Viewpoint: 5 Tips for Creating More Seamless Claims Technology

No matter where you stand in the insurance ecosystem, all roads lead back to the prime directive – serving insured parties in their hours of need. We’re here to fulfill the promise of insurance by analyzing losses, collecting information, and facilitating benefit claims.

We can’t do the claims professional’s job without the support of technology. In my nearly 30 years of industry experience – as a fraud investigator, adjuster, third-party administrator, claims manager, and senior claims management executive – I’ve watched that technology mature. My present role as head of claims for a complex, multi-tiered organization, responsible for a wide of range of P&C business involving multiple programs, including commercial property and general liability, as well as auto and personal accident, has given me a unique perspective on what’s required to develop robust technology that supports us and insured parties in the most substantial ways possible.

Technology is a pain point. My team supports numerous distinct entities, operating differently, that all need to communicate. We’ve had different payment codes, reserve codes, note entries, and audit structures. Complicating matters was the issue of legacy platforms and those modernization and integration issues. Any time you make a transition, one big challenge is simply getting payments out. We knew that any platform had to have a claims repository to hold financial and demographic data, and images. Additionally, to build out a general ledger for billing and to communicate with the bank, the system also had to integrate the accounting function. So, IT, accounting, operations, and adjusters all use the system in different ways, but all need to be on the same page.

From this vantage point, I offer these five insights to anyone looking to create more robust, more seamless claims technology.

1. Remember, you’re building tomorrow’s claims technology. When it comes to tech, we can’t be satisfied with what we’ve got today. We always must be thinking about what’s out there tomorrow. Is a new application coming? New software? Can we develop an innovation that may help someone save time or money or enable the brand to become a marketplace differentiator or disruptor? Is our system flexible, adaptable, and robust enough to continue maturing in a sensible way? Will it resist obsolescence? The rate of progress is telescoping. Just during the time we’ve spent developing our new platform, artificial intelligence has erupted into public consciousness. Change is inevitable. Are we stuck trying to fix something that may have worked for us in the past, or are we embracing the opportunities and workflow of the future?

2. Embrace continuous improvement. The system we create must be flexible enough to adapt to performance improvement. Developing technology is a never-ending feedback loop. We’re forever integrating new tools, new software, and improving service to our stakeholders. Our new system must include analytics, metrics and a process for responding constructively to the things that may not be working or aren’t working as well as they should. The further someone rises in management, the further they get from the front lines and the harder it is for them to understand what adjusters need and how hard it is for them to do their jobs. A fissure can develop, and so we must institute a formal, deliberative process of measurement, communication, and refinement so that the tools we create continue addressing the real-world needs of the people using them.

3. Raise a unicorn, a technology developer with claims expertise. For all the components to work cohesively, someone must understand how everything fits and works together. Required is a computer science expert who possesses a background in claims, an engineer who can process the various functions and “customers” that our system serves. This person needs to know what happens in our industry on a day-to-day basis, then be able to materialize and effectuate the processes and tools we employ. Is s/he able to envision the next unique situation proactively, so that we’re not always repeating to ourselves, “I never thought of that”? Any developer of our new claims technology must be able to max out the system, to take it as far as its potential will allow. This will require a unique pairing of skills.

4. It still takes a human. Every client is different and so even the most automated technology tends to require routine human involvement. There is no one-size-fits-all. When supplying claims data, for example, everyone has different underwriting criteria. Further, the challenge of conforming the two is compounded when Client A requires something slightly different than Client B. It becomes a decision tree. Working to clients’ individual preferences still requires competent human interaction. We can automate large parts, but the system can’t be entirely automated. Whether we’re serving commercial property, commercial general liability, or any other business line, the level of customization never ceases to amaze.

5. Keep team members engaged. Involving employees in a new claims system’s design and integration is vital but can be a challenge. On one hand, their input is crucial. We want engaged, passionate co-workers. And people want to feel heard and valued. But if the development process becomes too time-consuming or technical, it can backfire. People feel like they need a computer science degree to participate in meetings. Even the best employees tune out. Further, soliciting but infrequently implementing their input can kill employee satisfaction and morale. So, it’s a fine line. We need to balance giving them a voice in the process and keeping discussions relevant while offering the training they’ll need to develop and get the most out of the new system. Supporting them is my job.

Generally, few insured parties encounter a loss situation and so, when it happens, people can get emotional, frightened, and feel out of their element. One of our most important jobs is to hold people’s hands, to tell them things are going to be okay, and show them that we’re here to help them. That means developing robust claims technology that is forward-looking, ever-evolving, easy to use, and keeps human needs at the center.