The five aspects of a strong claims transformation

Auditing and assurance firm PricewaterhouseCoopers recently released an eBook that examines the five steps that insurers must take to streamline their claims processes and increase policyholder satisfaction.

 
 

In this post, we’ll take a detailed look at the most important aspects of this transformational process, and explain how a successful claims transformation can lead to better customer experiences and increase the growth of your insurance company.

According to PwC, the five dimensions of a successful claims transformation are as follows:

Customer experience

Offering an incredible customer experience is the first step in transforming your claims process. After all, nobody wants to file a claim – but your insurance company must be ready to step up to the plate and provide excellent service when they are needed.

Operating model

Interactions with your company should be smooth and seamless for your customers, with a smart operating model that can support effective delegation and transfers.

Integrated management

The claims department must integrate with other departments in the insurance company both bottom-up from claims, and top-down from every other department in the enterprise.

Advanced technology

Insurers need to leverage advanced technology to investigate new solutions for their business and replace outdated systems.

Information and analytics

“Big Data” analytics should be used by your company to develop smart, informed insights about your customers, allowing you to make appropriate changes to provide a better quality of service.

Expanding on the five dimensions

To achieve each of the above dimensions, PwC has laid out a detailed framework of each aspect of claims transformation. Here is a brief summary of each:

Customer experience 

  • Claims adjusters should be trained to function as trusted, valued allies to consumers – and to represent the insurer’s brand with dedication and expertise.
  • Customer needs must be addressed efficiently and professionally by minimizing touch points and making the most out of each contact point used by a patron.
  • Customer interaction maps can be developed to find problems to show where there can be increases in the efficiency of service throughout the claims process.

Operating model 

  • Efficiencies of scale should be built wherever possible by sharing talent. Larger groups of adjusters who have individual specialized skills can allow for a better internal work balance and increased efficiency.
  • Outsource where appropriate, to deliver high-quality claims service to consumers, while still focusing on the core business.

Integrated management 

  • Integrate closed loop claims which use high-quality customer data to inform the development of products, the pricing of products, and strategic decision making.
  • Develop and maintain relationships with a strong network of vendors including:
    • Lawyers
    • Doctors
    • Other medical vendors
    • Contractors
    • Automotive repair shops
    • Travel vendors
  • Strong relationships with vendors help improve customer experiences.

Advanced technology 

  • Claims systems should be integrated fully with other systems such as policy administration. This will allow data to be shared across organizational structure.
  • Seamless claims experiences should be provided for claims workers and customer-facing applications. Once these systems are optimized efficiency and satisfaction will increase.

Information and analytics 

  • Highly developed analytical skills should be developed within claims functions to provide critical customer insights and build models of consumer behavior.
  • Advanced analytics should be applied to clients. Data for these analytical models can be gathered enterprise-wide, from internal and external data that is already available.
  • Together, these five elements represent the necessary changes required to provide policyholders with an incredible, comprehensive claims experience.
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