The future of claims: Delivering at the moment of truth

September 10, 2020 / 4 min read

Like most industries, property & casualty insurance has been upended by disruptive technology and rapidly changing customer expectations. Customer experience is now one of the primary ways companies of all types differentiate themselves and compete. For insurers, it’s become the key driver of innovation and is shaping the future of claims.

Claim handling is the insurer’s moment of truth. It’s the time when they fulfill the fiduciary promise of the policy and where customer loyalty is won or lost. After a loss, customers want to be made whole as quickly and easily as possible. That could mean quick resolution after clicking a few buttons in an app, a conversation with an adjuster to better understand the claims process or getting alerts as the claim moves through an expedited process. Some carriers are progressing towards this future state by investing in automated technologies. But others are lagging and lack the technological capabilities and resources to deliver on rising policyholder expectations.

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COVID-19 has only accelerated the pace of change—and exposed gaps. While early adopters were already implementing innovation like virtual inspections and were able to quickly pivot early in the pandemic, others are having to scramble to catch up to remain competitive. Now, the pressure is on. The future of claims is about elevating the customer experience, and carriers that aggressively pursue digital enablement today will be primed to excel tomorrow.

Keeping pace with change

When stay-at-home orders swept across the nation because of COVID-19, it was a time of reckoning for insurers. Just prior to that, claims teams had on-site inspections scheduled and field adjusters were poised to go to the scene of accidents. That all changed in an instant. For some, it simply meant ramping up virtual inspections. For others, it became a time of uncertainty and concern. We’re working with carriers from different spectrums of their digital maturity, helping them transition to virtual inspections through video collaboration with policyholders. By mid-Q2 2020, more than 90 percent of simple claims at the largest insurers were adjusted virtually, and customer satisfaction had improved.[1]

Enhancing backend efficiencies

COVID-19 revealed deficiencies in operations that enable digital claims experiences that engage policyholders on their terms and keep insurers’ claim management standards intact. Digital transformation requires deep data stores and powerful analytics to process and analyze disparate inputs and pathways of every claim scenario.

For example, in a bodily injury claim, predictive models can analyze a claim’s attributes at intake and provide a severity score to quickly triage the claim to the appropriate handling unit. From there, the claim can be analyzed against historical company data to generate an accurate general damages assessment. And if the claimant obtains an attorney, legal analytics can provide insights on the defense counsel’s case outcomes to help adjusters determine whether to settle or litigate. These capabilities require the right combination of data and technology to enhance efficiencies. Those components are also critical to another important area of the future of claims—fraud detection.

Strengthening perimeter defense

It’s estimated that one in 10 claims may contain some element of fraud.[2] With fraudsters constantly pressure testing carriers to discover which ones have weak defense systems, a strong perimeter defense is critical.

Imagine this: Your insured was involved in an auto accident in which the claimant was injured. Your adjuster receives a medical package and damage photos from the claimant. As the adjuster enters claim information in your system, fraud analytics flag the claim and recommend further investigation based on a triggered fraud scenario. Meanwhile, image forensics reveal that the loss photo was taken prior to the date of loss. The claim is referred to SIU and managed through an automated system to speed resolution.

Those types of insights and tools are vital to helping prevent insurers from paying suspicious claims, as well as providing necessary checks to quickly process meritorious ones.

The Future: Imagine new possibilities

The same data and technology that can expedite claims processing and detect fraud have the potential to catapult insurers to a new level of innovation—proactive claim prevention.

As weather analytics automatically determine which policyholders are affected by a hailstorm, insurers may immediately deploy aerial imagery to identify damage to insured property, notify insureds, and instantly start the claim process for them. This type of innovation can redefine insurance companies, from being organizations you contact when something goes wrong to becoming innovators that deliver proactive customer service that improves the quality of life.

The future is possible today with Verisk. We power, develop, and accelerate digital transformation with unmatched data, integrated technology, and deep domain expertise. Let us show you what’s possible.

¹Celent. Data Science in Claims—Digital Acceleration and Customer Delight.

² Insurance Information Institute. Background on: Insurance Fraud. https://www.iii.org/article/background-on-insurance-fraud