Despite the sweeping digital transformations encompassing the insurance ecosystem as of late, automation itself is hardly a new concept in the industry. The formation of the Association for Cooperative Operations Research and Development (ACORD) back in 1972 coupled with the rise of the PC enabled the industry to standardize and automate much of the insurance form creation and data collection process; these days, ACORD forms and certificates are employed by 90% of U.S. property and casualty insurance companies. Notwithstanding, carriers still largely rely on manual processes for collecting client insurance form data and other administrative tasks. And in a post-pandemic world where client expectations have evolved to expect results on par with the speed of information, insurance carriers are increasingly under pressure to automate their processes to remain competitive and relevant to existing and future customers.
In this article, we’ll explore one aspect of the insurance domain that is low-hanging fruit for automation: claims administration and claims management. By automating the following 5 tasks with claims management software, insurance carriers, TPAs, risk pools, brokers, and more can maintain their competitive edge, realize new operational efficiencies, and improve and optimize the customer experiences throughout the claims lifecycle.
Claims Management: A Prime Automation Candidate
ACORD brought about much-needed standardization and automation around insurance form creation/use almost half a century ago; however, put into practice, most of these processes and workflows are still bound together by manual efforts. This is especially true of claims management—a framework of rule-based processes that involves a myriad of steps and parties. Fortunately, these conditions also make claims management the ideal candidate for automation. For example, claims administration systems such as Ventiv Claims, offer updated client-determined schemas that enable claim organizations to build their own workflow rules, thereby significantly reducing claims handling costs without compromising high service and quality levels. When selecting a solution, claim operations should expect a high level of automation from any claims administration system under consideration.
5 Tasks You Can Automate with Claims Management Software
From alerts and communications to customer claims status notifications, the following are 5 tasks ideal for automating with claims management software.
Automating Claims Intake and Onboarding
In the past, the inputting of new claims was relegated to phone or in-person interactions. A modern claims management solution allows for multiple input channels via website and mobile app integrations for streamlining backend data collection. Additionally, these new claims data collection channels may be further automated with chatbots and other AI/ML-powered interfaces for capturing initial claims data.
Automating Routine Process Approvals
Time-consuming, error-prone processes in claims management are both largely manual and routine. Automating these claims processes enables insurance carriers to eliminate the human overhead required for moving cases through the required approval workflows while allowing for manual handling/intervention by claims professionals when needed. Modern claims management platforms can automate data collection using AI/ML, with in-built workflow data checks and approvals across claims, policy, and service provisioning. Routine approvals are automatically communicated to parties via email, website, and mobile app—with traditional process approvals taking place via phone and mail as fallbacks.
Automating Alerts and Communications
As mentioned previously, routine process approvals can be automated using software for both validation and approval alerts. AI/ML-based automation and predictive analytics can also help in incorporating business rules and logic for alerts and communications across the claims lifecycle, automatically reaching out to the relevant parties with inquiries and updates based on their contact preferences. With the more basic administrative communications handled automatically by a claims management solution, insurance professionals can focus on more high-impact tasks.
Automating Customer Claim Status Notifications
Receiving timely updates regarding claims statuses is instrumental to an optimal customer experience. To this end, a claims management software platform allows for proactive, up-to-date claim status notifications for full visibility and transparency during the claims approval process.
A modern claims management software platform is capable of automatically notifying claimants regarding their claim statuses and any additional requirements—clients can automatically receive the latest status updates throughout the claims lifecycle, both on-demand and at predefined stages.
Automating Payment of Approved Claims
Once claims are approved, an automated claims management software platform allows insurance carriers to payout settlements automatically. Payments to clients and/or service providers are automatically initiated and expedited end-to-end, with little payment-related intervention necessary between claims professionals, clients, and service providers.
In short, modern claims management software provides automation that enables firms to focus more on customer service and less on administrative, manual tasks. These 5 tasks are just a few that can be automated and streamlined with claims management software. By eliminating human intervention and manual efforts and processes, insurance providers can reduce error and time-to-settlement, drastically improving the customer experience and maintaining a competitive edge. To learn more, please download our whitepaper to find out how to automate your organization’s claims processes.