How Companies Are Leveraging Technology To Reshape The Insurance Claim Process

Pratyush Chandramadhur, a CWA Gold Medallist and graduate in commerce from University of Delhi, has 20 years of experience in Financial service industry, Credit Bureau and Decision Analytics. Pratyush heads revenue and business at AuthBridge as the Chief Business Officer. With his passion for driving revenue for organisations, he is the brain behind transforming businesses into profit centres. He is an astute strategist who brings to the table more than 20 years of experience in financial services. With a proven track record in retail, wholesale, and corporate finance, he has been associated with reputed brands like Clix Capital, Hero Fincorp, Experian, Bajaj Finance, GE  Capital and ICICI Bank.

The insurance industry has been relatively slow in adopting tech-driven innovations. Although traditional insurance business models have been resilient, the new wave of digitalisation is causing fundamental disruption in the insurance sector. 

Technological and innovative trends like Internet-of-Things (IoT), Machine Learning (ML), Artificial Intelligence (AI), and Robotic Process Automation (RPA) are revamping every aspect of the industry from claims to distribution, and underwriting. 

This evolution will further pick pace as agents, insurers, brokers, and suppliers adapt to changing customer needs due to digitalisation. Customers now want simple—one-click access, quick delivery, relevant information and customisable products. Adopting new-age technology can lower costs, optimise the customer experience and improve decision making and productivity.

The advancement in technologies also helps with the main pressing issue for an insurance agency- fraud claims. Fraud claims continue to be a critical and worrisome subject for any insurance agency, and AI acts as a critical watchdog in the battle against fraudulent claims. These fraudulent claims can be prevented if the industry adapts to technological solutions such as a digital identity and address verification via face recognition and geotagging, digital document transactions, video KYC as well as e-signatures which prove to provide a more secure and safe environment for transacting and communicating.  

The insurance customers are thereby envisioning technology in the insurance claims process. With chatbots and automated customer interaction available, the insurance industry is no longer a disintermediate sector in which brokers and agents were the only ones responsible for maintaining customer relationships.

As digitalisation becomes more profoundly integrated within the insurance industry, insurers must position themselves to respond to challenges such as handling claim processes with new data sources that can increase productivity, efficiency, and accuracy. 

The insurance claims process consists of various touchpoints, complex regulations and an enormous dataset of information. For instance, handling a life insurance claim is entirely different from managing an accident insurance claim. Therefore, the automation of the claims enables insurers to improve their processes, thereby offering customers enhanced personalised interactions.

Six future-ready claims technology that can help insurers navigate their challenges:

  • Smart Processing – Automating the procedures, suggesting the next best course of action and making predictions to optimise claim outcomes, react to changing priorities, and being alert about all sorts of exceptions.
  • Seamless customer experiences- Guiding customers through seamless journeys, leveraging connected interactions across multiple channels.
  • Continuous collaboration- Optimising workloads and managing multiple aspects of each claim parallelly.
  • Operational transparency- Identifying the trends, opportunities, compliance, inconsistencies and inefficiencies occurring in the claim process.
  • Business dexterity- Responding rapidly to client responsibilities, administrative prerequisites, and changes in business processes.
  • Creative adaptability- Seamlessly present new case cycles or innovations, with no thought of sunk costs due to dismissed changes.

The insurance industry has witnessed a revolution in customer data management, which has an avenue of growth as insurers are leveraging this to improve their claim process. 

The circulation chain in the insurance business is complex, as a progression of brokers inspects data between the insurer and the applicant, creating room for human error and manual work that eases back the cycle. As the majority of the underwriting process is now automated and backed by a combination of AI and machine learning models, the processing time has reduced to a few seconds.

These workflows are supported by a vast set of internal and external datasets. These datasets enable insurers to make decisions regarding underwriting and pricing. Regulators verify the datasets to identify if data usage is appropriate for underwriting and marketing.  

Claim organisations have shifted the focus from risk avoidance to monitoring, mitigation and prevention. New data sources and IoT are used to monitor risk when factors surpass AI-defined thresholds. They might dissect pictures, sensors and the agent’s authentic information. An insurer or agent can then investigate the outcomes to confirm the settlement claim. 

With AI/ML and deep learning algorithms, measuring a customer’s creditworthiness is now simplified. These algorithms help an insurer verify the background of an applicant to compare if the chosen policy is best suitable for them or not. Since the whole process is streamlined and digital, the most significant benefit it gives is the multi-functionality of an agent with no possible human error. With the help of tools like these, an agent can handle multiple applicants at one time, thereby increasing productivity altogether. 

As we’ve seen, AI and ML have changed the insurance claim process by decreasing human error and dramatically increasing accuracy. This results in significant improvement in accuracy, turnaround time, and customer experience. These signs point to the claim process evolving further as more companies enter the fray with increasingly innovative solution sets that reshape the old model of insurance claim management (and sometimes even insurance itself).

The advancement in technology is causing a shift in how claim cases are handled, overseen and detailed, thereby bringing about improved functional execution and further developed consumer loyalty. The winners in this increasingly competitive landscape will be insurers that adopt new-age technologies.

AI-based insurance will be carriers that use new technologies to develop innovative products, lower costs, streamline processes and surpass customer expectations.

The claims process is a key part of the insurance industry. However, over time, the process has become lengthy and arduous. Technology has now allowed bringing about a change in this process and the insurance industry has adapted to this transformation rapidly. With this acceleration, the insurance industry can change the face of the future in the forthcoming years providing a safer and secure environment for the younger generations.

Source : CXO Outlook

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