Winning the Claims Innovation Race with Next-Generation Technology
“Life is a marathon, not a sprint.”
It’s remarkable how this old expression still holds true. So many of life’s lessons and successes unfold over time, building like successful sprints that ultimately result in a marathon victory. After witnessing so many insurers implement core system solutions, we see a parallel in insurance claims technology, which continues to evolve over time in response to customer priorities and preferences.
To successfully run the claims innovation race, insurers need next-generation technology. They must have a broad perspective and stamina. Too narrow a focus may be great for one aspect of the implementation, but may yield unexpected, negative consequences in another. Insurers must balance efficiency gains, providing superior customer service, and reducing leakage, as new solutions often need to be refined to maximize these different metrics. In addition, priorities and innovation will most certainly evolve, so the insurer must be prepared for a long-distance race until the next-generation technology gains can claim victory: namely, improved practices, growth, and most importantly, customer satisfaction.
The Current Course
Group insurance has made great strides in offering next-generation technologies that customers want to use, including self-service portals for faster claims cycle time, real-time claims tracking, and collaborative workflow implementations. For disability insurers who want to shorten claims durations and get customers back to work as soon as possible, some have employed counselors to accelerate customers’ return to work or find alternative positions that accommodate potential challenges. Claims integration is now a preferred technology, and voluntary benefits providers have been making significant investments in its development by working with third-party providers of medical claims data or internal group life, disability, and supplemental health data to streamline and further automate claims processes. Throughout the industry, providers have been making significant use of analytics for fraud detection, absence management, and collaborative care.
Claims communication and integration
For some of the more immediate, next-generation technology needs, carriers need to further align their digital strategies with customer preferences, especially in terms of electronic claims communication. A recent poll revealed that most customers would prefer to receive status updates via email and text, but most carriers still do not have that capability.1 Of the 34 carriers polled, most still lack robust omnichannel support; only 12 percent of carriers allow for seamless channel switching, resulting in frequent transitions between website chats and phone calls.2
In a separate medical claims integration survey from earlier this year, there were encouraging results among the 28 major carriers polled. The majority (19) offer integrated claims services, with the most common integration with life, disability, and supplemental claims data.3 This suggests that claims integration is becoming an expectation by customers who are demanding more rapid cycle times. Overall, claims integration can improve the customer experience by eliminating paperwork to streamline the process and by storing customer data for faster claims adjustment. When offered by carriers during enrollment, about 35% of employees opt-in to these programs, despite potential privacy concerns.4
Future technology advances that would add significant value to providers’ systems would be the further increased auto-creation of potential customer claims when appropriate (assuming previous data exists from other claims) through optical claims recognition and cross-product claims identification. The ability to assign claims based on type and staff availability are other features that would further accelerate the claims cycle for maximized customer service.
Running a successful marathon requires an experienced coach, the right training, and yes, even the latest in sneaker technology. For insurers to satisfy and retain customers, they need innovative claims technology that results in best-in-class customer service. Next-generation technology can streamline the claims life cycle so that the claims innovation race results in a consistent, first-place finish.
“Delivering on Digital Customer Experience: Are Workplace Benefits Carriers Aligned with Employee Preferences?” LIMRA, 2021