Modernizing Claims Processing for Insurers
Overview
Quick and accurate claims processing is key to customer satisfaction and retention, in addition to being very important to an insurer’s bottom line. It’s not an exaggeration to say that claims management is the most important aspect of any insurance company’s business. Why? There are cost and control considerations to be sure, but the biggest impact to the bottom line might be the heavy scrutiny placed on the insurer by the insured.
In this whitepaper, we discuss the five biggest claims processing challenges to insurers as well as five key benefits of automating the claims process: cost savings, better fraud detection, stellar customer experience, integration across existing IT environments, and tools to adapt with the ever-changing insurance business.
THE SCENARIO
When customers file a claim on their insurance policy, it’s a sure bet they will have to fill out several forms and submit various types of documentation. All of these documents need to get to the right people to handle the claim, and the information contained on them needs to make it into whatever in-house systems the insurance company is using to run its day-to-day business.
Some insurance companies rely too much on either aging software or personnel when they need the best of both of these scenarios: the speed of new tech like AI and robotic process automation with the intelligence to correctly identify and capture data, bringing humans in the loop only when necessary.
There’s no standard document
The forms created by an insurance company represent the only paperwork they have any control over. When a customer files an auto insurance claim, for example, the insurer knows what forms to provide and what kind of information is requested on it. And that’s pretty much where predictability ends. A claim on a car accident could require photos, police reports, estimates from mechanics, medical reports, witness statements, legal correspondence, and even video content (such as dashcam footage). These can show up electronically or via postal mail, and photos could be any number of file formats. There is an endless amount of variation in the kinds of information insurers receive and the ways in which they receive it, making it difficult to create a one-size-fits-all approach to identifying and validating any of it.
There’s an existing software infrastructure
An insurance company is likely operating among several different enterprise software suites. There is, of course, a claims management software, either out of the box or developed in-house. But these don’t exist in a vacuum. Other kinds of software that all live in the same ecosystem are Enterprise Resource Planning (ERP) and Customer Relationship Management (CRM) platforms; image and data archive systems; and email servers. Any or all of these might be a touch point along the flow of documents and data, and at any point could need to be used to validate or receive information to move the claim along. Companies aren’t likely to want to change out what’s working to accommodate new software.
The volume of documents is constantly changing
There can be predictable seasonal spikes in the volume of documents being sent, like an increase in property damage claims during hurricane season. But there are also other factors at play that aren’t quite so easy to see coming. Changes to the law might affect compliance regulations dictating document storage, for example. However volume can also be in flux even when there are no external factors. Sometimes it’s just a matter of certain claims requiring larger volumes of paperwork: one claim might only need a few single page documents while another includes a file that’s nearly 100 pages. Depending on the time of year and the size of the business line, the number of incoming documents could be in the thousands, or the hundreds of thousands.
Mistakes can be very costly and communication is vital
The nature of insurance dictates that payouts and customer communication are a vital part of day-to-day operations. Even the slightest of uncaught typos can be a very costly error. An incorrectly recorded case number could send payment to the wrong person. A misplaced decimal point could result in a hundred-fold overpayment. Not noticing slightly mismatched VINs could render an insurer the victim of fraud. Insurers are hesitant to rely on automation with so much at stake. And, claims often must be made during particularly stressful periods in a person’s life: amid the trauma of a car accident or while attending to a resulting personal injury, for example. Proactive and timely communication on the progress of a claim can minimize anxiety and ensures the claimant or injured party feels supported and informed throughout the process.
It’s not an exaggeration to say that claims management is the most important aspect of any insurance company’s business. Why? There are cost and control considerations to be sure, but the biggest impact to the bottom line might be the heavy scrutiny placed on the insurer by the insured.
THE SOLUTION
TCG’s approach to document logistics is so flexible it seems as though it were tailor made for the insurance industry. It’s able to process any type of file and pass it along to any of the other operational systems in use on the network. Insurance organizations don’t have to adapt the way they do business to use DocProStar. Instead, DocProStar adapts itself to our customers’ environments. Using a combination of AI and an insurer’s existing claims team, DocProStar can normalizes documents and data, verifies the information, checks against internal systems compare for accuracy and makes managing exceptions and discrepancies easy--all while keeping customers informed, automatically. This reduces manual work and improves the customer experience.