The Evolution of Claims

By Rob Higgins

Protection used to be a business conducted exclusively on paper. Older customers will remember only too well the pain of filling in long, laborious forms to make a claim and then sending these off in the post, trusting they would arrive safely at the correct destination. Advances in technology have improved the customer experience massively, supporting slick, online processes that are far easier and quicker to complete.

There is no doubt that an investment in computer systems and enhanced web capabilities has benefitted customers, Advisers and Insurers hugely. They have also driven innovation and improved accessibility across the protection industry. The emergence of AI offers a wealth of new possibilities that could revolutionise the claims process even further.

For example, interactive voice response (IVR) systems that can understand requests and provide information without the need for any human engagement are evolving rapidly, getting ever more sophisticated. They have become much more commonplace and can perform a very useful role, particularly if what is required is straightforward.

If someone needs to change their bank details or their address, then being able to do thatonline or over the phone, helped by a virtual assistant can fit the customers needs. However, in our world when someone is making a claim that relates to a very personal thing - their health - it is vital that they have an option to speak to someone to explain their problem.

Claims can be relatively simple, involving a common injury. For example, if a builder breaks their leg, the medical report will make it clear that they will be unable to do their job until it is healed. However, a significant number of claims are not straightforward. A claim relating to mental health or cancer will be intensely personal. How the person feels, how they react to treatment and their rate of recovery can vary enormously depending on their background, the support available, their job and many other elements.

We are dealing with people in very challenging situations and instead of helping, technology can act as a frustrating barrier when all someone wants is to have someone to listen to their story and understand what they are going through.

Our Claims Consultants often talk to people when they are at their lowest. They are worried, fearful and sometimes in pain. They may not be thinking clearly and have all the information needed to hand.

Teaching them how to deal with difficult or challenging conversations is part of our training as we realise how stressful this can be for both the claimant and our Consultants. The more empathetic they can be on these calls, the better the outcome for all concerned.

While it is important we have a process in place to manage our claims, it’s also vital that we empower our Consultants to not be completely driven by it. They must feel comfortable to show human concern when the person on the other end of the phone needs it. If they want to share what they are going through or just need a sounding board, our Consultants will give them that time.

Technology can be a very powerful tool. It can analyse huge amounts of data in seconds. This can identify anomalies and highlight trends in claims data that could easily be missed by the human eye. These can help us refine our processes, amend our approach and ultimately provide a better service.

It is our responsibility to embrace innovation and explore how it can benefit Members. We are here to service their needs and adapt as expectation evolves. However, we cannot lose sight that people are at the heart of our business and supporting them both financially and emotionally is an essential part of the claims process. Using that technology to enhance the personal touch we can give is what we need to strive to achieve.