Refine IT Infrastructure To Streamline Claims Processing

From how we connect to how we do business, technology is—and has been— changing the world in which we live. But with this disruption comes innovation, and the wealth of tools related to social media, mobile technology, and predictive analytics is staggering.

While technology offers many opportunities and potential benefits to P&C insurers, it also poses challenges, especially for claims organizations. In this new era of visibility, the claims process is under intense public scrutiny and must be constantly re-evaluated and optimized. Recent disasters such as Hurricanes Irene and Sandy illustrate this and seemingly solidify insurers' place under the microscope.

The reality is that customer expectations have also perhaps never been higher. Customer satisfaction will continue to be a key differentiator in a highly competitive market, and insurers seeking to attract and retain customers will need to streamline their claims operations on multiple levels.

Brad Fisher, the vice president and director of the property claims division at American Modern Insurance Group, knows a thing or two about using technology to optimize the claims process, from FNOL to settlement. Recently we spoke with Fisher about the evolving role of technology at his company and the new era in claims handling. Click on “Next” at the bottom right of this page to read what he had to say.

How is technology streamlining your company's claims process?

American Modern has invested heavily in its IT infrastructure and software solutions in the last year to streamline each claim from first notice of loss (FNOL) to check issuance. Now that we are paperless, information gathered during the claims investigation is available more quickly to others in the organization to support the claims process. This enables us to handle analysis, authorization, and customer support while the adjuster investigates or responds to other claims. This should also improve accuracy, resulting in faster settlement, which averages less than 30 days.

Are certain technologies becoming more crucial for the claims process than others? 

Claims processing is simply a microcosm of evolving attitudes in the general marketplace in regards to an expectation of immediate accessibility and response. So, mobile technology solutions that are incorporated with high speed internet are helping us better meet that expectation by allowing customers and adjusters to share information more efficiently.

How is technology changing the way adjusters perform their jobs? 

One of the recent changes we have noticed is that many insureds prefer to receive a text from the adjuster instead of a phone call. Also, for technology to be used effectively, more system training must be provided for adjusters about how to use smart phones to, for example, share digital photos.

How is the role of the adjuster changing within your company? What are some of the issues the industry must address in terms of the quality and experience of adjusters?

One important change in our adjusters' role is to relieve them of responsibility for performing “non-value-added” tasks by using software to streamline the process and eliminate repetitive data entry and administrative tasks. This, in turn, frees them up to focus on conducting quality claims investigations in order to resolve our policyholders' claims both quickly and accurately. Product knowledge is not only a requirement for accurate claims settlement, but also a significant driver of customer satisfaction. To have a staff of knowledgeable adjusters, companies need to invest in their hands-on training and education. Our industry needs to focus on educating college students about the opportunities and rewarding careers within the insurance industry. 

How has mobile technology changed the way claims professionals go about performing tasks?

Mobile technology has enabled our field adjusters to have access to more information while they are onsite during an inspection. That kind of immediate access to information and tools of the trade at the loss site can enable them to resolve the claim faster and with increased accuracy.

How has mobile technology changed case assignment, FNOL, location, and routing?

Our FNOL process includes loss assignment to the adjuster based on the loss location. This then generates a text message with several initial data elements to enable the field adjuster to complete initial contact. We're in the process of installing a state-of-the-art new claims system that will allow us to leverage mobile technology considerably more while in the field.

What kind of feedback do you receive concerning customer satisfaction with the claims process, and how does this affect claims processes?

We conduct telephone surveys with a sampling of policyholders who have recently had a claim with us. This sampling includes both policyholders whose claims were paid and those whose claims resulted in no payment. The feedback we receive from these surveys covers everything involved in the claims experience, from FNOL through the resolution of the claim. We have a team of claims associates that analyzes the feedback to confirm our top drivers of satisfaction, as well as to identify areas where we can improve the customer's experience. Based on this feedback, we can better team up with the product and marketing areas of our company to enhance processes that are likely to improve customer satisfaction.   

How has social media affected claims? Do you monitor social media in terms of customer satisfaction? What steps can you take—if any—to deal with unfavorable publicity about a claim?

Social media hasn't materially affected the claims process because we have always been responsive to customer concerns when those concerns were brought to our attention. As a matter of corporate policy, we never debate the validity of different opinions on Facebook or Twitter. Instead, we follow a process that is fairly common in the industry. We acknowledge receipt of the social media message and, if we are able to identify the person posting the complaint, we then reach out through another medium to discuss the claim. If it is not possible to identify the individual, then we post a message of our own, encouraging him or her to reach out to the claims department via phone.

How satisfied are you with your claims administration system? What areas work best?

We are currently in the process of updating our claims administration system. The new system will be able to better support our growth and will bring more information directly to the adjuster. We will also be able to more fully integrate it with other systems so as to present real time claim status information to our agents and policyholders through online portals.

What inroads are you making in the area of self-service for claimants?

Policyholders are able to file FNOL through our website. Those who create an online account with us are then able to access basic claims status information on their own. We continue to look for ways to use technology to enable policyholders to provide information that will assist in resolving their claims. For certain types of claims, when the policyholder chooses, we utilize their digital photography to assist in showing us the damage being claimed. This reduces the time required to settle the claim by eliminating the need for an on-site inspection. We are able to use their photographs to write an estimate of damages and get them a claims payment faster so they can get their loss repaired, resulting in increased customer satisfaction.

How often do you reexamine your processes? Would you be able to share some examples of changes you have made recently?

We re-examine processes constantly to ensure we are using the [most appropriate] new technology and customer feedback to improve our overall effectiveness. A few examples of changes we have implemented as the result of process analysis include EFT payments to vendors; printing of checks in the field; and obtaining bank status on a check when the claims payment changes so the adjuster can directly stop, void, and reissue a check, if needed.