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Blog | Mar 7, 2024

5 Steps to Automating the Customer Claims Experience

Claims Experience
Table of Contents

Create Better Customer Claims Experiences

Claims handlers face the challenging task of delivering excellent customer experiences to policyholders, who from the first notification of loss (FNOL) have already been hit with an unpleasant experience. Insurers can either excel in resolving their problem (and receive glowing online reviews and recommendations) or risk accelerating dissatisfaction levels even further if they don’t meet expectations. This can impact customer churn and net promoter scores (NPS).

Customers Are Calling the Shots

Customers want their insurers to provide a quick and easy resolution. If they’re met with an unsympathetic or inefficient service, insurers risk customers moving their business elsewhere. Global research from Accenture reveals that dissatisfaction around the claims experience is the key driver for customers to switch insurers:

“Nearly one-third (30%) of dissatisfied claimants said they had switched carriers in the past two years, and another 47% said they were considering doing so.”

Today, the insurance industry faces an urgent need to modernize. The typical ways once sufficient for ensuring a lasting connection with customers, must now adapt.

What Matters to Customers During the Claims Experience?

Intelligent automation (IA) and generative AI can significantly enhance the customer journey and streamline internal operational processes at each stage of the claims process. These technologies enable insurers to attract and retain customers.

In this blog, we’ll look at:

  • Challenges customers and insurers face at each stage of the customer journey.
  • How IA and SS&C Blue Prism can resolve these challenges.
  • Real-life examples of how SS&C Blue Prism has delivered exceptional customer experience outcomes.

“Automation is about removing the repetitive tasks and allowing teams to focus on customer and value-add activities, and encouraging innovation and bold thinking.”

Chris Hartley

BPM, automation and salesforce practice leader, Allianz

1. Simplify customer onboarding

Making a great first impression with your customers is paramount to kickstarting their journey in the right way. It also provides upsell or cross-selling opportunities across insurers' product portfolios by capturing valuable information about customer needs, which might be used to qualify them for more relevant offers. Customer onboarding data can come from multiple sources via the phone, online, post, in-person or through an aggregator's website. Insurers must verify customer identities and assess the risk and suitability of every new customer.

Manual onboarding

The customer onboarding process is usually repetitive, time-consuming and error-prone. Employees re-key the same information into multiple systems and spreadsheets, manually access third-party systems and liaise with different teams. Customer data often sits in different departments with no single source of truth.

Customers are asked to provide a wealth of information before securing their policy, which can be complicated or confusing. Customers may be asked to provide the same information multiple times, and what was promised to them as “easy and fast” can take longer than expected – and may result in the customer calling in to speak with an agent, adding further burden to your customer service team.

How to create a better claims experience

  • Extraction and verification: Leveraging insurance automation to accelerate document verification and data extraction can streamline the onboarding process for both customers and employees.
  • Customer interactions: Chatbots or virtual assistants powered by artificial intelligence (AI) can assist customers in providing necessary information and guide them through the initial steps with ease.
  • Tailored products and solutions: IA can identify opportunities for additional policy cover across insurers’ offerings by correlating the data provided by the customer. Insurers can then serve up tailored insurance packages and deepen the relationship with their policyholders immediately.
  • Personalized content: Gen AI’s content generation capabilities can create personalized welcome messages, policy explanations and other communication materials to diffuse any confusion and ensure a simpler and smoother onboarding experience.

How do you make the claims experience better for customers and employees?

By deploying digital workers to fulfill the customer onboarding process, your people can remain focused on the high-value activities, enabling you to achieve (as examples):

  • 75% cost reduction of customer onboarding as part of know your customer (KYC).
  • 92% reduction in account review time (from 3 hours to 15 minutes).

Let’s explore some more IA use cases in insurance.

First2Protect accelerates insurance applications

First2Protect deployed SS&C Blue Prism digital workers to tackle bottlenecks in their insurance policy application process and:

  • Save 100 hours each month.
  • Manage peaks in demand.
  • Process applications 24/7.

Old Mutual automated their entire claims process

Old Mutual relieved employees from manually filing a claim by utilizing digital workers to extract data, validate information, cross-reference for accuracy and generate real-time customer updates.

2. Frictionless FNOL

    First notification of loss (FNOL) can be a particularly emotionally distressing time for customers, whether they’ve been burgled, experienced a car accident, or found themselves or their pets in ill health. They expect claims to be processed smoothly and without any delays, so they can get their lives back on track as quickly as possible.

    As the highest value touchpoint, the FNOL experience plays a critical part in affirming the customer's experience. If they have a positive experience, they feel even more secure in their choice of insurance provider. If the experience is poor, it may reinforce the customer's belief that they need a new insurer.

