Insurers Are Realigning Their Claims Intake Process to Meet New Demands

A new survey shows how expectations are changing around claims intake. It’s time for carriers and TPAs to find solutions that can change with the industry.

It’s a time for new thinking in the insurance industry. Whether it’s insurtech companies competing for capital or carriers seeking brand loyalty among millennials, there’s a race to innovate and get a foothold in the future of the insurance industry.

What that future looks like, however, is still coming into focus. A new survey from NetClaim shows digital change coming to the claims intake process. Gone are the days when contact centers can succeed on efficiency and cost effectiveness alone. Insurers and TPAs are now looking for solutions that improve quality control and fraud protection.

The survey found 87 percent of carriers and TPAs either agreed (41 percent) or strongly agreed (46 percent) that there is a need for innovation in the claims intake and distribution process. More surprising was the factors driving that need.

While improved efficiency and reduced expenses were still seen as the leading driver of innovation among carriers (68 percent), the demand for better quality control and fraud protection measures was just behind (64 percent), suggesting a need for new solutions.

Carriers and TPAs are expanding their search for these solutions beyond their own walls. About half of respondents said their companies have already outsourced their claims intake process or are actively looking for vendors to take over.

And 83 percent said claims intake and dissemination vendors are valuable partners and an integral part of the process. Yet only 17 percent of those surveyed said they are very confident in their current vendor’s level of preparedness to respond to their changing needs (58 percent were somewhat confident and 25 percent were neither confident nor concerned).

So what should carriers and TPAs be looking for in claims intake solutions? And what should vendors be offering to meet these new demands?

Agility and configurability are crucial, both because of the rapidly changing state of the business and the inherent uncertainty across the insurance spectrum – whether its climate change and property insurance or evolving digital shopping habits and franchise insurance.

Rather than trying to predict the future, carriers and TPAs need to find solutions and partners that allow them to make rapid changes to operations when strategies or products change. Insurers need contact centers and vendors capable of setting up new intake solutions in days – and making sure that as soon as calls start coming in, they are getting full and accurate information.

Carriers and TPAs also need solutions that can scale up at a moment’s notice. Wildfires on the west coast and hurricanes in the southeast are a reminder of just how important it is for insurance companies to have technology that can support rapid expansion of their services. Insurers need digital solutions that can stretch with demand and allow intake professionals to focus on areas that need a human touch.

But where to start, an entire business infrastructure can’t be shifted to digital overnight. The insurance industry is facing the same question as many other consumer fields – how to move into digital in logical steps? How to do this is especially difficult given that old ways of doing business are still highly profitable.

To make progress, forward-looking insurers are finding parts of the business that can lead the digital transformation – relatively small auto claims such as broken windshields or straightforward healthcare claims like maternity. And they are targeting tech-savvy customers who are anxious to have their insurance experience take place entirely online.

These steps can help insurance companies overcome the burden of legacy systems and achieve the digital agility required to remain competitive in the years to come.

On the distribution front, carriers and TPAs need to upgrade data systems to be ready to move quickly onto digital platforms that will host the insurance marketplace. They need to have be comfortable with using digital technologies throughout the claims process and to be flexible enough to move among insurtech partners who can extend their digital capacity.

And they need to realize that claims intake is no exception. Insurers now realize that searching for the cheapest intake solution is no longer good enough. They need solutions that can change as fast as the industry and scale up to meet the challenges ahead, whatever they might be.

Revel Force is Vice President, NetClaim, which offers customizable insurance claims reporting and distribution management solutions. As the largest provider of outsourced first notice of loss (FNOL) in North America, the company delivers advanced intake systems that implement client-specific rules while developing customer interaction. Integrity checks provide automated, real-time quality assurance, and a dissemination and escalation engine supports complex logic and routing in multiple formats.