Viewpoint: Digital, human touch vital

We live in an increasingly digitized world where there’s an app for everything and we turn to Google — or increasingly ChatGPT — for all the answers, which means we have information at our fingertips. The insurance industry has started to embrace the change, deploying artificial intelligence and machine learning technologies, data analytics, IoT, mobile and web-based apps and other tools to transform how it does business and interacts with policyholders. Such innovations are streamlining operations, automating quote and bind processes, and allowing insurers and brokers to receive and process information more efficiently.

Digital advances and data insights are also helping improve buyers’ experience by connecting insurers quickly with digital-savvy customers who want an insurance transaction to mirror the ease of online shopping. In personal lines, insurers have had some success in replacing a traditionally laborious manual claims process with video and internet chat services, for example. Behavioral and data analytics enable them to further personalize certain coverages like auto and health insurance, charging premiums based on policyholders’ driving or exercise habits though the quid pro quo relies on them being willing to share their data in return for an incentive from insurers.

In the commercial lines sector, too, many insurers and brokers have launched online portals and other tech tools enabling businesses and risk managers to buy coverage more efficiently and submit sometimes complex data about their portfolios in a less duplicative, error-prone and labor-intensive form. In difficult insurance markets, there’s no question that these technologies can assist policyholders in better defining their exposures and differentiating their business, perhaps attracting the attention and capacity of underwriters ahead of others. But in claims, where technology is interjecting at the most delicate point in the contract between insurers and policyholders, there is more on the line.

Who hasn’t had an online interaction where a customer service issue was responded to quickly but resolving the issue required multiple phone calls and lengthy delays before a helpful human could be reached? And in the health insurance industry, the use of software technology is currently the target of litigation alleging that thousands of patient claims were automatically and erroneously denied. As we report here, mobile apps, telemedicine and AI are entering the workers compensation claims management process. According to a recent survey of claims executives by Rising Medical Solutions, some 78% of high-performing claims management organizations used one or more technology-based strategies in 2022, versus 42% in 2019. 

Such innovative approaches are projected to become more frequently deployed with the idea that they will free up claims professionals so they can spend more time communicating directly with injured workers and providing a personalized level of care.

While data and predictive modeling in claims have an important role to play in projecting risks and better understanding outcomes, there’s clearly more to a positive claims experience than simply introducing an app or self-service tool. 

The Rising Medical survey also highlighted the importance of “soft skills” such as empathy and listening for claims to be managed successfully. A balance between human and digital interactions will be critical if insurers and claims professionals are to retain the trust of policyholders and injured workers going forward.