Leveraging AI: A road map for claims managers - Part 2

Today, all claim managers face the challenge of having to do more with less. Often technology provides the solution. Artificial Intelligence (AI) technology offers many ways to streamline the claim handling process while enhancing the policyholder’s experience.

While the decision to purchase AI technology is usually made in the home office, it will fall on the local claim manager to successfully implement the technology. There is a long list of obstacles to deploying AI. According to a Cognizant report entitled “The Insurance AI Imperative”, these can include:

• Access to timely and accurate data,
• Recruiting and retaining talent, and
• Measuring performance

As a claim manager, to manage through these obstacles, you should vigorously advocate for a pilot program to be run in your office. Yes, it will mean a disruption of the status quo, but it will also show the willingness of your office to try new solutions. This pilot program should be of limited scope and duration, such as the first significant windstorm of the season. This will allow you to:

• See how the technology performs,
• Identify what processes need to change,
• Determine the impact on staff,
• Receive feedback from staff, policyholders and agents, and
• Evaluate the success of the pilot program

Let’s assume that your company has decided to implement AI technology to assess windstorm damage caused by a catastrophe. Prior to the beginning of the pilot program, communicate with your staff that this technology is simply a tool to help them perform their jobs better. For claim supervisors, the technology will make it easier to triage claims and dispatch adjusters to the more complex claims. For the catastrophe adjuster, it will shorten their time in the field. For the inside adjusters who will have to pick up the slack when the catastrophe adjusters are out of the office, it will mean a quicker return to normal staffing levels. Emphasize the human health and safety benefit, i.e., not having to send adjusters onto roofs that have sustained an unknown amount of damage or having them standing on a roof in 100-degree heat.

At the same time, you need to have similar conversations with your agents. Explain that this technology will provide more efficient claim service and a better claim experience for the policyholders. Enlist the agents’ help to spread the word among their clients that this is for their benefit.  This is extremely important because, according to a Vertafore survey published in 2017, the majority of consumers (60%) think that AI technology would automatically deny them coverage that would otherwise be offered by a human adjuster.

Set up a demonstration for all the agents and claim staff who will be impacted by the AI technology and dispel their fears about inefficiency and job loss. The message to staff, agents and policyholders should assure all that the AI solution is a tool to automate tasks and provide decision support, not a tool to take away jobs or make automatic denials of claims. You can even use a catastrophe example where a windstorm is of such a magnitude that policyholders are forced to evacuate, and the AI technology would allow the insurer to check for windstorm damage before the policyholder was even allowed to return home.

Set up a training program for all of the claim staff who will be involved in the pilot program. Make sure to allow sufficient time to become familiar with the technology before the actual pilot program starts.

Once the pilot program begins, document the processing changes that have already been identified and those that still need to be adjusted. For example, see if the new data elements are easily entered or if multiple tries are needed to get an acceptable entry. Assign both supporters and skeptics to work on integrating the technology into the claim process. Have them devise the success metrics you will use to evaluate the utility of the technology.

Create a customer experience team to solicit feedback from agents and policyholders to determine if their expectations have been met. Create a team to assess the overall impact on claim staff. Was the technology too cumbersome? Was it easy to explain the claim determination to policyholders and agents? Solicit suggestions on how to improve the process.

Remember that the claim adjuster is your best ally in making a successful integration of the AI technology because they are the ones who will be using the technology as a decision support tool and they will be interacting with the policyholders directly.

Donna J. Popow, Esq., CPCU, (donna.popow@verizon.net) spend more than 30 years in claims before becoming a consultant to the property/casualty insurance industry. She has managed catastrophe operations and written extensively on claim-handling procedures.  

Related: Leveraging AI provides a road map for claims executives