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Shifting Claims Processing and Management from Customer Service to a Customer Experience

By Cynthia Paisley, VP, Claims Strategic Leadership, ProSight

Cynthia Paisley, VP, Claims Strategic Leadership, ProSight

Buying insurance has never been a particularly pleasant experience, in large part because customers often don’t fully understand what they’re purchasing. In the absence of a physical product, buyers essentially purchase a promise from the insurance company’s claims department that they’ll provide an exceptional customer experience in the event of an accident.

Because claims processing is part of an insurance company’s product, adequate resources must be devoted to this department to facilitate innovation. The company has limited opportunities to win the customer’s confidence. If it doesn’t offer a modern, best-in-class experience, the customer will likely move on to a new provider.

What constitutes a modern, best-in-class experience, and how do insurance companies navigate claims challenges to achieve one? In my view, insurance companies must evolve their traditional claims handling experience to include technology investments, partner with the best legal experts, and establish a claims philosophy to allow employees to handle claims processing aligned with the company’s approach. To get started:

1. Invest in modern technologies. In the digital age, customers are accustomed to seamless user interfaces, and they won’t accept anything less from their insurance providers. The speed of responses matters and an investment in modern technologies can greatly help to bring down waiting periods. Start by looking for areas of the claims process where customers may face friction or bureaucracy. Is there a technology fix available on the market? This could include a chat bot system or a video-conferencing service. At ProSight, for example, a solution our claims team utilizes is what we call a Direct Response Center, where we can interact face-to-face with customers, and they can take our team virtually to the site of their claim. If it’s property damage, we can see live, within minutes, what we’re dealing with, greatly expediting the speed of recovery services.

"Because claims processing is part of an insurance company’s product, adequate resources must be devoted to this department to facilitate innovation"

2. Know your clients and their industries. In-depth knowledge of a customer’s industry allows claimagents to relate to and empathize with their clients. Most of the time, a claimprofessional’s expertise in the customer’s industry is limited to their types of claims. At ProSight, we go a step further too truly understand the client’s business and the unique risks that can develop from their business. With this understanding, we can better protect and defend our customers. We’ve found this extra layer of knowledge is invaluable to customers.

3. Go all in. Claim professionals should always stand up for their clients’ best interests. Sound obvious? It is - but it’s not just to please your customers. Being fearless in defending claims will solidify your claim department’s reputation in the industry, which positions your team with an advantage when it’s time to face other industry professionals or represent your clients in court. Legal opponents will understand what they’re up against, knowing you are willing to go all in, fighting ferociously in litigation to defend your customer. As an added benefit, this reputation will also appeal to and attract new customers.

4. Establish partnerships where needed. If you have a client doing business in an unfamiliar geographic location, get to know that venue well. This means learning about the players, the courts, the judges and any unusual risks that may apply to best underwrite the risk. You should also proactively prepare to respond in the event of a catastrophic event, lining up whichever local experts and resources would be needed, so you can respond as quickly as possible. For a customer in crisis, this prep work and swift action will mean everything.

5. Create a culture of empowerment. Company culture has a direct correlation with how claims agents treat your customers. By empowering your employees to take initiative and think outside the box, you can ensure your customers are receiving the best possible customer service.

An exceptional claims experience is ultimately what differentiates one insurer from the next. Exceed customer expectations by meticulously servicing the customer through the entire process to achieve the best possible outcome. It will have a profound impact on your customer’s bottom line and connection to your company. An exceptional experience is also likely to result in customer referrals and retention rates.

Claimsare extremely fact sensitive and a final outcome varies by each individual situation. Whether or to what extent a loss is coveredor defense is provided depends on the actual facts and circumstances of each claim and the terms, conditions and exclusions of the applicable policy.

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