Using Technology to Streamline Claims Management in the Insurance Industry

The moment a policyholder files a claim is when the insurance company needs to step up and fulfill their promise and respond immediately. Historically, insurance providers saw claims solely as an obligation instead of as a method of strengthening customer loyalty and boosting customer retention rates. As a result, the entire industry has difficulty building meaningful relationships with policyholders. Customers want great customer service from their providers, and a claims process is a critical component of such an experience.

How to Think About Claims Management

The fact is that many insurers still rely on obsolete software to handle claims processes. As a result, there very little attention is paid to customer satisfaction.

Therefore, optimizing the claims process ought to be the objective of every growing insurance provider.

What is Involved in Claims Management?

When a policyholder files a claim, they first contact the claims department of their insurance carrier. Once all the necessary information is collected, then it’s up to the claims department to process the claim while keeping the claimant informed along the way.

Customer Expectations

Simply put, policyholders expect a quick response after a claim has been filed. Carriers should acknowledge the claim without delay and request the necessary contact information.

Also, insurers need to quickly reassure the policyholder about the scope of their coverage.

Streamline the Claims Process

Reimbursing policyholders is only one component of insurance claims management.

Given that a fast claims settlement process means higher customer satisfaction levels, insurance companies can get an edge over the competition (including insurtechs) by streamlining the claims process.

For this reason, an efficient claims management process is great for the bottom line.

Fighting Against Fraudulent Claims

Insurance is one of the industries that are extremely vulnerable to fraud.

Of course, reimbursing fraudulent claims costs insurers money, which is then passed on to policyholders. As a result, the cost of insurance premiums increases.

Fraud Detection Technology

One of the best ways to fight against fraud is with a rules engine, which uses business rules to examine payment history and spot potentially fraudulent claims.

For example, a high number of times an insured files a claim can be a strong sign that fraud is involved.

Not Everything Can Be Automated

Even though there have been major advances in artificial intelligence technology, human employees continue to play an essential role in the insurance claims management process. And by using rules engines, the claims department is able to work more effectively by automating mundane and time-draining processes. As a result, employees can convey authentic human empathy while focusing on claims that require nuance.

Generally, complicated claims require human attention and expertise and can’t be replaced with sophisticated artificial intelligence software.

Rules engines can help insurance carriers to authenticate routine and simple cases with predictable outcomes.

Boost Customer Retention Rates

A rules engine is a flexible piece of software that runs conditional statements to make business decisions. When new criteria are introduced in the claims process, adjusters can easily make instant changes in the rules engine without having to rely on IT support. A rules engine helps insurance carriers to create a seamless claims lifecycle by accurately evaluating and approving claims.

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