Automated Claims Management: Connecting the Dots

It’s great to see an increasing number of providers investing in claims technology – it’s a vital step toward insurance digital transformation. But while it’s important to improve the performance of specific aspects of the claims process, to transform it from end-to-end you also need to consider how each step in the handling process could be connected more efficiently to move the claim toward settlement faster.

By connecting the dots in the claims process you can improve customer experience and reduce your cost per claim.

Automating Claims Processing: Connecting the Dots on Claims

When we talk about connecting the dots, we understand that there are already processes and people in place to move a claim through the stages of the handling process. The challenge is that there may not be enough resources to cope with the volume, and even where there are, it takes a person time to complete the tasks necessary when they could be better deployed in more complex work.

And considering the number of ‘dots’ even a straightforward claim touches, it’s no surprise that it takes more time than is cost-effective to handle and settle a claim. From the time a claim is first reported the data is passed through several systems (some of which belong to external suppliers), through various people for validation, fraud checking, and claims adjustment, through billing and finance, and often back and forth with the customer where information or documentation is missing.

Communication with the customer is one of the dots that is connected less frequently than it should be. Aside from during the FNOL stage, for some lines of business, customers don’t hear from the insurer again until it’s time to settle. According to a claims survey by Accenture, 90% of insurance customers say regular and timely communication is important, or very important, during a claim. And the same survey suggests that 83% of people who have a bad claims experience will switch providers.

In addition to customer experience, fraud detection is an increasingly important aspect of managing a claim. With the pandemic pushing more people than ever into financial hardship, claims fraud numbers are expected to rise. Telehealth visits have increased exponentially, opening up the health insurance industry to regulatory concerns and an increase in claims. Auto theft and fire instances tend to go up when the GDP goes down. The biggest increases will likely be in opportunistic fraud which may be more difficult to detect. In recent news from the Insurance Fraud Bureau (IFB), there is one insurance scam per minute happening in the UK.

All of this points to the need for creating efficient connections throughout every stage of the claim; for reducing handling costs, creating a better customer experience, and managing wide-scale fraud detection and prevention measures.

Digitizing elements of the claims journey helps up to a point. For example, providing a portal or app for customers to report claims ensures that the relevant data and documentation are collected upfront and in a consistent way. Using AI to detect fraudulent documents identifies fraud much earlier in the claim and reduces the cost associated with claims fraud. But even when such new technology is introduced, how is the output processed and passed on to initiate the next step?

How Does RPA and Intelligent Automation Automate Claims Management?

An intelligent automation platform such as Blue Prism has tools that can help to map out your claims processes across the entire journey. By diving into your existing processes, you can identify where bottlenecks occur, where tasks take the most time if there is specialist technology needed, where the most costs are incurred, and where customer experience failures are occurring.

Additionally, you’ll be able to use this information to start the process of standardization across your claims division. First for individual lines of business and then across the portfolio. A report from McKinsey – Successfully Reducing Operating Costs - revealed that process standardization across an organization helps to significantly reduce operating costs.

An intelligent digital worker can then be directed to do the time-consuming and manual work involved with each claim:

FNOL Automation: Ensure accuracy and speed

Intelligent automation helps in FNOL by speeding up and ensuring accuracy. It can extract data and documents from any digital communications channel, connect that data with other systems for analysis, and provide the outcome to the claims adjustment team.

Data entry and claims document processing

An intelligent digital worker can open, read, and extract data from any channel in use. It can scan and interpret information on documents and send them off for AI fraud analysis. All this can be done exponentially faster by a digital worker than by a person.

Passing the data between parties

Digital workers can take on the role of go-between, performing many of the same tasks as an employee, and doing them 24/7/365. This results in significant improvements in the speed and accuracy of claims

Communicate claims updates with customer

Intelligent automation can help to regularly communicate with customers. For example, you can automate regular messages to customers as they progress through the claims. This helps to reduce the number of complaints from clients as they are informed about the stage of the claim.

Its intelligence skills are also helpful for reading emails, interpreting documents and photos, picking up anomalies that may indicate fraud or misinformation, and much more.

How to Get Started with Automated Claims Management

The challenges created by the pandemic have served to highlight the need for digitization across every area of an insurance business.

Intelligent automation is a logical addition to a digital-first strategy as it can be implemented alongside legacy systems and processes and adjusted as new technologies are brought on board. Claims is a great place to start with automation, as cost savings and ROI can be generated quickly, and improvements to customer experiences seen in a short period. It also relieves pressure on your claims teams, allowing them to focus on the parts of the claim that need human intelligence and on more complex claims cases.

Learn more about our insurance solutions and claims process automation solutions