5 Ways to Improve Claims Processing

April 22, 2021
Agustin Morcillo

Most insurance companies are under constant pressure to meet policy holder’s demands and live up to their expectations. At the critical time when a policyholder requires a quick response, you must be in a position to deliver a positive experience by capitalizing on the vital interaction with customers. According to Deloitte, the cost of claims pay-outs and expenses is the largest spending category for a P&C insurer, often accounting for up to 80 percent of premium revenues.

You need to refocus your efforts and adapt to the fast-paced technological changes. In an increasingly technology-centric world where customers embrace digital technologies, you must enhance your service delivery capabilities and improve claims processing in the following ways:

1. Digital Documentation

Managing hefty volumes of daily paper claims are a significant challenge that you don’t need to face in this digital age. According to Gartner, Insurers leading in digitization will outpace slower digital adopters by 100%. Digitalizing information-intensive processes will reduce operational costs and improve turnaround times. This will enable the opportunity to achieve regulatory compliance and gain greater access to structured data and critical business documents.

digitizing documents with a computer
Source: Adobe Stock

2. Speed and Transparency

Prompt communication is a vital element of customer interactions in claims processing, and if you regularly send claim status reports to customers, they feel more secure. Transparency means an open environment that is proactive, highly accurate, and communicated to its customers. You need to give a clear picture and real-time information on what they need to do next.

person using a mobile phone
Source: Adobe Stock

3. Process Automation

According to HIPAA regulations, electronic claim transmissions take 30% less time to process than paper claims. Optimizing the insurance processes and automating straight-through data processing helps extract, scan, and validate the data and minimize errors on a claim, form, or document in one step. By incorporating process automation and leveraging technologies, such as RPA and AI, you can save time and costs in your workflow.

process automation concept
Source: Adobe Stock

4. Insurance Analytics

Analytics in insurance provides the right capabilities to handle complex claims, avoid common errors, and effectively manage risks, remove performance variability, and reduce operating costs. Collecting, analyzing, and extracting relevant insights from various data sources help deploy the right people at the right place and apply the best possible claims management in insurance, such as life and property or casualty.

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5. Insurance Claims Investigations

You need to investigate the legitimacy of a claim and follow up with the account for improperly processed claims. According to Gartner, annual losses due to insurance claims fraud can go around $40 billion per annum. You can identify inflated claims and avoid paying potentially high costs to a fraudster. Thoroughly collect and review documents, conduct surveillance, survey the suspect, analyze social media accounts, and more.

businessmen analyzing an insurance claim
Source: Adobe Stock

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