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Claims Processing and Management

Andrew Leeds, Vice President of Claims, Plymouth Rock Home Assurance Corporation

Andrew Leeds, Vice President of Claims, Plymouth Rock Home Assurance Corporation

Today – whether we realize it or not - we are experiencing a renaissance in homeowner claim settlement processes and technology.The COVID-19 pandemicserved as a catalyst that accelerated carriers’ shift from field-based adjusting to virtualinspection and claim settlement. Much of that change is enabled by technology, some tried and true, some cutting edge. Today, carriers are measuring the impact and trying to understand the benefits to both the carrier and the customer and as of now, the results are largely mixed. Yes, we can adjust more claims remotely, quickly and accurately but customers still feel strongly about having a direct role in the claims process. Figuring out the right balance between process and technology and human interactionwill determine the winners in this space.

Critical to the claims adjusting process is the ability to “see” the damaged property. In the past,this was done exclusively through visual inspections supported by photos processed on film. The next evolution was instant photos (Polaroid) and then digital photos.Now, smart phones and other digital technology allow carriers nearly instant access to images of damaged property.

Virtual Inspections – Customers don’t have to wait for a field adjuster to come to their homes to inspect the damage. Off the shelf applications, like FaceTime and Zoom, allow nearly every carrier to conduct a video virtual inspection with their customers in real time. Insurance specific applications like ClaimXperience and Symbility Video Connect go a step further and integrate with estimating platforms that import inspection data directly into the claim file.

Augmented Reality Measurement – Gone are the days of asking customers to pace their rooms, convert their shoe size and steps into inches and feet to measure the square footage of a room (yes, we did that). Today’s smart phones equipped with Light Detection and Ranging (LIDAR) allow customers to take a handful of photos and, with the help of apps like PLNAR, convert that data into complete 3D renderings of a room. This information is seamlessly imported into estimating platforms and from there adjusters are provided a highly accurate floorplan that can be usedtoprepare damage estimates.

Robotic Process Automation (RPA) – “Simple” losses that meet certain specifications are excellent candidates for RPA. As increasing amounts of data become available to insurers, it can be used to validate claims made by customers. For simple losses,when details are easily confirmed, coverage can be determined and an estimate of the loss createdin close to real-time.The level of adjuster oversight can be modified by complexity, allowing for even greater numbers of claims to be processed using RPA.

Looking to the future, the biggest opportunity lies in material identification.If pictures are worth a thousand words, augmented reality measurement adds thousand more. However,they don’t tell us thespecific materials used in the home. Is the wall we are looking at ½” sheetrock, blue board, or plaster? Is the baseboard PVC or wood? Each of these nuances has a direct impact on claim costs, estimate accuracy and customer satisfaction.

ITEL has begun to make headway in this space with their mobile app and ability to identify flooring and siding. The real question is who will be able to go further and what technology will be needed to identify all materials in a home quickly and accurately? Can this technology integrate with estimating platforms? Can it be simple enough that a customer can be guided through a process in minutes to write their own estimate?

The seamless integration of all of these technologies will have a material impact on the speed and accuracy for how all home insurance claims are settled. It is not outside the realm of possibility that in the not-too-distant future carriers will be able to use weather data, real time satellite/drone footage, on the ground customer provided photos and AI/RPA to accurately settle thousands of claims nearly instantly following major catastrophes. As these solutions are increasingly implemented into the claims process, it will still be important to find the right mix of human interaction and technological applicationsthat will help us not only find ways to make the claims process easier, but more effective.

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