New external data sources can augment a carrier’s existing data and modeling to digitize claim processes. These sources improve efficiency, reduce cycle time, and support loss cost management strategies. But how to incorporate them into the claims process? Let’s think big about the possibilities new data can bring.
This blog is based on “Incorporating New Data Into the Claims Process,” a webinar presented by Carpe Data’s Director of Business Development & Strategy, George Naftzinger, as well as VP of Claims for The Hanover Group, Doug Kratzer for CLM’s webinar series on June 9th, 2020. CLM members can view the recording of the full presentation free here.
What do you know about the parties involved in a claim?
When it comes to their insureds, all carriers have the information gathered at the time of policy sale. But when was this information last captured? Is it regularly updated if they never have a claim? Even less is known about 3rd party claimants, who often scribble down basic information like name, phone number, or email address at the scene of the accident.
This gap in information can delay or impede the handling process and forces the claims adjuster to choose between offering fast service or spending precious time searching for information on the web. 3rd party data providers can supplement basic claimant information and provide the adjuster with further context into the claimant’s situation before they ever pick up the phone.
Every claim typically involves other non-party participants in the loss handling as well. There are repair facilities, contractors, medical providers, attorneys, to name a few. Knowing more about the other participants can also help carriers pay the claim more quickly, identify further opportunities for streamlined claims handling, or flag for review.
What don’t you know about the parties involved in a claim?
Has anything changed with your insured? Is the 3rd party who they say they are? What about non-related insureds? Are the vendors and providers trustworthy and reputable? All of these details are often left to the claim professional to answer. Why put your adjusters at odds with your customer’s experience when they could be leveraging this information to support the claim beforehand?
Fill in the gaps from open to close
Integrating new data elements is a necessary step in the evolution of the claims handling process and provides value across the entire claims lifecycle. Consider these examples:
A new claim is filed and the adjuster can see that this claimant’s preferred language is Spanish. Instead of routing through a 3rd-party interpreter, this claim is sent to a Spanish-speaking adjuster to optimize the quality and speed of the conversation. One small piece of added context has made for a smooth customer experience.
Imagine again that a new injury claim is filed, but little is known about the injured party except for name, email address, and phone number. But you have a robust 3rd-party data strategy and these three data points provide much more context than it would seem on the surface: you verify their identity quickly by matching their name and email address against online sources; a GoFundMe page set up for the claimant helps you confirm loss facts; you also know that the claimant has kept the same phone number for ten years, the email address for seven, and both are connected to the same LinkedIn account which is frequently updated. All of these factors combine to indicate a low risk for fraud and may qualify the claimant for straight-through processing, but you continue to monitor the injury over 6 months in case any new data is presented. The best part? The adjuster handling the claim did not have to spend any time finding this information on their own.
Whether you’re looking to automate and streamline, enhance the customer experience or gain real-time insights into your open claims, emerging data sources can provide these opportunities no matter the size of your claims organization.
Questions (and answers!) from the webinar:
How can the data process help “explain the claim process?”
Though the data itself does not assist with explaining the claim process, providing relevant data to the claim professional reduces, or in some cases, eliminates the time and effort they need to take to obtain data, relative to the parties involved. This allows the claim professional more time to interact with the involved party, explain the claim process and find the best, most efficient solution based on the involved party’s specific needs to properly resolve their claim.
Bringing in 3rd party data will no doubt help with straight through processing, but that requires a robust 3rd party data strategy. What areas of claims processing should be looked at first?
Initially the focus could be on relatively simple 1st and 3rd Party non-injury, physical damage losses and simple 1st Party medical expense claims. These are the most common, least risky, and lowest hanging fruit for automated decisioning. As the process matures, there is potential to expand the use cases to other claim types and situations.
Within Emerging data, it is now possible to automate FNOL (date, time, VIN etc). What is the true value of real-time FNOL for auto collisions to the carrier?
The real-time value is speed and efficiency. By providing previously unknown (or hard to gather) data up front the claim process can be executed with speed and precision, claims professionals can focus more on the needs of the involved party as opposed to the information gathering process.
Are there any concerns about privacy or access to private data that may hinder leveraging 3rd party data?
Anytime you’re leveraging 3rd party data, compliance and privacy need to be consideration number one. While we collect, clean, and normalize data from more than 20 million digital sources, we only work with data that is publicly available and we always make sure we’re abiding by the terms of service for each source.
Visit theclm.org/Webinars and click on the “Archived” tab to view the recording of this session.