Humanizing the insurance claims process: The power of integration and automation

Getting injured on the job or in an auto accident can have a significant impact on a person’s life. Going through the process of filing a claim and getting treatment can make it even more complicated. In fact, a 2018 study found that one in seven survey respondents said it took longer than expected to settle their property & casualty (P&C) claim, with delays adding to their burden.

One of our collective goals as an industry is to simplify the insurance claims process as much as possible to create better experiences and outcomes for anyone injured in an unfortunate event, whether it takes place at work or on the road. But with regulatory compliance and required paperwork, streamlining the process isn’t as simple as it sounds.

Technology that facilitates automation can help create the positive experiences for claimants that we strive to provide. Though we all have heard the scary predictions about how artificial intelligence and automation will take away jobs and completely change the nature of work, the P&C industry has a great opportunity to embrace technology and use it to both simplify and personalize the claims process.

By integrating technologies and automating administrative tasks, the workers’ compensation and auto casualty industries can free up employees’ time for higher-value tasks that require a human’s touch. As a result, they will be able to focus on making the best decisions to help restore the injured person’s life.

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Automation’s impact on the claims process

Due to the large number of administrative tasks in the claims process — activities like taking notes, transferring information between systems and filling out forms — the P&C industry is well positioned to reap the benefits of automation. A 2017 McKinsey report found that there is huge potential for automation in today’s workforce: about 50% of work tasks could be automated, and in six out of 10 occupations, at least 30% of all activities are automatable.

Imagine, for example, if we could apply technology to automate 30% of a nurse case manager’s job. Nurse case managers are highly skilled, yet they spend a significant portion of each day doing administrative tasks that could be automated. If we could automate a sizeable portion of these manual responsibilities, the nurse case manager would then be able to apply that newly freed-up time to focus on coordinating care, helping injured workers get the right treatments and ultimately getting them back to work faster.

An adjuster’s job could see similar benefits from automation. A rules engine could help to set customizable thresholds for the bills that are good candidates for straight-through processing — leaving an adjuster more time to focus on complex, high-severity claims that need special attention and greater skills and experience to process. As the claims process becomes increasingly automated, adjusters will likely have more time to gain an understanding of the full picture of each claim that comes across their desks to help them to make the best decisions for the injured person.

Another benefit: automation also helps to reduce human errors, meaning that there is a higher probability that the process goes more smoothly (less lost paperwork, fewer coding errors, etc.) and that the injured person has a better experience throughout the course of treatment and recovery.

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How to automate the claims process

Systems integration drives automation and is essential to helping claims professionals realize even greater efficiencies. The current claims process is filled with all different types of technology, and in many workflows, these systems are not integrated. Between claims systems, bill review platforms, pharmacy benefit management solutions and more, adjusters could be switching in and out multiple systems every day. Disparate systems often lead to scattered data, causing inefficiencies and missed opportunities for payors.

None of these different technologies are going away anytime soon. Statista predicts that the estimated global market size for insurtech claims processing improvements will be $72.53 billion by 2020. As the insurtech market continues to grow, it’s important that payors understand the importance of integrating all of these systems to help drive automation and free their employees from manual tasks.

Integrated technology systems are changing the claims process for the better, helping drive efficiencies and freeing up time for adjusters and others to use their valuable expertise to focus on the needs of injured parties and create better claim experiences and outcomes. The insurance industry should embrace both automation and systems integration, not as ways to replace jobs, but instead to boost efficiencies and simplify the claims process.

Submitting an auto casualty or workers’ compensation claim is personal — and through technology integration and automation, we can bring a human touch back into the process.

Nina Smith is executive vice president and general manager of Mitchell’s Casualty Solutions Group, and leads the company’s auto casualty solutions and workers’ compensation solutions divisions. Contact her at  casualtysolutions@mitchell.com.