Managing Insurance Claims is A Business Opportunity


Historically, insurance companies across the globe viewed claims solely as an obligation, and not as a means of generating loyalty, boosting the customer experience, or increasing retention rates. As a result, the industry in its totality has a difficult time nurturing customer relationships and coming up with new business models. Insurers who want to thrive in today’s competitive market must offer a first-rate claims experience.

The Importance of Managing Claims Properly

One of the major mistakes that many insurers make is using antiquated software solutions to manage claims processes, making it difficult to focus on customer experience.

Insurance carriers should aim to find efficient ways of cutting down on costs and fraud while offering a human touch during the claims process.

Understanding Claims Management

What does a successful insurance claims management process look like in the insurance industry? 

Once the carrier receives the notice of claim, they open the claimant’s file to determine the scope of the coverage. Then, the insurer requests relevant documents that support the claim, such as police reports or images of the damage to the property. 

Finally, the claimant is reimbursed and the repairs are carried out when the claim has been approved.

What Do Claimants Need From Insurers?

Naturally, policyholders expect a fast reaction from their carrier once they notify them of the loss. Therefore, insurance companies must instantly acknowledge the claim and request the contact details and supporting documentation.

For more complicated claims, carriers need to be sure that their experts get in touch with the claimants to discuss how to proceed. 

Accelerate the Process

The steps after a claim has been made determine whether it is valid and the amount the provider is required to cover. 

Claimants require that their carriers settle claims quickly and without much hassle. In fact, the latest reports show that a large percentage of policyholders would switch to another insurer if the claims process isn’t seamless. 

This is why an effective claims management process is one of the principal drivers of growth for insurance companies. 

The Human Touch Remains An Important Component

In spite of significant advances in machine learning, human adjusters will continue to play a critical role in the claims management process. Insurers that are able to convey real human empathy will enjoy a significant advantage over those who only go through the motions. 

Typically, complex claims cases demand nuanced judgment from an insurance professional.

A rules engine helps insurance providers to approve simple claims with conventional characteristics and results. This allows the claims department to focus its attention on more nuanced claims. 

Rules Engines Run Efficient Claims Management Software Programs

Insurance providers can smoothly manage the entire claims lifespan with a rules engine — from first notice to full reimbursement. 

A rules engine is a powerful software solution engineered to enhance insurers’ decision-making processes. A rules engine runs expressive “if-then” conditional statements in order to streamline the claims management tasks. 

Regardless of whether the claim is a fender bender or a complicated compensation liability claim, a business rules engine contains all of the features necessary to improve the performance and accuracy of an insurance claims operations procedures, cut down on costs, and boost customer experience.


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