Five key criteria for successful automation in claims


Five key criteria for successful automation in claims

Achieving straight through processing of claims to improve business performance and customer service. Five key criteria for successful automation in claims.

By Jeremy Burgess, CEO, The Insurance Network

Sponsored by: KOFAX

As insurers and brokers search for operational efficiencies that also improve the customer experience, automating insurance processes is a key priority for directors across many job functions and business lines in the industry. With this in mind we ran a breakfast briefing, sponsored by Kofax, exploring the challenges of automation in claims – a key area where automation could have a potentially game-changing impact.

With 18 directors, from across the GI industry, the discussions were frank and challenging, exploring the critical issues to consider when looking at automating claims processes.

There were initial concerns that using ‘robots’ as part of claims handling would introduce cold analytical processes into what should be an intimate and personal claims experience: customers value empathy and ‘the human touch’ during the claims process, and the extent to which they experience it can be a big driver of retention (and conversely churn). Around the table it was agreed that this was a legitimate concern, but when done holistically automation of claims could be consistent with delivering excellent claims service.

It was also mentioned that automation and digital are synonymous so ensuring you have the capability to handle claims in a multi-channel environment is essential.


The language around automation was also discussed, with the majority agreeing that claims automation should not be described as Straight Through Processing (STP) – which could be a misleading or even dangerous term. This is because STP implies a linear, almost fixed process that all customers embark on to resolve their claim. Customer and claims functions should not expect claims to be a linear process as every customer believes their claim to be unique (even if there are ‘standard’ elements to it) and so should be handled, or perceived to be handled, in a unique way.

This led the conversation into that area of FNOL and why customers did and didn’t notify insurers online. According to research conducted by one attendee’s organisation, the channel of choice for claims notification is based on whether customers believe that using a particular channel would result in a personal and speedy resolution to their ‘unique’ claim. It is critical to understand your customers and what they require and expect from the claims service – and think carefully about how automation could improve their claims journey.

When implemented with the aim of improving customer outcomes as the goal, effective automation can lead to cost savings, efficiencies and improved customer experience.

Although today’s technology can do a lot in terms of automation it can’t yet do everything. So it’s important to make sure the organisation is ready to experiment to discover where the boundaries are for technology investment – and not just go searching for the next new bit of tech. The focus must be on the businesses challenges that need solving today.

Five key criteria for successful automation in claims:

1) If you don’t have a bold vision and strategy for digital claims automation you will fail

2) Understand your customers and your business to know what data you’ll need to solve the business challenges of today

3) Have a clear view of your technology architecture and your end state

4) Engage claims handlers and especially middle managers in the positive aspects of automation

5) Challenge and stretch your team and the organisation to keep pushing forward

 Automating claims processes – 5 key criteria for success