops and reviewing photos during the conference. Customers can be updated “on-demand” through Web portal access to claims information. Insurers saddled with incompatible and/or outdated legacy systems may find the concept of collaboration to be daunting, especially given the range of available technologies and the variety of vendors.

Implementing Collaboration Technology

Given the benefits derived from collaboration, however, it is important to start somewhere. We find that there are three logical entry points for implementation of collaboration technology:

Stage 1. Property & casualty insurers in the beginning stages of collaboration development may find that instant messaging is an easy way to start, especially when accompanied by desktop sharing. Updated instant messaging systems now incorporate features that make it easier to find out, for example, if a supervisor is available for a quick conversation. This can be invaluable for call center staffers who may only need a quick answer to continue the process on a claim that might otherwise be delayed. Faster access to supervisors is especially important if, as is true in many cases, different parts of the claims function are in different locations.

Stage 2. For insurers with basic collaboration technology already in place, the next step is a claims system that provides users with the ability to see the same information at the same time, while incorporating restrictions as to document access and edits. The ability to view information while engaged in a telephone or online meeting greatly enhances the efficiency of the process.

Stage 3. To reach an optimal state in collaboration, insurers should add smart business rules to automate the collaboration process. Rules that automatically route inquiries, for example, to special investigative SIU, recovery units, or for supervisors to then review can create a smoother path for specific claims.

Overall, collaboration is still in the early stages of adaption in most insurers’ claims functions. However, by providing the ability for claims professionals to create and edit claim information as a team─and by improving overall communications both inside and outside the claims process─investments in collaboration can deliver substantial returns on relatively modest investments. These benefits, in turn, will be amplified as insurers invest in other new claims technologies and process improvements.  

Patti Griffin is a senior executive in Accenture’s North American insurance practice. She can be reached at Patti.griffin@accenture.com

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