Struggling to automate claims initiation and processing? Here's how to do it in a human way

Photo by Daniele Levis Pelusi on Unsplash
Photo by Daniele Levis Pelusi on Unsplash

You are as good as the service you provide. The litmus test for any insurance company begins when it actually comes to handling a customer’s claim. Clients form their first impression when they initiate a claims process.

During the outbreak, insurers were bombarded with all kinds of claims. Recent studies state that in the middle of the pandemic, Australian and New Zealand clients and insurers were having almost twice as many conversations as pre-COVID. As the call center capital of the world, the Philippines, shut down and outsourcing was no longer an option, insurers turned to text chat. As for claims processing, many companies rushed to mobile apps in an attempt to automate the process. 

But was this a positive change? Many people have found themselves in a situation when they needed help with an insurance claim, including, for example, seniors who aren’t exactly tech-savvy. Imagine their confusion when they found out call center phone lines were clogged and the only option they had was to seek help online. Not cool. 

As far as apps for claims processing - based on our conversations with insurers we have found that for many insurers only less than 30% of customers use the app to file claims, others call the claims in. At least one insurer we spoke with shared that only 3-4% of their customers use the app to file a claim.

Let’s not forget that voice is the most natural way to communicate – and the most comforting. Merijn te Booij, CMO of Genesys, says that when it all began customers deliberately switched from online to voice since they wanted to hear the person on the other end of the line and get some assurances. To add to that, contact center agents are often perceived as free psychological counselors. People will just call up and dump their fears and concerns on the agents. 

And now we’re left with two problems. First: text communication is not as effective today. Second: voice communication is effective, but there are only so many call center agents to handle thousands of repetitive calls a day. They get tired and stressed out by these low value tasks. They simply can’t help everyone.

Here is an example of how insurers use Dasha for claims automation. 

The contact center inefficiency was a huge concern for one of our clients. 60% of all conversations at their call center were initial claims filing conversations. As their business is very seasonal, they ended up having to hire temp agents during the high seasons. The company used Dasha AI technology to automate the first step in the claims initiation process. When a customer calls to file a claim, they are connected with Dasha AI. Dasha confirms the customer’s identity, asks about the reason for the claim and then, if approved, emails a form for the customer to fill out. As such, Dasha does everything that a call center operator used to waste time on (and can now focus on more value-added tasks).

As the second step, the client is using RPA to process the claims. With RPA implemented, they will be on track to cut back the number of people involved in the process from over 40 to 12. 

If something out of the ordinary happens, Dasha will excuse herself and transfer the call to a human agent, along with all information provided by the customer.

Now that you know how to automate claims initiation and processing, you are on your way to providing superior customer service. Ready to turn the tide? Read this report on how industry leaders are doing it.

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