Host, Merlin Beyts, asked what problems were the most pressing for customers during the claims process, broken down into three categories: people, processes, and technology. Insurance claims, as a whole, need to be looked at as an ecosystem, and with these facets in mind, we should have no problem controlling that. Do people have the appropriate training and are they clear on what matters? Are our processes streamlined and automated correctly? And are insurers looking at technology as their fundamental platform and building off of that?

People

To start, you must make sure you have the right people working for you. Many folks in the industry have begun to worry about the presence of millennials in claims handling, for example. They’re relatively new to the insurance industry, so should we be cautious about working alongside them? In short, the answer is no.

When assigned to the right aspect of claims, the experience and skillset millennials have can create great prosperity for a carrier. Young people bring a lot of value to older industries, especially when they are put in a position where their knowledge can be adequately utilized. However, for insurers that are worried about this transition, it’s important to remember that you must leave room for them to gain wisdom from more experienced people in the industry, as well.

A great example of this is Laka, where all but one of the claims handlers are millennials. They recognize that if technology has the ability operate the mechanics of claims handling on its own, then insurers can start to bring in people who are more suited for specialized areas. Hiring enthusiasts and mechanics, who are invested in what your company is selling, will set you apart from the competition. But when it does come to more complicated claims, keeping someone in-house who has a better understanding of fraud and the inner workings of your policies, is vital too. This is because that’s what they specialize in. People should be working on what they enjoy rather than tasks they find mundane, which may be better suited for someone else.

Processes

In terms of processes, there is no “single aspect” of claims that needs to be improved. In order to solve inefficiency as a whole, you have to make sure that the claims process isn’t built off of fear. Often times, both customers and carriers look at each other cynically, thinking that the other wants to take advantage of them. Carriers are afraid of fraud, and customers are afraid of being rejected for an honest claim. So, if you want to create a better system, you have to understand where that fear is coming from and mend that first.

Also, understanding key dependencies is an important part of that. If you’re launching a customer portal, for example, do you have the right metrics to measure things like customers satisfaction? Adding new elements to any process is challenging, both internally and externally. So, you have to make sure that you’re not underestimating the element of change, and need to prepare your company for that, too.

Technology

Finally, it’s valuable to recognize the advantages and disadvantages of technology. In a recent study conducted by FRISS, 500 insurance professionals in 50 countries were asked about the problems they faced with digitization. The top three results included:

• Quality of internal data
• Inadequate capabilities of external data sources
• The ability to use technology without compromising privacy

These issues weigh immensely on a carrier’s ability to thrive and must be addressed if they want to innovate their claims process successfully.

These aren’t the only issues. When you introduce new technology, you also open the door to new fraud that many carriers have never encountered before. This can blindside insurers who are not expecting it, but luckily, when addressed correctly, it can also lead to incredible accuracy of detection. To solve this, you have to make sure that claims handlers aren’t relying too heavily on newly introduced AI capabilities. People can sometimes lose sight of the problem they’re fixing and become overwhelmed by new systems. It’s crucial that carriers plan for this, as well, to know if fraud is being detected correctly.

Source: FRISS