Claims automation: the momentum must continue


Removing pain points from and increasing efficiency in the claims process using automation at a time when customer expectations are high is becoming an important point of differentiation for carriers.

COVID-19 has accelerated the move towards greater automation but it’s vital that carriers maintain and possibly even increase that momentum, says Will Sellenraad, principal of insurance at Pyramid Solutions.

Today’s insurance customers have high expectations. Used to a seamless omnichannel experience in many other areas of their lives, they may fail to understand why their insurance provider should be any different—and understandably so.

The reality is that many carriers are not yet able to offer a truly joined-up customer journey, and this is particularly evident in claims—but it needn’t be the case. A growing variety of automated technologies are available to carriers to help them overcome their barriers to delivering seamless customer claims experiences. From front-end data collection to back-end processing, there is a wealth of opportunity.

Some carriers still resist implementing change, however. Intelligent Insurer caught up with Will Sellenraad, principal of insurance at Pyramid Solutions, to find out why some insurers are yet to make the most of automation’s potential, and how they could identify the areas most ripe for transformation.

This article is published ahead of the Intelligent Insurer webinar “Transform Legacy Claims Processing With Automation Capabilities To Speed Up Settlement, Optimise Your Workforce, And Improve Customer Retention” to be held on February 23, 2021.

Q: What are the typical challenges carriers face when trying to deliver optimal customer claims experiences?

Will Sellenraad: People want to communicate with insurance companies through a variety of different channels such as phone or email, and that’s a challenge for a lot of companies. They want a fast experience and immediate responses. Carriers have to give excellent customer service, and respond quickly to people coming from a wide range of channels and that creates problems in terms of efficiency and accuracy.

This is about delivering on the omnichannel experience. No matter how a customer interacts, they want their information to follow them. They might have been on the web chat 10 minutes ago and then decided to call in, but a lot of carriers don’t have the transparency across their organisations to be able to provide that sort of joined-up customer experience.

Q: Are carriers ready to use automation join up their claims experience?

Sellenraad: First of all, they have to be. The COVID-19 pandemic was the great leveller. For some it was a hiccup, for others the move to remote working was a major hurdle and they were caught flat-footed. Now companies are evaluating where they are on that journey and how they can accelerate it.

When you’re dealing with claims, there is a percentage that can be fast-tracked. Replacing a windshield or a minor fender-bender can typically be resolved pretty quickly. There’s not a lot of information that needs to be gathered when talking to the claimant.

But when it’s a complex claim, for example if injuries are involved or there are hospital bills, there’s a lot of information to sift through. It can get very complicated, very quickly. People are communicating through a range of different channels—they’re texting, emailing, calling—and it’s hard to pull all that data together and give them an accurate answer.

Q: Is there a single aspect of automation that all carriers can get on board with today?

Sellenraad: This is a tough question—it depends on where everybody is on their journey. When you’re solving a claim, there can be a variety of different applications the carrier needs to access to gather the information. I’ve seen claims adjusters with 11 or 12 apps on their desktop and they’re jumping between them, trying to get the data. You can imagine that, when it comes to customer service, there is the same challenge.

It depends where the longest response time is happening in your process—maybe that’s where you prioritise. Alternatively, it could be an accuracy issue: you want to play claims straight away but you don’t want accidentally to pay the same claim twice or duplicate medical bills.

The first precision point could be collecting the data as easily as possible from the customer, because onboarding is going to be their first experience. If it’s during the claims process, it could be in any interaction but overall, how easy is it to supply the carrier with that data—and can that be made easier with automation?

As carriers look at their whole claims process, they need to identify what their number one priority is. I’m looking forward to hearing from companies during the webinar about what their needs are and to see if there’s a pattern.

Q: What do you say to carriers who don’t feel a pressing need to transform their legacy claims process?

Sellenraad: I once saw this great cartoon on digital transformation. It was the same scene split into two sections. On the left, there was a bunch of people in a conference room. The guy standing at the head of the table is saying ‘We’ve got plenty of time to automate, why the big hurry?’.

On the right side of the divider, it’s exactly the same scene, only nobody sees a huge wrecking ball labelled COVID-19 swinging toward the conference room window.

You just don’t know what lies ahead. I’ve seen a lot of insurance companies like that. They say ‘This has worked for us for 50 years, why change?’.

It all comes down to cost. Companies could spend millions of dollars to implement new systems—if they believed the old ones were working at about 80 percent, why would they spend that money for an extra 10 percent output?

Before the pandemic, carriers did think this way but after it, they’ve evolved. It’s a whole new game and you have all these insurtechs popping up with new architectures and faster processing.

The bar has been raised significantly and even the legacy carriers that were slowest to transform are now accelerating their pace of change. Across the board, we’re seeing companies that wouldn’t have considered putting anything in the cloud now having those discussions. There’s a bigger push now for digital automation than ever before.

Q: As companies move towards more automation, there are knock-on effects across the business. Are carriers prepared for the consequences of automation?

Sellenraad: What we’re seeing is the transition of the workforce. Automation just doesn’t require the same headcount, so people are being repositioned to different tasks that are more challenging or meaningful for them. The technology and automation aren’t necessarily there to replace people, they are there to help them work more efficiently.

There’s nothing more cognitive than the human mind. Leaders in these organisations really need to home in on that message.

Q: What will be the most exciting part of the automation transformation in the near to mid-term?

Sellenraad: There are so many great technologies now available, and they’re not expensive to implement. It’s more about low code configuration than customisation. Project trajectories can now be measured in weeks or a few months and derive faster business benefits. Large multi-year transformations are becoming history.

One of the more exciting technologies that can be implemented with immediate benefits is robotic process automation (RPA). These bots can go out and gather all a claimant’s disparate information, pulling it together by using a claimant’s ID and presenting it to the loss adjuster in an easily understandable graphical picture.

This means they can immediately respond to the claimant regardless of the communication channel. There will be increased accuracy and less worker stress. A win-win all round.

At Pyramid we spend time evaluating other technologies to separate marketing hype from reality. When we come into a claim organisation, we already have the intelligence and expertise to listen to where those pain points are and know the right choice of solutions to address those pain points.

We always try to leverage a company’s current technology investment. In most cases, we’ve been able to help increase claims productivity by at least 30 percent.

A lot of organisations see their claims processes through the lens of the technology they currently have in place. We become part of their claims team and bring fresh perspectives of what is possible from our experiences in medium and large companies.

We have built an arsenal of best practices, utilities, tools and templates to optimise claims outcomes.

Find out how automation is transforming claims in this upcoming webinar.


Pyramid Solutions, Claims, Automation, Insurance, Reinsurance, COVID-19, Will Sellenraad, North America

Intelligent Insurer