Balancing Personalization and Automation

Seemingly impersonal digital transactions underscore the criticality of personalization. The key is to pinpoint the exact moment of need in the insurance buying and filing experience.

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The insurtech industry is hot with data gathering, analytics, automation and all-things digital. And for good reason. As more people prefer online experiences and are accustomed to intent marketing practices that “know” your online moves, it’s inevitable that carriers will also know and mine digital movements like purchasing, enrolling and filing claims. Does all this digital transaction insight and big data mean that human touch or consult has gone by the wayside? Not at all. In fact, all these seemingly impersonal digital insurance transactions further underscore the criticality of personalization. The transformative opportunity is to pinpoint the exact moment of need in the insurance buying and filing experience.

With increasing integration connections to sources of customers’ information as well as investing in analytics, carriers are poised to create the perfect blend of automation and personalization. It’s critical that a carrier consistently proves that they understand the customer and can streamline their needs. It all hinges on clearly understanding the customer’s journey. 

Carriers that understand the customer’s motivations for buying insurance and filing claims will reap the benefits of the nexus between automation and personalization. It’s short-sighted to think of the customer as a single-touchpoint transaction, such an enrollee or a claimant for a single product. Rather, they are on a life journey that includes a variety of experiences where insurance can assist. Understanding this balance creates opportunities for customer loyalty to, and engagement with, a carrier. 

The Journey of Employee Benefits

Take employee benefits. This journey begins when the employee enters the workforce and ceases on retirement or their death. Each employee begins with enrolling in benefits, continues the journey through life experiences that cause them to file for claims, such as short-term disability or paid family leave. As the employee’s life and career matures, they may make further investment in benefits. This journey with employee benefits typically ends with accessing retirement plan benefits. Upon death, their beneficiary files for the death benefits from the employee’s life policy. 

Understanding the employee’s journey is the first part. The next is to home in on the employee’s motivations to consider each employee benefit through that journey. Savvy insurance carriers understand this. 

See also: Why Customer Journey Mapping Is Crucial

Enrollment: The Journey’s First Step 

Because an employee is excited to embark on their career, they are less focused on employee benefit enrollment upon hire. Creating an easy, informational enrollment process is key. Carriers can use their decades of data coupled with connected census and policy information to create an automated yet personalized experience. Layering in AI-enabled informational touch points for the typical questions an employee raises during enrollment adds the right level of human intervention. Auto-enrollment in certain benefits such as 401(k) retirement or low-cost life insurance is even better. At this juncture, the carrier has provided an automated but personalized experience. 

Claim Filing: The Journey Continues

When it’s time to file a claim against the employee benefits, typically years after enrollment, the employee likely experienced a dramatic event in their life. This could be exciting like welcoming a new child or enrolling in a graduate program or stressful like an illness or workplace injury. Now, the employee’s motivation is to avail themselves of the benefit quickly so that the benefit assists them with navigating the life experience. But, due to the complexity of the employee’s life change, the employee likely has questions that need answering quickly and easily. At this point in the journey, carriers must provide the human consultation, the empathy and critical thinking necessary to assist the employee through the benefit-filing process. 

At this stage in the journey, automation expedites the filing process, including surfacing the relevant and eligible customer products and employee census information. In the example of the employee giving birth, personalized automation should quickly present short-term disability, paid parental leave or FMLA, or trigger health insurance requirements like adding the baby to the policy. When a carrier delivers a personalized but automated approach to the employee’s life situation, the employee gains a sense of understanding of their specific wage replacement and job-protected benefits, or their out-of-pocket costs.

Industry data is clear that online claim filing is trending, but the majority of claimants still prefer personal communication when filing and questions answered by humans. Optimal insurance experiences are often found when humans and machines work together. Integrating transfer points between technology and carrier staff along with real-time data access is key to creating a balanced approach.

Additional Benefits: Advancing the Journey

Later, as the employee settles into their career and begins to further consider their finances and potential additional benefits, carriers again have an opportunity to leverage the employee’s motivation. This is an opportunity to delight employees by understanding this stage of their journey by automating information, or even enrollment, around retirement benefits, family care leave and life insurance.

Even at this stage, though, carriers must remember that customers often don’t understand the complexities of insurance, such as how the benefits available to them might meet their personal goals, risk adjustment and what goes into quoting and underwriting. Employees are primarily focused on their personal life advancement, not details of their insurance. Therefore, it’s essential that benefits are characterized in a way that is relatable to a customer’s stage in their journey. This includes not only accessing information about the benefit (online versus a consultative broker or HR professional), but actually accessing the benefit itself. Auto-enrolling new hires into a company 401(k) plan was once controversial; now, it’s deemed as a brilliant and helpful way for employers to ensure employees’ financial future. Automation such as auto-enrollment at certain stages of an employee’s journey provides incredible value. Auto-enrollment at certain points in an employee’s journey is well worth considering, especially for long-term disability or paid family leave when an employee reaches a certain tenure or adds a family member to insurance.  

See also: Why Cyber Strategies Need Personalization

Cashing Out: The Final Stage

Finally, filing for retirement or life insurance benefits comes from an obvious different motivation than filing for benefits around an illness or family-related life event. With these end-of-career benefits, carriers can again easily automate to expedite benefit decision and payment. Connecting with fraud detection sources allows further acceleration of benefit processing. 

Chatbots and AI can be a bridge to human interaction as well as provide a 24/7 convenience. When used well, AI can manage high-frequency inquiries in a way that feels natural to users. By now, customers expect the carrier to have information about them readily accessible. As the “conversation” progresses, AI can use workflow to route the claimant to a trained human resource professional.

The Market Is Changing, but Human Basics Remain

This increase in the use and demand for relevant and pinpointed insurance requires that carriers rise to the occasion. By focusing on the customer journey, not the insurance product, insurance carriers have an opportunity for life-long relationships with customers. Carriers can apply automation and ecosystem connection to adapt to rapidly changing market expectations and create positive insurance experiences by leveraging technology-enabled information, as well as human consultation and empathy. This benefits customers and carriers alike. 

In this new era of insurance, carriers can replace siloed, product-focused and human-heavy interactions with state-of-the-art, responsive personalized ones. The result is a contemporary and financially beneficial experience. In doing so, carriers provide easy access to needed benefits and helpful services, thus creating loyal customers for years.


Megan Holstein

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Megan Holstein

Megan Holstein is the executive vice president of claims and absence product at global software company FINEOS, Holstein is responsible for the strategic design and marketing of the company's claims, absence and integrated disability and absence management (IDAM) software solution.

She is an expert at the nexus of employee benefits, paid leave and technology. She believes the time has arrived for a modernized, holistic approach to absence benefits and is influencing insurance carriers, third-party administrators (TPAs) and employers to move toward more efficient, comprehensive, easy-to-navigate solutions for employees needing to take time away from work.

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