Innovative Claims Experience

The Challenge :

  • To find an innovative and scalable solution beyond existing customer contact center to engage agents, brokers and a large pan-US customer base 24×7, particularly for claims.

The Solution :

  • Identify client’s automation needs in the area of customer engagement, both in immediate and long term.
  • Enable best-fit chatbot technology platform with a phased approach to create new business capability of AI based customer engagement.
  • Create a chatbot, as first phase of solution, that would engage customers for their claims related queries such as –
  • Queries around FNOL.
  • Guide with type of claim needed to be filed.
  • Help customers with queries on their open claims.
  • Help customers reach their Claims adjudicator.

The Outcome :

  • 24×7 channel available for online query resolution.
  • Quick turnaround & better customer experience.
  • Reduced call volume at contact center.
  • Improved productivity of customer service – Faster resolution of complex issues.

 


 

The Challenge :

  • To reduce claims processing time and increase quality of handling through an automated omni-channel submission of claims, while leveraging existing technology investment and scale for integration with future technologies.

The Solution :

Implement technology and labour based CDP solution to achieve.

Automation through latest technology – Intelligent automation including industry-best OCR and handwriting extraction engines.

Improved Customer Experience.

Long Term Business Value – Proven platform & technology solution that can be leveraged by client’s long term claims strategy program.

 

The Outcome :

  • 35,000+ pages processed daily.
  • 25-30% increase in efficiency.
  • Reduction in overall claims cycle time

 

  • High quality delivery within 24 hours of invoice receipt.
  • Higher adjudication rates at lower costs.

 


The Challenge :

  • Four distinct claims technology eco-system built over time didn’t provide future state platform. There was a very complex operating environment for their Claims with issues like lack of functionality and overtly complex architecture that required significant work to maintain operational stability.

The Solution :

  • Improvement of the multi-year, multi-initiative, business-driven transformation program – Claims Roadmap program’s progress for a significantly enhanced Frontline, Claims Adjudication and Operational Management experience.
  • Target Operating Model Definition.
  • Single Claims System Implementation.
  • Optimization of Claims lifecycle from Loss intake through recoveries.
  • Single Repository & Production Process.
  • Forms & Letters integrated with claims & documents systems.
  • Integrate with agent, customer & employee portal.
  • Report claim status and facilitate vendor management.

The Outcome :

  • Enhanced total claim outcome (effectiveness, efficiency & customer service).
  • Effective vendor management.
  • Improved ease of doing business.
  • Electronic document mgmt & claims correspondence.

 


 

The Challenge :

  • Our client, one of the top 10 insurance providers in the US, wanted to define a strategic vision and a set of key experience moments that would shape the claims experience towards a touchless future (and current objective of 75% touchless claims capability).

The Key Insight :

  • Our research led to a strategy built from a set of deliberate choices that impact the entirety of the claims experience, including the addition of pre-FNOL and post-payout moments that increase the likelihood of consumer acceptance of a fully touchless experience.
  • Our choices were driven by the company’sunique assets and competitive differentiators in service of a community of military members that value control and preparedness.

The OutCome :

  • Our Touchless Claims Experience strategy and set of solutions were designed to help not only the achievement of cost reductions and organizational efficiencies, but also the creation of a defensible position for USAA in relation to its unique customer base – and set a uniquely USAA experience fueled by a robust data backbone that inspires trust, loyalty and advocacy.
  • The solution allowed the company to be empathetic, efficient, and successfully leverage an ecosystem view and partnerships with emerging technology players. The effort as a whole laid the foundation for new growth opportunities for the company, while ensuring current member satisfaction is maintained.
  • The company is actively pursuing the strategy and solutions, towards pilot initiatives, and internal capability building.