Claims: Beyond the 'Moment of Truth'

New capabilities for interoperability in the claims ecosystem are leading to at least a dozen profound changes.

I have proudly worked in the North American insurance claims and information technology industry for over 30 years and have witnessed significant, albeit gradual, improvements in process and service. More recently, almost overnight, the switch of information gathering and distribution from analog to digital has transformed claims.

Mobile consumer technologies have been adopted rapidly, disrupting sales and distribution models and their supply chains. Instant gratification has become a natural expectation.  

Insurance Claims Process Evolution

In insurance, claims remains the “moment of truth.” Claims represents the best single opportunity for an insurer to engage personally with its customer, satisfy the coverage promise and foster loyalty. But claims has begun to evolve. It has been a highly complex, labor-intensive, stubbornly long, expensive and customer-unfriendly process. But it is benefiting in a big way from new and exciting technologies, and investors are eager to place bets on a new generation of entrepreneurs who shun working for large corporations (at least until those companies acquire them for mind-boggling amounts).  

The “Amazon effect” (immediate delivery of virtually anything from entertainment to information to merchandise to food through a simple, digital interface) drives consumer expectations even for insurance claims service, no matter the behind-the-scenes complexities involved. In the fiercely competitive personal lines market, traditional carriers are responding by transforming the claims process to make it more “Amazon-like.” In the process, carriers are lowering claim costs, producing savings that can then be reinvested in lower, more competitive, insurance premiums. 

See also: Breakthroughs Finally Appearing in Claims   

The claims process is still complex. It involves many disparate technologies and services, and firms that range from very large corporations to smaller, more local providers. Integrating and streamlining all of the related interactions is not trivial. But new, low-cost computing capabilities and information management technologies are enabling the interoperability of this ecosystem, leading to an array of profound changes, including these 12.

Claims in 2020 and Beyond

  • Control over first notice of loss (FNOL) will be contested as technology enables real-time accident notification. The change will allow for new influences in claim process response, resolution and the customer relationship 
  • Average cost of auto repair will rise further, exceeding $3,600, as more late-model-year cars enter the car park loaded with costly accident avoidance and self-driving technology that requires post-accident scanning and recalibration. A $5,000 average repair cost is already in sight. This trend will be reinforced by strong consumer preference for more expensive light trucks and SUV/CUVs, now representing 70% of new sales, and, soon, more electric vehicles (EVs)
  • As cost of repair climbs, so, too, will total loss frequency. It is now at 24% for some carriers, increasing claim costs and placing added stress on valuable claims-adjusting resources. Tech-enabled processing solutions will emerge to compress cycle times and ensure compliance, but deployment and integration will take time 
  • The collision repair industry and its traditional direct repair program (DRP) relationships with insurers will change in more fundamental ways as OEM repair network certification programs gain traction, with support and encouragement from trade groups, consumer safety, legal and regulatory advocates. This, in turn, will add upward pressure on average repair costs  
  • Growth in claims self-service, including auto photo estimating, will outpace other methods of inspection. The change will upend staffing models and disrupt appraisal work forces as well as the traditional collision repair referral process
  • A culture of speed and transparency will develop and attract new talent, filling an important gap
  • AI, including computer vision, machine learning, data analytics and automation, will begin to streamline and compress the insurance claims process, identify and deter fraud and remake related work forces and skill sets 
  • Digital imagery and measurement from aerial to drone to ground-based will permanently alter the property claims estimation, settlement and repair process. The change will create new strategic partnerships between carriers and third-party providers and transform the property claims field and desk appraisal
  • On the journey toward touchless claims, carriers are realizing that they need to deliver empathy at scale. They will leverage intelligent platforms while recognizing and deploying emotional data – and achieving a proper balance between digital and human touch 
  • CEO-led diversity and inclusion initiatives will become critical to attract talent in claims and boost organizational performance across the enterprise as well as increase competitiveness in the market
  • Emerging technologies getting greater attention and testing in claims use cases will include virtual and augmented reality (VR/AR) for staff training, field service and support
  • Success in the art of developing and managing effective strategic alliance and partnerships and collaborating with others, including competitors, will become table stakes for innovation 

Collaboration in Action

Now, more than ever, cross-industry collaboration across the vast claim ecosystem is critical to delivering an efficient, high-quality, low-cost claims experience to policyholders. One excellent forum for such collaboration is Connected Claims USA Summit, taking place this year in Chicago on June 24-25. As chairman of this exciting event, I invite you to join us this summer to discuss and learn how to move from strategy to action and implement the future of claims today.

See also: Future of Claims Intake for Insurance?  

Stephen Applebaum

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Stephen Applebaum

Stephen Applebaum, managing partner, Insurance Solutions Group, is a subject matter expert and thought leader providing consulting, advisory, research and strategic M&A services to participants across the entire North American property/casualty insurance ecosystem.


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