The role that claims management functions play in an insurer's long-term strategy has changed dramatically. No longer are claims cost or expense metrics the primary measures of a successful claims organization. The ability to provide a highly consistent and personalized claim service experience is a must for insurance carriers in both high- and low-frequency claims environments. Just watch any given NFL football game to see that the policyholder is king, and that claims service is now an essential cog in their value proposition.
This new operating environment is not without challenges. There are a host of factors that an insurer must address in order to deliver a comprehensive response to policyholders' vast needs. In short, policyholders expect flawless delivery by a uniform, fully integrated provider. To meeting claimants' preferences while ensuring satisfaction and fostering retention, insurance organizations must:
- Not only support policyholders regardless of the difficult times, but also become more focused to turn a negative experience into a positive one.
- Optimize touch points and opportunities throughout the claims process to improve the policyholder experience.
- Understand each policyholder's unique needs and marshal the strength of the total claims value chain in response.
- Guide claims adjusters through the appropriate protocols and considerations crucial to adequately address each policyholder's unique needs.
- Consistently provide the aforementioned service and noticeable value to insureds in a cost-effective, scalable operating environment.
To effectively address these challenges head-on, insurance carriers must align business strategy with business capability, and then create the appropriate supporting resources. A natural and fitting place to start down this path is the claims business process. In order to achieve an optimal outcome for each and every claim, insurers must instate best practices and optimizing the entire claim process. Specifically, there are five key steps that insurers can take here to build a closer, more ideal relationship with policyholders.
1. Change the view of the claims service experience.
Adopt a more holistic philosophy about what the claims experience means to your insurance organization as a whole. Instead of viewing claims interactions as mere transactions, carriers should instead view them as opportunities. How do we deliver on our obligations and simultaneously exceed policyholder expectations? How do we change service processes without bringing our organization down to its knees? Insurers need to exploit their total value chain in support of a total claims service experience. This can be accomplished by matching capabilities to a holistic view of service so as to orchestrate the right response for each policyholder.
2. Respond consistently across channels of interaction.
In an increasingly mobile world, insurers need to provide multichannel capabilities matched to policyholders' specific needs and preferences. With more people opting to carry out business on their smartphones instead of calling a contact center, those insurers who adapt to customer needs the most quickly stand to gain the most. More importantly, this capability must provide a consistent approach to ensure a policyholder has the same experience on an iPhone app as he or she would have in the contact center. To gain even more visibility, carriers may even want to provide an adjuster in the field with his or her own iPad or at least access to one. This will afford visibility into the same customer-facing processes and decision-making capability that an adjuster in the back office would have. In addition, insurers need to explore a cohesive strategy that allows them to create an infrastructure capable of evolving and adapting at the same pace that new channels are being created.
3. Make every interaction count.
With rules and process unified in one solution, insurers can seamlessly integrate claims handling policies and customer-centric procedures into dynamic, intent-driven service processes that automatically match the needs of a claimant with the intent of the business during a claims interaction. The intelligent process automatically guides staff through optimal handling as the interaction unfolds. This means that the service staff no longer needs to worry about which system to use, or which step to take next. Instead, they can focus on the more high-touch activities that differentiate the company's service experience from its competition. By leveraging customer-centric, intent-led processes, insurers can anticipate what a claimant's needs may be, along with how to match those needs with the optimal claims or service process. Imagine the power of being able to anticipate and respond to a policyholder's specific needs before he or she even asks the question.
4. Leverage data to maximum effect.
Increasingly, insurers are driving improvements in service or operations results by incorporating business intelligence (BI) and analytics into the claims management processes. However, many insurers are just beginning to scratch the surface and have yet to realize the full potential of such capabilities. While the insight that these tools provides is high value, many insurers lack the means to turn that information into the next best action.
In order to get closer to policyholders' needs, insurers must first gain greater leverage from analytics, specifically by making them actionable. With business process management (BPM) solutions that embed analytics within the claims process, insurers can use business insight in real time. Items such as fraud scores, settlement potential, churn risk, and so on can be leveraged to drive the next best action in the claims process. This allows insurers to invoke the right processes to actively address any claims issues and remediate potential risks, thereby expediting claims outcomes on behalf of policyholders.
5. Start with the service and business outcome in mind.
By combining rules and process with case management, insurers can manage the orchestration of a complex claims process across multiple systems, analytic tools, data stores, or third-party services. This unique capability allows insurers to marshal the right resource at the right time, in pursuit of the best-case claims outcome. Because advanced BPM provides rules-driven processes, insurers no longer have to rely on adjusters to be the key drivers of the claims process. Instead, automated case management can be easily integrated with back-end systems, accessing and using appropriate assets in real-time as part of the streamlined process.
Carriers that are able to master these ideals can spend more time delivering on their customer commitments and better managing total indemnity expenditures. In addition, carriers will have the innate ability to implement more agile claims processes that provide real business benefits. This means they will be able to further differentiate themselves from competitors. In an already stressed market where numerous natural disasters are weighing on their resources, if not their bottom lines, insurers can drive substantial gains in short time periods across customer satisfaction, retention, market share, and competitive advantage—all while reducing losses and claims leakage.
These business benefits are readily achievable, and many have already been realized by some carriers. However, it's hard to explain why some still haven't gotten more serious about it. The time couldn't be better for them to double down on this.
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