Duck Creek: a four-part framework for claims considerations

There’s frequently an emphasis on automation in the claims arena but, in reality, a balance between automation and personal interaction must be struck.

​Insurers looking for guidance on how to configure their claims operations to meet business strategies were provided with a four-part framework by Matt Sheridan, Senior Director of Product Marketing and Strategy at Duck Creek Technologies, a Boston-based provider of software-as-a-service (SaaS) enterprise software to the property and casualty (P&C) insurance industry.

Sheridan delivered a keynote presentation, “Business to Human: Configuring Claims to Meet Business Strategy,” during the first-ever Claims Innovation Virtual Event, organized by Intelligent Insurer. The session, which took place on October 28, was moderated by Paul Carroll, editor-in-chief of Insurance Thought Leadership.

“There are high-level important aspects and strategies carriers are going after, such as driving efficiency improvements, better customer experiences, and greater innovation,” Sheridan said.

When people think about improving the claims process, they tend to think about it in terms of outcomes, he said.  These outcomes—efficiency, personalization, accuracy, and empathy—form the four-part framework.

​​Duck Creek: a four-part framework for claims considerations1. Efficiency
On both sides of the efficiency equation—the outside (the customer) and the inside (the adjustors and the people processing the claims)—automation is sought.

“Achieving a high level of automation is a great way to reduce costs and speed closures, but some interaction has to take place,” said Sheridan.

He went on to outline challenges that carriers may be faced with when attempting to introduce automation.

“As we try and improve automation, we can introduce confusion if the status for an insured is pending too long or the information isn’t completed. The insured then has to call, which reduces some of that automation and efficiency,” he explained.

And, as more of the workflow is automated, channel conflicts can arise. It’s vital to ensure that the information associated with the claim is available to the person who takes a call from the insured and that this person has the information required to move the claim forward.

He added: “It’s not one-size-fits-all, but there’s certainly a drive to continue to be efficient and automate. In order to do this, you have to ensure that you have a claims system in place that can handle a high level of configuration, manage different data types, and easily connect to new data sources.”

2. Personalisation
“Today we’d say efficiency is more of a priority, but personalization can go a long way towards customer satisfaction,” explained Sheridan.

For personalization, the insured is entering information and, while some interaction is still taking place, carriers are trying to automate as much as possible.

The executive noted that carriers need to ask themselves whether they are setting the right expectations for customers upfront, and whether customers understand the next steps in the claim.

Other questions to be asked include: Is there transparency in the process once a customer has completed a number of automated steps? Is there a clear explanation of how the customer, through personalization, can improve their interaction with the carrier, like choices for receiving information?

“We’ve seen that in order to get to a more automated state, many of the standard questions are pushed out to the customer, who ends up doing a lot of the job that was done by the adjuster. It’s not a very personalized interaction; instead, we’ve simply shifted responsibility to the customer,” Sheridan warned.

3. Empathy
Some situations require empathy and understanding rather than automation, and many carriers have clearly adopted this strategy.

“Conveying empathy does not mean every transaction is human-to-human.  However, there are interactions where automation is not going to cut it.  From the carrier side, it’s asking the question of how we make sure that empathy is coming across,” said Sheridan.

He highlighted the implementation of terminology changes, which includes adding empathetic terminology to the scripts used to interact with customers. This, said Sheridan, is a straightforward change that many carriers have already implemented or are considering.

Others are going further and looking to change the user interface of their systems, so that the adjusters and other people interacting with customers are seeing them in a more “human form.” Sheridan cited the example of a change in the wording from “claimant” to “homeowner” which, he said, helps the adjuster feel more connected to the person making the claim.

4. Accuracy
Finally, insurers looking at accuracy need consider how automated and human interactions during the claims process relate to accuracy.

While certain claims may be automated, driven by rules and data, it is important to be able to identify and involve the right people when necessary. In these situations, automation can identify needed human interaction, routing claims to adjusters with the right skills or to specialists when there is potential fraud.  

“While we want to automate as much as possible, there are certainly key moments where systems need to invoke human interaction,” said Sheridan.

Again, for greater accuracy, carriers need to consider how they can ensure all the people involved in processing the claim have access to the necessary information.

Gauging improvement
“Leaders inside insurance carriers need to consider these four outcomes and how they can improve in each area.  They can use this outcome framework to improve their future planning,” said Sheridan.

 “I don’t think anybody is trying to improve one specific area exclusively—carriers are trying to think about the entire claims process across all these outcomes.” To enable a balance of automation and human interaction, carriers need a system that allows configuration of their environment, with the ability to bring in new data and to integrate with partners and other systems to help drive rules and decisions. “To help organize possible improvements, carriers should review a particular outcome, empathy for example, and gauge how well they’re doing throughout the entire process” he concluded.  

To watch the full session, titled “Business to Human: Configuring Claims to Meet Business Strategy”, on-demand click here and scroll down.