The claims experience… where the customer promise is delivered

Opinion by Martin Rimmer, CEO of Sirago Underwriting Managers

The true measure of how satisfied and loyal an insurance client is, manifests primarily in their claim’s experience.

The insurance value proposition

The efficient and timely settlement of a claim, in a manner that meets your customer’s expectations, is ultimately the insurance value proposition. It’s the promise that insurers make to policyholders – to cover them for an unexpected loss, when they need it most.

The insurance claims experience is the pivotal moment for insurers and policyholders alike. A lousy claims experience will nullify the greatest client service, the best advice and the grandest advertising campaign.

It’s little wonder that insurers are seized with improvements and innovation in the claims process, finding ways to make an administratively intensive process more efficient and effortless for the consumer. Better claims management fundamentally translates into more loyal customers, and less churn.

Performance in three key areas

Improving the insurance claims experience demands that insurers measure their performance in three key areas:

• Technology – how the claim is logged, tracked and taken through the process, from submission to payment. Outdated legacy systems, disparate data sources and internal systems and fragmented vendors make it impossible to achieve speed, efficiency, quality and scale in the claims experience. Technology plays a key role in harmonising the claims process and bringing disparate processes together into a cohesive flow. The role of Artificial Intelligence (AI) with embedded rule sets creates a more fluid outcome of the claims process. Now, more than ever, customers expect the same digital efficiency and ease of engagement from their insurers, as they do from their banks with online banking.
• The process to log a claim – it is often at the First Notification of Loss (FNOL) that clients will experience the most frustration. Clients are often made to jump through hoops to get a claim coordinated and submitted. This process can be drastically improved if clients know how to claim, what to expect from the outset, with clear directions and expectations of what information is required, by when, and what to expect throughout the process. Make the claims process easier, accessible, automated and most of all, transparent to your customer.
• Service and feedback – customers want consistent, great service throughout the insurance journey, and not just during the sales process and policy inception. It’s during the claims stage, when emotions are fraught, that great service and empathy are even more critical. Consider, for example, gap insurance claims. By the time a gap claim is lodged, the client is already a few weeks down the line from when they underwent their in-hospital treatment and are only now dealing with any shortfalls that may have occurred as a result of the design of their medical scheme option. Chances are, they may already have received calls from healthcare providers to follow up on outstanding payments. They may have already paid shortfalls from their own pocket. These dynamics demand that the process to submit their gap claim is highly efficient to ensure rapid settlement – given that the claims cause is already weeks in the making. Consider that gap claims can only be settled once everything has been through the medical scheme claims process and the evidence is presented via the scheme’s claims transaction report. Once the gap claim is lodged, use the opportunity throughout the processing of the claim to provide regular feedback and create customer touchpoints, manage their expectations and let them know what happens next. The onus should never be on the client to follow-up on the progress of claims settlement.

The very best claims experience

The insurance claims environment has been ripe for disruption for years since in most cases, it is entirely disparate from the client’s usual service engagement channels. Insurers spend fortunes in attracting new clients and expanding their distribution models. But the best way by far, to retain existing customers, build loyalty and create raving ambassadors to attract new business, is to build the very best claims experience that delivers your ultimate customer promise.

This article was originally published by FA News magazine – to view an online copy of the November issue of FA News go to https://www.fanews.co.za/publication/pdf_286_fanewsnov2022