    Manual FNOL

    The FNOL stage of the claims process is the most challenging, labor-intensive and critical when meeting customer service goals of most insurers. The FNOL process involves accessing and updating multiple legacy and existing systems. Due to delays in updating information in all corresponding systems, accurate status is not always readily available. Data errors can result in processing inefficiencies, which ultimately leads to poor customer experience.

    How to improve FNOL processes for customers

    Using an IA platform supports connectivity between both old and new technology. Combined with the broad range of IA capabilities including optical character recognition (OCR) and natural language processing (NLP), IA can:

    • Analyze the insurance claims submission.
    • Detect specific policy language to validate the claim.
    • Consult third-party databases to verify a customer’s identity.

    This enables customers to benefit from a faster, more seamless, and empathetic experience by freeing up those in claims handling, giving them time to focus more on customer service skills while digital workers take care of information processing.

    How do you speed up claims management?

    This claims process automation allows an insurance provider to easily analyze and consolidate claims data, ensuring insurers have timely access to all relevant information. Insurers can speed up claims management with IA by quickly verifying the claim and automatically routing the right information to the claims department – while simultaneously updating customers about the progress of their claim.

    How IA speeds up FNOL

    IA and AI are already used throughout the insurance industry to enhance the FNOL experience and achieve:

    • Accurate status insights.
    • Seamless submission processes.
    • Faster assessment outcomes.

    3. Streamline claims settlement

    The real essence of insurance lies in seamless claim settlements. Buying an insurance policy is meaningless if claims aren’t settled appropriately. Claim settlement delays can take a significant financial and emotional toll on policyholders. Due to risk and fraud-related issues, making prompt decisions without errors is a huge challenge, which can lead to inordinate delays in settlement.

    “87% of policyholders believe the claims experience impacts their decisions to remain with insurers. Speed of settlement and process transparency are the most important contributors to the customer experience.”


    , Claims Digital Era

    Manual claims settlement

    Delayed payouts can occur for several reasons. Insurance companies may conduct extensive investigations into an accident to determine fault or liability. This might require ongoing damage reviews, or the claim may even be contested. The number of people involved in the claim can also affect the time it takes to settle. If the customer fails to follow the correct claims filing process, this can also adversely affect the entire claim journey, impacting the time to settle.

    How automation can streamline the claims lifecycle

    Automating the claims process streamlines and accelerates the often costly, time-consuming and error-prone claims settlement processes. By harnessing technologies such as IA, organizations can automate tasks across the entire claims lifecycle, from submission to payout, while also reducing fraud and rework.

    Once investigation, validation and rectification elements of the claims process are complete, IA can also automate the payment process for accuracy and speed using digital payment methods and ensuring clear transaction records.

    Automation’s predefined rules can set payment amounts and coverage, with the option for a human-in-the-loop (HITL) for final checks. Once the claims process is complete, the insurer can perform a claims analysis. Automation tools can help analyze claims data and identify customer behavior patterns – flagging any potential fraud and identifying areas for improvement.

    How other insurers automated their claims processes

    Zurich makes faster claims payments

    Zurich leveraged IA to overcome inefficiencies in processes across the entire organization, which were impacting their ability to serve customers well.

    • 3 million transactions processed.
    • 120 processes managed by 55 digital workers.
    • Enhanced customer experience.

    “I’ve often heard our executives say, “This is proven technology.” This has proven itself already, now it’s about kicking on and building more capability."

    Alastair Robertson

    Head of continuous improvement and automation, Zurich U.K.

    Slovak enhanced premium calculations

    Slovak was processing half a million premium requests each year, manually assessing the risk of each driver. This led to customers being undercharged and at risk of receiving significantly reduced claim payments. With IA, Slovak achieved:

    • €0.4 million additionally collected premiums.
    • 500,000 accurately processed premiums per year.
    • Reduced risk of underpayment for customers.

    4. Excel at customer support

    According to McKinsey & Company, “Customers typically interact with their insurance carrier once or twice a year. This starkly contrasts other financial services industries such as banking, in which customer interactions take place ten to twenty times more often. The low frequency of customer touchpoints in insurance means it’s extremely important to get each one right.”

    Traditional customer support

    Delivering great customer service means ensuring your agents have the tools they need to focus on your clientele, especially during periods of peak activity, to allow excellent customer service at scale. Customers today require a truly omnichannel experience, which means offering them the opportunity to engage with insurers via eight different methods, including online, in-person, over the phone, mobile and by post.

    It’s not just essential for customer support agents to provide friendly, professional and timely service. They must also be proficient at dealing with the complexities of high-value claims processes, all while being aware of potentially fraudulent activities. In a role notorious for high employee attrition due to the complex and challenging nature of the job, finding and keeping team members with this niche mix of skillsets is challenging for insurers.

