Are you concerned about your ability to meet the ever increasing expectations for operational efficiencies and customer experience in your claims process? Is your senior management increasing goals for revenue and earnings growth while the hurdles seem to be growing every day?
The intersection of policy holders, staff and technology in the claims process is particularly challenging – but if done right it solves many of the challenges.
Did you know that one in three customers cited poor claims handling as a major factor in deciding to switch insurers?
Your policy holders are more demanding than ever. They expect to communicate in the channel they prefer, and they expect an instant response! The number of channels customers use to communicate with you is exploding – web, email, chat, social media, fax, and even regular mail have joined voice – and more are coming. Worse, the information coming from these new channels is 80% unstructured, leaving you sorting inquiries by channel, which has no bearing on the actual content of the message.
You have only one choice – ensure that you effectively engage with your customer base: Allow your policy holders to communicate with you following their preferences and fully integrate all communication channels including social media; in order to make this input valuable you want to find a solution that understand the true meaning of any type of text based input, regardless of structure, source, and format
Your claims staff is in most cases your face to your policy holders. The fact that only 30% of insurance industry customers worldwide rated their experience as positive is more than alarming. While your claims adjusters are your most important asset, it is also a key cost factor especially considering that it takes 10 years and more to reach senior expertise. Many of your most experienced claims adjusters are near retirement age, so you need to empower your less experienced staff members to cover more demanding cases to close the experience gap.
You need to find the optimum balance for your workforce expertise levels i.e. between aging experts and less experienced staff by allowing them to focus on cases or requests that align with their expertise while providing less experienced staff with a comprehensive, yet dynamic knowledge base. Our solution that is based on Artificial Intelligence allows to on ongoing learning from the exception handling done by senior experts and the surfacing of most relevant responses leveraging semantic understanding and intelligent filtering of potential responses
As result your staff is more satisfied and in consequence the turnover rate declines and their motivation impacts the satisfaction and loyalty of your customers.
The handling of a claim still requires matching the request with customer information that resides in various systems and databases. Finding this data, such as policy holder status and associated entitlement to reimbursement, and automatically processing the claim accordingly is another big hurdle to achieving the goal of straight through processing.
For the future success of your insurance carrier it is key to improve and where feasible automate your claims process connecting your mailroom, back office operations, and your service center.
Our solution uses self-learning classification, extracts and enriches data through integration with existing systems, and proposes relevant responses back to the policy holder. Rekeying and other time-consuming manual activities are reduced significantly.
Through insightful automation, processing times are significantly decreased from time of notification to reimbursement, and true end-to-end automation is achieved.
Did you know $30B per year are lost due to insurance fraud per year in the US alone. What is the impact in your company? Some insurers employ hundreds of specialists using innovative technologies and network analysis tools to identify and help prevent fraud. Fraud analytics tools are a critical tool to master the challenge and to create a competitive advantage by segmenting risk better than other insurance carriers. Advanced data mining and predictive modeling, supporting highly skilled employees for a comprehensive fraud detection framework is critical for future success.
Your success in reducing fraud has a significant impact on your profitability.
We flag potential fraudulent claims based on comprehensive analysis of vast quantities of information and monitoring of the complete communication history of each customer. This data serves as key input source for comprehensive data mining efforts and close the door” on fraud.
Join us tomorrow to learn more how our solutions based on cutting edge technology addresses these and other challenges that you are facing in your claims process.
A sample of the webinar materials are available on slide share.