Data Science in Claims - Digital Acceleration and Customer Delight

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14 June 2020

Customers Demand Digital End-to-End Experiences


Claims is a melting pot for all lines of insurance — personal, commercial, and specialty. Often more than 70% of the total cash flow in a company flows through the claims department and fulfills the promise to indemnify insurance policy holders.

Being mindful stewards of that responsibility keeps claims departments on the frontlines of changes in customer needs, which in today’s environment means faster, better, connected, and digital — a perfect situation for applying data science at scale.

Learning from world-class data, analytics, and cloud examples during COVID-19 may be the only good thing to come out of this crisis. It has been surprising how much ingenuity and inventiveness have evolved in just weeks. And how much of the total is driven by data, analytics, and cloud.

Office work and agency storefront visits may never be the same as customers, employees, agents, and vendors adopt touch-free, socially distanced, digital experiences with the help of data, AI, and cloud.

Core systems, people, process, and technology intersect, interact, and intervene, to uphold the integrity of the insurance contract for risk transfer as well as to support customer advisory, claim satisfaction, and retention efforts. At each point in a transaction and across the insurance value chain they stay vigilant against fraud, waste, and abuse and look to recover any monies owed by any other party.

Savvy companies create a culture where everyone understands that digital ways of working require accurate data that is kept up to date to deliver full value. These companies also keep their analytic strategy fresh by assessing business opportunities, new/better data, new/better analytics, and new/better decision-making across a growing range of ever-smarter claim segmentations.

Celent research and experience in claims noticed markedly increased movement toward data science in recent years. These trends have accelerated due to the necessities imposed by COVID-19.

What insurers should do now:

    • Create and act on an analytics strategy in fast-changing times.
    • Link customer needs and business outcomes with hubs, dashboards, maps, models, analytics, decisions, and feedback.
    • Embrace remote data collection, data pre-fill, robotic services, sensors, and vendors to reduce costs and add resiliency to your business.
    • Create data policy, procedure, and governance to manage all sorts of new surveillance, health, safety, prevention, and compliance demands.
    • Establish a mechanism to identify and track COVID-19 claims.

Digital and touchless ways of working cannot fit every job, or every experience, but it has closed the gap on being remote and socially distanced by using connectivity and collaboration technologies quickly.

Tele-everything is now a thing, from video doctors to virtual grocery shopping to home delivery of anything. How this works in a secured office environment will need to be tested and refined.

Expect more customer self-service with images, video, live interactions, chatbots, and conversational AI.