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COVID-19 accelerated the need for next-generation claims-processing goals. To make these capabilities a reality and create long-term value, insurers should focus on five key areas. Digital natives—millennials and GenZ’ers increasingly expect seamless, omnichannel, and real-time interactions integrated with the platforms they already frequently use.

In a recent survey, 85 percent of executives said they increased the digitalization of employee interactions and engagement in the pandemic.

To prepare for the future of claims that is now closer than many expected, carriers should concentrate on five areas: empowering the claims workforce, redefining proactivity, reimagining the insurer’s role, evolving the claims ecosystem, and transforming talent.

Empowering the Claims Workforce

simple claims <> complex claims

For simple claims, the technology to enable full straight-through processing already exists. But what happens to your system when the claim becomes more complicated? Does it route to an agent?

“Segment”, “route”, “appraise”, “estimate”, “choose” – these are all decision words. What if you could automate some of these decisions?

The concept of cognitive “whisper agents”—tools that provide relevant information to aid in decision making—will automatically guide complex-claims handlers in their customer interactions. But in order to be effective, the system needs to understand the human’s decision-making role and be explicit about it.

Redefining Proactivity

A personalize claims experience is now required to stay competitive.

Until now, was based largely on claim characteristics and the system treated all customers the same but clients now expect more.

Reimagining the Insurer’s Role

Preventing claims – yes, and yet more decisions to automate homes or buildings, make decisions about working conditions etc.

Evolving the Claims Ecosystem

Leveraging sensors and new data is great but only useful if acted on. What data would make you decide differently?

Transforming Talent

New roles, new successes and failures, new goals, and motivation.

From HITL to HITLFE and HOTL systems. Click here to read more about exception handling.

From recent McKinsey article:


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