DRIVING GENUINE TRANSFORMATION
OF CLAIMS CX
Claims is the moment of truth in the insurance journey. It’s when the peace of mind that the purchase of an insurance policy confers is put to the test – how easily, how quickly and how fairly was a loss restored? And beyond fair compensation and speed-to-settlement, how did the experience make you feel? It is in claims that the balance between digital and human is most keenly put to the test.
But striking that human/digital balance can be difficult. Every customer comes with their own needs, preferences and capabilities, all of which may change moment to moment during the claims lifecycle. Many carriers struggle to even capture customer satisfaction data, which leaves them flying blind about how to drive improvement.
‘NPS is completely inappropriate for the claims organization,’ said Grace Hanson, a serial C-suite claims executive and the former Chief Claims Officer at Hippo. ‘The best way is to measure all the touchpoints along the entire claims journey and to really deeply analyze how they drive the best outcomes.’
Key metrics to look for, according to Hanson, include the complaint ratio, the escalation rate, the timeframe between communications, frequency of litigation and who’s instigating communication, the policyholder or the carrier.
‘All these data points can be pieced together and put into a comprehensive dashboard to help you measure how people are feeling,’ said Hanson.
Sentiment analysis tools have a role to play here, helping sift out those claims where customers may need additional support or empathy. AI capabilities such as common ground tracking, to aid dispute resolution and build a common understanding of what’s happening with a claim, and dialogue state tracking to estimate customer goals for enhanced routing, can help with case management while Open AI’s voice engine is an important tool for scheduling communications to maintain momentum during the claims process.
But maximizing the benefits of these new technologies will require process changes, both internally and potentially for customers, as Greg Hamlin, SVP Chief Claims Officer at Berkley Industrial Comp explains:
A paid claim is, typically, a happy claim and most claimants want – and need - to get paid quickly. According to insurance thought-leader Lori Pon, automation and digital payments are key to ‘democratize getting paid faster’, even in complex claims.
Gwen Olson, AVP, Enterprise Claims Strategy at American Family, points out that automation can be agnostic when it comes to loss type. ‘Once you have the automated capability, it’s then a question of scaling that capability by capability so you start to chip away at the volume of claims that are automated,’ she said. She cautioned, however, that just because something can be automated, doesn’t mean it should be.
If the decision to automate is just about making the claim adjustor role more efficient, then we will do wrong by the customer. If the decision is focused on the experience we want the customer to have, then we will make adjustors more knowledgeable and more efficient. Coming at it through the customer lens will give you a different outcome.
GWEN OLSON
AVP, Enterprise Claims Strategy, American Family
The importance of human agents cannot be understated. Carriers that experiment with all-digital self-serve claims solutions repeatedly report that in some situations, customer preference will always be for human interaction.
Here, AI tools will take on the tedious, repetitive and time-consuming processes that create what Lori Pon called ‘painful minutes of silence during a call’, carving out more time for humans to do what humans do best.
Philippe Lafreniere, SVP & Advisor, Strategic Accounts at EIS on empathy, and what personalized empathy can look like in practice:
At Berkely Industrial Comp, which specializes in workers comp for high hazard industries, ‘what humans do best’ looks like writing letters that acknowledge injured workers’ distress, empowering agents to solve problems and even sending cookies to injured workers.
‘If you do the right thing, it builds trust and helps customers along the path to do what you need them to do,’ said Greg Hamlin, SVP Chief Claims Officer at Berkely. ‘It gives you more chances to nudge people towards better choices and ends up costing you less.’
As AI tools gain more capabilities at speed, this balancing act of human and digital may shift – stay in the loop with Insurance Innovators.
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