The Intersection of People, Customers, & Technology in the Claims Process
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The Intersection of People, Customers, and Technology in the Claims Process Daniel Hughes, Enterprise Solutions Manager, Kodak Alaris
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The intersection of policy holders, insurance staff and technology offers significant opportunities in the challenging claims processing business: Engaging and communicating with your customer base: Allow your policy holders to communicate with you following their preferences and fully integrate all communication channels including social media; in order to make this input valuable you want to find a solution that understand the true meaning of any type of text based input, regardless of structure, source, and format Workflow talent management: Balance workforce expertise levels between aging experts and less experienced staff by allowing them to focus on cases or requests that align with their expertise while providing less experienced staff with a comprehensive, yet dynamic knowledge base More efficient processes: Improve and where feasible automate your claims process connecting your mailroom, back office operations, and your service center Fraud prevention: Focused data mining to detect and prevent fraud Business growth: The automated and shortened handling significantly reduces the cost involved in the claims processing. At the same time customers are more satisfied and consequently more loyal. Agents are more motivated and have more time to focus on up selling, thus creating addition revenue.
Transcript of The Intersection of People, Customers, & Technology in the Claims Process
The Intersection of People, Customers, and Technology
in the Claims Process
Daniel Hughes, Enterprise Solutions Manager, Kodak Alaris
30% …of insurance customers worldwide rated their experience as positive
…is spent on fraudulent claims annually $30 billion
1 in 3 …cited poor claims handling as a major factor in their decisions to switch insurer
Are These Your Challenges?
Business Growth
Workforce Talent
Problem
Reduce Fraud
Engaging with
Customer Base
StreamlinedOperations
New and Developing Media for Customer Engagement
Social Transparency – Words Travel Fast
The problem was resolved quickly 69%I had to explain my problem to multiple
people72%
The person who helped me was nice 65% The person I dealt with was unpleasant 67%
The problem was resolved in one interaction - no passing around to
multiple people63% My problem took too long to resolve 65%
The outcome was what I was originally hoping for when I contacted customer
service47% The problem was not resolved 51%
Factors that Contribute to Good and Bad CustomerService Interactions with Medium-Sized Companies*
According to US Internet Users, 2013% of respondents
Good Customer Service Interactions(n=1,004)
Bad Customer Service Interactions(n=565)
*Any company that was not large, well-known or a small local or online company
Source: Dimensional Research, “Customer Service and Business Results: A Survey of Customer Service from Mid-Size Companies” sponsored by Zendesk, April 15, 2013.
Customer Interactions – the Challenge
Source: Converseon, 2012
• Social media input arrives 24/7 • Most organizations are at the beginning of the maturity curve
Handle All Input Dimensions
Format
Source
Structure
Fax ServerScannerFile System
Mail Server
Image Paper PDF Email
Unstructured
Semi-structured
Structured
Self Learning Expert Forum
Content RepositoryAcross System Boundaries
Any Content Documents
Free Text SearchIntranet Any Source
No Administration Versioning
Dynamic Q&A Scripting
Workforce Talent Management
Data
www
Semantic Understanding Extracts Real Meaning
Graphically
Linguistically
Rule Based
Contains “Claim”
Streamlined Operations
• About 75 % optimization potential for extraction
• Current methods of data recognition and processing are inadequate
• About 80 % optimization potential for classification
• Existing automation approaches only apply to structured documents
Optimization Potential
Scan, Fax, Emails,
eDocs, SMS, Social Media
Recognize Classify Extract ValidateExport Process Route
Correct / Incorrect?
Advanced Document Classification
Techniques• Symbolic (barcode)
• Document analytics • Graphic-based• Text-based
• Statistical methods
• Semantic understanding
LOW
HIGH
COMPLEXITY
PropertyClaim
PropertyUnderwriting
Customer correspondence
Car claim
Fraud Detection and Prevention
Advanced data mining Mobile Devices
Segment RiskPredictive Modeling
Pattern Spotting Self Learning
Hard FraudCross Provider
Security Mechanism
Artificial Intelligence Opens New Opportunities
UNDERSTAND PROCESS KNOW
? i!
The Intersection of People, Customers, and Technology in the Claims Process
Presents significant opportunities for insurance carriers to secure their future
Engaging and communicating with customer base: Support policy holder communication preferences and fully integrate all communication channels including social media
Workforce talent management: Leverages the expertise of most experienced agents and offer a comprehensive, self learning knowledge base to new staff
Streamline d Operations: Reduce manual steps and silos into end-to-end claims process automation
Fraud prevention: Focused data mining and analytics
Business growth: Reduce cost and create additional revenue
Do you want to discuss further?
See you at booth 110 in the exhibition hall
Contact me at [email protected]
