Claim technology is more than just software; its creation and adoption by companies can have big influences on adjusters. Claims' Eric Gilkey confirmed this when he spoke with Vincent Cialdella, who leads ISO's American Insurance Services Group as well as the development program for ISO ClaimSearch. Cialdella offered his opinions about technology trends, baby boomers, and whether the adjuster could one day become an endangered species.
What trends do you see developing in claim-management software/technology?
Insurers' abilities to manage the claim process impacts both their financial results and their reputation in the marketplace. Execution is key. With ever-changing regulations, increasing customer expectations, privacy and disclosure implications for medical claims, calls for accurate financial reports mandated by the Sarbanes-Oxley Act of 2002 (accurate reserves based on correct claim information), and state laws addressing unfair claim-settlement practices, insurers are making claim-technology initiatives a top priority.
One development in claim-management technology includes insurers addressing the challenge of outdated legacy systems. Companies are seeking imaginative ways to update serviceable legacy systems with leading-edge components that can be added to their existing systems. Comparative liability and subrogation are also ripe for change. Missed opportunities abound in those areas, and technology can help improve recoveries and positively impact the bottom line.
We're seeing exciting new technologies that will be important in managing claim investigations, including data and text mining. In addition, predictive modeling technology is increasingly being used to streamline SIU referrals, as well as to expedite payment of meritorious claims.
What impact will these developments have on the claim workforce?
When new technologies are successfully integrated, the handling adjuster can take advantage of software applications, data sources, and other tools to evaluate claims consistently and control workflow. The payoff is undeniable: adjusters get more done in less time, cycle times decrease, costs are controlled, and fraud is detected and successfully prosecuted. In addition, when decision-support software is used, adjusters are better able to determine a claim's merit.
Clerical tasks that take the workforce away from higher-level claim work can be frustrating. Some of the most rewarding technologies for adjusters are solutions that let them shed these time-consuming administrative tasks.
Every new technology requires a learning curve. Managers will need to ensure that adjusters are trained to get the most out of systems that can integrate information and processes to settle claims with speed and consistency. Increasingly, this instruction can be handled with online, real-time training programs.
How can insurers improve their customers' experiences through technology?
Insurers recognize that customers have a choice. When insurers cannot compete on price, they must compete on service. While this is particularly true in the field of auto insurance, the industry as a whole is wise to heed this lesson.
Claim-management software that quickly distinguishes between payable claims and those that require further investigation can help adjusters meet customers' service expectations. Expediting the settlement process leads to greater customer satisfaction and improved retention.
The retirement of baby boomers is an issue that is getting a lot of attention with claim executives. How will technology fill in the experience gap?
The experience gap caused by retiring baby boomers is a significant challenge that requires a multifaceted solution. Insurers must make a concentrated effort to recruit talented young people to the field. Managers should also avail themselves of experience-based claim-processing technology that can offer senior-level expertise to every staff member, helping bridge the divide between incoming college grads and outgoing senior managers. Additionally, if staff levels drop because of retirement, managers can turn to technology that not only increases capacity without adding to staff but also assists in matching the complexity of a claim assignment to the proper associate.
Technology has replaced underwriters in some insurance organizations. Could technology one day make the adjuster obsolete?
Absolutely not. Underwriting is an analytic process and may require the statistical measurement of relative facts and trends for the application of proper premium. In claims, the personal judgment of an adjuster is absolutely necessary. At its best, technology is a support tool that can sort through large sets of data and provide guidance, but the process will always require and benefit from human oversight. Technology can provide data and trends, but it cannot measure pain and suffering or effectively negotiate a settlement.
Adjusters are there for clients after their worst days: hurricanes, auto accidents, and other traumatic events. By exhibiting empathy, explaining the claim process, and communicating information throughout the claim, adjusters serve roles that no technology can replace.
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