eClaims

Claims Management to the Next Level

The core of insurance is claims. In Non-Life (P&C) on every € 100 insurance premium paid on average € 67 is to compensate for claims (including expenses), for which the premium ultimately was paid. One third (€ 33) of the insurance premium is used to do the job. Whether this is a reasonable/sustainable ratio or not is another discussion.

Getting this Claims Flow well under control is really making the difference. Not only financially but also for customer satisfaction and retention.

As an insurer key responsibility is to protect customers when the worst happens and get them back on their feet as soon as possible. So let’s shine here.

So the objectives for eClaims were:

• Automate as much as possible (but be there in person if necessary)
• Reduce the number of claims (risk-management, predict and prevent)
• Online claims notification and tracking with fully integrated mobile solutions (and guest domains (TPC))
• Reduce handling costs
• Outsource claims handling or go for a relevant mix
• Speed-up the process and make it paper free
• Reduce actual claims costs
• Reduce fraud
• Survey each claim to learn
• Increase customer satisfaction (CX)
• Real-time monitoring and MI
• And last but not least put the customer in the center and solve all “issues” as soon as possible. Increase customer satisfaction (CX)

Smartphone

There is a clear shift to the smartphone (or: Personal Smart Device) being the gateway between the insured and relevant parties. Possibly after synchronization with the data produced by other sources. Having all those data and know how to use them offers competitive opportunities.

Prevention

It starts with being proactive. Using environmental and infrastructural data in combination with data actually produced by the insured. Improving behavior (scoring) and create early warnings.

Accident

When it nevertheless comes to an accident a claims app is opening. The customer/user/driver is guided in a dynamic way through a relevant notification process and the information is automatically attached to the right policy. The result is sent as pre-FNOL and integrated in the online FNOL to complete (if necessary) at a convenient time and place. If requested assistance is provided (e.g. in combination in eCall).

Get immediate FNOL (First Notification of Loss) with evidence (time, location, images (accident location, damages, objects involved), witnesses, video, car: speed, deceleration, dashcam footage, etc.). If possible (partially) via smartphone on the spot. This FNOL basically goes in 5 steps:</br>

1. Identification of the claim and automatically issue a claim-ID number;</br>
2. Identify the type of claim and do an automated coverage check and decline or accept;</br>
3. If accepted ask for the relevant data to prepare the different claim files, to automatically set the reserves and to prepare the dynamic step 5;</br>
4. Give advice, explain the current situation, inform about possible consequences, the best way to proceed and a possibility to draw back;</br>
5. Details; only to fill in case the customer continues claiming.

This FNOL is immediately integrated and available in the Private Domain of the customer and for the claims handler(s). An overview with all the questions and (outstanding) answers for the claims handler and loss adjuster is online available. And on top of that: In case of a car accident a look alike of the Standard (European) Claims Form can be produced afterwards as well (for (international) recovery and litigation; as long as all parties are not there yet). Professionals involved, customer and third parties can follow every step in the process online (claims tracking with guest domains). Based on automated analyses the claim is categorized in low and high risk (80/20 and improving).

Where Low Risk means speed and customer satisfaction (STP). Low risk is handled along automated guidance. Random checks and audits. So far everything is automated, there is no manual intervention.

High risk claims need some more attention; however when indicators give green light they are pushed back to Low Risk. Otherwise the claim is further scrutinized carefully or ends up in litigation.

Highly automated

Based on the structured and dynamic FNOL a Claims Binder is generated with one or more Claims Files, all the initial reserves are set including the relevant cost type. A notification lands at the Inbox of the Claims Department where Claims Handler and Claims Owner are determined and when the claim is not settled in a fully automated way (STP), the Claims Handler takes off immediately. Response asap but within 30 minutes.

Reserving

The initial reserves set at FNOL give an accuracy in a bandwidth of +/- 1.5%. Triangulation is as good as flat. The real-time MI on the Dashboard shows the Claims and Loss Ratio spot on.

Customer Experience (CX)

All communication preferably takes place via the Private Domain(s) and is integrated in the claims file, named and with a time stamp. The customer can follow progress in detail.

As soon as the claim is closed for the customer a button with “Your opinion” automatically appears in the Private Domain linked to that specific claim. At the same time the claim gets the status “Closed” an eMail and SMS are generated automatically to remind the customer to have a look in the Private Domain. The eMail also contains a direct link to the Private Domain. By clicking on the button a short survey pops up enquiring about:

• Speed of the claims handling
• Information provided
• Result of the claims handling
• A comment box allows the customer to enter free text.

Third Party Capture (TPC)

Normally the Third Party is not your customer. And here you have the perfect moment to shine and offer all your services and best practices to a prospect you have to deal with anyhow. So also create Guest Domains to include third parties in the process.

Conclusion

Claims Handling and Claims Management should be valued at its true importance. And yes, servicing and compensating your customers in case they experience material or personal damage should be attractive and exciting.

eClaims as a fully integrated claims module is there to support this. Taking claims to the next level; the customer is worth it.

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