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Using Data to Empower Claims Journey Offers Significant Benefits for Insurers

Reduce costs. Catch fraudsters. Improve the customer journey. Collect more data. Boost cross-selling. The list goes on, and claims managers must often find themselves wondering how to meet the challenges that their boards hand to them.

Customer expectations are being re-shaped in the digital era, and ease of engagement is becoming the new norm. The standards are being set by the likes of Amazon, Netflix, fast-food delivery services and, increasingly, by InsurTech disruptors nibbling away at legacy insurers. One of the keys to their success is how they use data to build a complete view of each individual customer—the holy grail of the single customer view (SCV).

Claims Is about Delivering the Promise that the Customer Has Bought

Deploying more data and greater automation should not mean imposing a one-size-fits-all system on customers—quite the opposite. By pulling in all the data on a customer and using it intelligently, an insurer should be aiming to deliver a service that is fit for the customer but also benefits the insurer.

Insurers need to get out of the mindset that they must always ask the customer questions. Often the answers are in the data they already hold. However, searching systems for that data remains a major challenge with 40% of those who responded to the recent MarkLogic in-depth research saying it is difficult or impossible to search across all systems. Put that right, and big strides can be made towards meeting the expectations of customers that are being shaped by their digital experiences elsewhere.

One of the big challenges claims managers talked about in our research was reducing the number of touch points—the perception being that this is what customers want, as that is what “one-click” services elsewhere offer. That is too simple a response.

It will become one of the key outputs from proper data integration, but it should not, of itself, be the ultimate goal. Insurance is too complex. The real objective is to automate those parts of the claims lifecycle where there isn’t specific value derived from a human intervention. Obvious examples are where a policyholder making a claim is asked to provide information that an insurer should already hold in its database or where new data can easily be collected automatically.

Improving the Claims Experience Balances Greater Automation with More Empathy

The focus should be on automating those parts of the process where a machine can do it faster, more consistently and at least equally well.  We shouldn’t be looking to automate things where the customer expectation is that a human would do it better or more appropriately. This expectation will differ from customer to customer, and a fully integrated customer-focused system should be capable of acknowledging this.

When most of us have a claim, at some stage, we will be looking for empathy and ultimately a judgement that we have a valid claim. We still want the human involvement at these key stages.  So, it should not be about reducing touch points at all costs, it is about getting the best outcomes from the combination of human and machine and deploying those in the right balance for each customer.

Automation will then release human resources to deal with those customers with more complex claims or who want greater human intervention.

Automation, chatbots and artificial intelligence clearly all have a large part to play in the digital-oriented world; but they need quality, comprehensive data to power them. Much of that data already lurks in the legacy systems that proliferate in the complex world of established insurers. Digital transformation starts with the integration of that data into a single, searchable repository shared across the business.

Better Claims Data Integration Can Be an Insurer’s Best Defense against Fraud

Our research revealed that if insurers get this right, other benefits quickly follow. Fraud can be squeezed. Of all survey respondents, 74% placed this as a top-three benefit of well-managed digital transformation. This is not just part of a wish list. Where the transformation has happened, huge gains have been made. One insurer reported motor fraud down from 35% to 1%. If you have a genuine 360-degree view of your customer, you should know whether a claim is valid from the outset. Poor data integration is the fraudster’s friend.

Using data to empower the claims journey also offers significant operational efficiencies and consequent cost savings, according to 72% of claims professionals surveyed.

If claims are the ultimate test of the promise that the customer has bought, then it follows that making the claims experience better for the customer should inspire greater loyalty. It should also unlock cross-selling opportunities—something 45% of our respondents believed to be possible. Excelling in claims unlocks cross-selling opportunities and completes the 360-degree circle.

Suddenly that list handed down from the boardroom on high looks a lot less daunting.

Access to the full research report from MarkLogic and Research in Insurance can be found here.

Steve Forcash - Chief Strategy Officer, Insurance | MarkLogic

Steve joined MarkLogic in 2019 as Chief Strategy Officer where he leads the strategic development of solutions designed to help insurance organizations solve integration challenges, enabling agility, cost reduction and customer satisfaction. During his 15 years in the insurance industry, Steve has been central to the development of one of the largest multi-payer claims databases in Healthcare Insurance, as well as leading IT data modernization projects and a large-scale claims automation effort resulting in close to a 300% YOY profit improvement.

Prior to joining MarkLogic, Steve held Senior Leadership positions at Discovery Health Partners, Change Healthcare, and MultiPlan.

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