    How intelligent automation steps up for customers

    Intelligent automation (IA) helps agents work more efficiently with systems, connect channels, standardize customer data and process documentation more quickly. IA improves the entire claims management process by creating better connections. Most calls to contact centers are from claimants inquiring about the progress of their claim. You can remove this one task from call center agents by sending automated updates on claim progress, giving your team the time to resolve more complex claims quickly and improve your net promoter scores. As a result, you can reduce:

    • The volume and length of calls.
    • The need for manual follow-ups.
    • Waiting times.

    All while enhancing transparency for customers.

    AI-powered chatbots and virtual assistants can handle routine customer queries, allowing human agents to focus on more complex issues that require a personal touch. AI-driven natural language generation can be used to create personalized and empathetic communication, ensuring that updates and responses are tailored to the individual customer's situation. Gen AI can also assist with real-time agent assistance, guidance and conversational analytics to deliver exceptional customer service aligned with the insurer's communications standards.

    “We centralized all our communications, including inbound and outbound emails through SS&C Blue Prism® Chorus. Any team member can now instantly look up what’s come in or gone out and find it in one place.”

    Craig Gorin

    Project manager, Ansvar

    How our customers are boosting customer support

    ERGO excels in customer service at scale

    Hailstorms are hard to predict, so it’s impossible to scale human resources to respond. Instead, ERGO gave the task of collecting customer claims to SS&C Blue Prism intelligent digital workers and achieved:

    • Completed 80% of 4,000 claims made in one week.
    • 70+ digital workers deployed across 25 departments.
    • Rapid processing which improved customer experience.

    First2Protect refocuses its customer support agents

    Advisers needed a way to deal with the increased number of transactional inquiries. Their transactional nature made them ideal candidates for IA. Digital workers now enable:

    • Increased customer support.
    • 24-hour availability.
    • Futureproofing to introduce new channels.

    Laya Healthcare delivers critical information faster

    When it came to looking after claim assessments and member requests for documentation, Laya wanted to deliver a higher level of customer service. And they did! With help from intelligent automation, Laya now benefits from:

    • Delivering critical customer documentation 99% faster.
    • 70% faster claims processing.
    • 99% faster response time to process critical member documentation.

    "A digital worker checks the file every 15 minutes. Instead of days, members are getting an answer in minutes. When a member has an important request, they don’t want it on Friday, they want it now. And with our digital workforce, we can deliver.”

    Eoin McAndrew

    RPA lead, Laya Healthcare

    5. Remove renewal risk

    Policy renewal occurs on average once a year and is a crucial step that must be designed in such a way that it’s perceived by policyholders as transparent and frictionless. Insurance renewal processes are defining moments in the customer-insurer relationship that contribute (if successful) to long-term business sustainability. This is because retaining existing customers is often cheaper than acquiring new ones. Enabling a smooth, transparent and customer-centric renewal experience increases the likelihood of retention and drives up customer loyalty significantly.

    Manual renewals

    The key to retaining customers by securing renewals is in meeting and exceeding customer expectations throughout the previous elements of the journey detailed above. Another key element is in making the process of renewing policies as simple as possible. Similar to customer onboarding, simplicity of language, lack of repetition and minimizing customer efforts are essential, especially given customers are now known to insurance companies.

    How automation can boost targets

    By incorporating IA and generative AI at each stage of the claims process, an insurance company can not only improve efficiency and accuracy but also enhance the overall customer experience. This leads to increased customer satisfaction scores, loyalty and retention. Utilizing IA to gather and consolidate customer data to identify behavioral patterns lets insurers present tailored policies at the time of renewal. IA can automate reminders constructed using gen AI to align with these insights and include data gathered from the market to share comparisons and help your customers make this decision more easily.

    How are other insurers mitigating risk with IA?

    Ansvar increased policy renewals

    Ansvar required centralized visibility and management of all customer service activities, including communications, task allocation and document management. They identified this as a critical differentiator to stay ahead of the competition and retain their existing customers. Automation helped Ansvar achieve:

    • Increased policy renewals.
    • Improved workflows.
    • Greater efficiency during peak periods.

    Are You Ready to Transform Your Customer Experience?

    From achieving cost efficiency to managing consumers’ expectations, bringing transparency in the process, and taking care of every parameter needed in a claim settlement process, IA is making the entire end-to-end process seamless for the whole value chain in insurance.

    If you're ready to accelerate the customer-centricity of your insurance organization, read our eBook, 'Breaking Down Barriers in the Insurance Industry'.

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