Solving The Customer Claims Experience Puzzle

The moment of truth for any insurance company is the claims process. How an insurer handles its customer at the time of loss is telling. irrespective of whether the loss is a major catastrophe or a simple lost baggage claim. According to a recent survey by JD Power, speed is one of the most important factors that influence customer claims satisfaction. To overcome this challenge and improve the claims experience, carriers are beginning to deploy claims automation tools for low severity claims.

However, implementing Straight Through Processing (STP) for claims is not as easy as it sounds. In fact, claims automation can be a double-edge sword. There is no doubt that STP can improve the customer experience and lower loss adjustment expenses. Unfortunately, carriers have also experienced a significant increase in fraudulent activities. Suspicious claims have increased as much as three times from what was reported before claims automation was deployed.

To overcome the challenge of increased suspicious activity, an AI-powered fraud detection engine is an essential component of any claims automation strategy. As indicated, speed is an important factor in claims automation which confirms real-time scoring of claims for fraud is critical. Traditional business rules results in either too many false positives or missed opportunities.

Solving the customer claims puzzle can be tricky. Ultimately insurance companies that embrace an AI data-driven customer claims experience strategy can get an edge on the competition which in turn creates value for their organizations.

To see what an exceptional claims experience can look like, watch this short 8-minute video. It demonstrates, using Shift Technology’s Luke solution, the straight-through processing for legitimate claims and proactive steps that can be taken to prevent fraud on suspicious claims.

Shift Perspectives

Shift Seminar Tokyo 2019

シフトテクノロジー東京セミナー:国内における保険業界のイノベーションに向けたAI戦略をテーマに

November 15, 2019

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正確な不正請求検知は、請求処理自動化の鍵となります

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