Building the Better Claims Experience

Clear Technology’s Brian Cohen believes that improving the claims experience means starting at the ground up, where claims are accepted and adjusted.

BEST’S REVIEW: How far along is the insurance industry in automating theclaims process and where are you seeing the most progress?

COHEN: Throughout the insurance industry, the claims process is moving to center stage as an area ripe for improvement. Some leading insurance companies are already focusing on automating claims activities such as subrogation and medical bill pay. It’s just a matter of time before the rest of the market follows suit.

BR: Some have said that claims and subrogation are the softspots in insurance operations. Why?

COHEN: Most insurance companies focus on pricing and marketing of new products. Claims is still relegated to the back office and viewed as a cost of doing business. But, we’re beginning to see this view of the claims operation change. As the soft market matures, insurance executives are evaluating the accuracy and consistency of their claims and subrogation efforts where improvements flow directly to the bottom line.

BR: You’ve highlighted how insurers accept the first notice of loss notifications. Can you talk about what’s involved in making that a web-based process?

COHEN: Given that reporting a claim may be the only time that an insured may interface with the insurance company, it’s often the moment of truth where you’ll win or lose a customer for life. Therefore, it’s critical to make the claim reporting process as simple as possible for the claimant, while gathering as much information as you can to properly adjust the claim. Given the overwhelming adoption of the Internet as a communications medium, it’s a natural fit for first notice of loss--providing a simple method of collecting the information once, sharing as needed, and conducting follow up calls for clarification. Web-based claim reporting enables the consumer to choose the method of communication they are most comfortable with--directly to the carrier through the web, phone, or fax, or via their agent.

BR: What about the role of adjusters?

COHEN: The adjusters’ intellectual capital should be viewed as a company asset. But, unfortunately their brainpower is underutilized because their day is predominantly spent on mundane and repetitive tasks like locating and collecting data and verifying coverage. Their time and talents would be much better spent if the bulk of these tasks were automated, freeing up the adjuster to apply their experience and skill to actually analyze and adjust claims.

BR: What is the next frontier in insurance claims technology?

COHEN: Interestingly enough, the next frontier of claims technology doesn’t start with technology at all. The next frontier starts with people. The best claims process and practices are really found among an insurers best claims people. They know the way to get things done, where to find the information, the exceptions to the rules, and what steps can be skipped all together. Understanding what these folks do and adopting their best practices enterprise wide is the next frontier. The right claims technology can then be selected, implemented, and leveraged to deliver their full potential.