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The Intersection of People,
Customers, and Technology
in the Claims Process
Daniel Hughes, Enterprise Solutions Manager, K...
30% …of insurance customers worldwide rated
their experience as positive
…is spent on fraudulent claims annually$30 billio...
Are These Your Challenges?
Business 
Growth
Workforce 
Talent
Problem
Reduce 
Fraud
Engaging 
with 
Customer 
Base
Streaml...
New and Developing Media for Customer Engagement
Social Transparency – Words Travel Fast
The problem was resolved quickly 69%
I had to explain my problem to multiple 
peop...
Customer Interactions – the Challenge
Source: Converseon, 2012
• Social media input arrives 24/7 
• Most organizations are...
Handle All Input Dimensions
Format
Source
Structure
Fax Server
Scanner
File System
Mail Server
Image Paper PDF Email
Unstr...
Self Learning Expert Forum
Content Repository
Across System Boundaries
Any Content      Documents
Free Text Search
Intrane...
Semantic Understanding Extracts Real Meaning
Graphically
Linguistically
Rule Based
Contains “Claim”
Streamlined Operations
• About 75 % optimization 
potential for extraction
• Current methods of data 
recognition and 
pro...
Advanced Document Classification
Techniques
• Symbolic (barcode)
• Document analytics 
• Graphic‐based
• Text‐based
• Stat...
Fraud Detection and Prevention
Advanced data 
mining Mobile Devices
Segment Risk
Predictive Modeling
Pattern 
Spotting Sel...
Artificial Intelligence Opens New Opportunities
UNDERSTAND PROCESS KNOW
?
i
!
The Intersection of People, Customers, and
Technology in the Claims Process
Presents significant opportunities for insuran...
Do you want to discuss further? 
See you at booth 110 in the exhibition hall
Contact me at daniel.hughes@kodakalaris.com
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Transcript of "Thurs june26 8 00am-theintersectionofpeople"

  1. 1. The Intersection of People, Customers, and Technology in the Claims Process Daniel Hughes, Enterprise Solutions Manager, Kodak Alaris
  2. 2. 30% …of insurance customers worldwide rated their experience as positive …is spent on fraudulent claims annually$30 billion 1 in 3 …cited poor claims handling as a major factor in their decisions to switch insurer
  3. 3. Are These Your Challenges? Business  Growth Workforce  Talent Problem Reduce  Fraud Engaging  with  Customer  Base Streamlined Operations
  4. 4. New and Developing Media for Customer Engagement
  5. 5. Social Transparency – Words Travel Fast The problem was resolved quickly 69% I had to explain my problem to multiple  people 72% The person who helped me was nice 65% The person I dealt with was unpleasant 67% The problem was resolved in one  interaction ‐ no passing around to  multiple people 63% My problem took too long to resolve 65% The outcome was what I was originally  hoping for when I contacted customer  service 47% The problem was not resolved 51% Good Customer Service Interactions (n=1,004) Bad Customer Service Interactions (n=565) *Any company that was not large, well‐known or a small local or online company Source: Dimensional Research, “Customer Service and Business Results: A Survey of Customer  Service from Mid‐Size Companies” sponsored by Zendesk, April 15, 2013.
  6. 6. Customer Interactions – the Challenge Source: Converseon, 2012 • Social media input arrives 24/7  • Most organizations are at the beginning of the maturity curve
  7. 7. Handle All Input Dimensions Format Source Structure Fax Server Scanner File System Mail Server Image Paper PDF Email Unstructured Semi‐structured Structured
  8. 8. Self Learning Expert Forum Content Repository Across System Boundaries Any Content      Documents Free Text Search Intranet   Any Source No Administration Versioning Dynamic Q&A Scripting Workforce Talent Management Data ww w
  9. 9. Semantic Understanding Extracts Real Meaning Graphically Linguistically Rule Based Contains “Claim”
  10. 10. Streamlined Operations • About 75 % optimization  potential for extraction • Current methods of data  recognition and  processing are inadequate • About 80 %  optimization potential  for classification • Existing automation  approaches only apply  to structured  documents Optimization Potential Scan, Fax,  Emails,   eDocs, SMS,  Social Media Recognize Classify Extract Validate Export  Process  Route Correct / Incorrect?
  11. 11. Advanced Document Classification Techniques • Symbolic (barcode) • Document analytics  • Graphic‐based • Text‐based • Statistical  methods • Semantic  understanding LOWLOW HIGHHIGH Property Claim Property Underwriting Customer  correspondence Car claim
  12. 12. Fraud Detection and Prevention Advanced data  mining Mobile Devices Segment Risk Predictive Modeling Pattern  Spotting Self Learning  Hard Fraud Cross Provider Security Mechanism
  13. 13. Artificial Intelligence Opens New Opportunities UNDERSTAND PROCESS KNOW ? i !
  14. 14. The Intersection of People, Customers, and Technology in the Claims Process Presents significant opportunities for insurance carriers to secure their future  Engaging and communicating with customer base: Support policy holder  communication preferences and fully integrate all communication channels  including social media  Workforce talent management: Leverages the expertise of most  experienced agents and offer a comprehensive, self learning knowledge  base to new staff  Streamline d Operations:  Reduce manual steps and silos into end‐to‐end  claims process automation   Fraud prevention: Focused data mining and analytics  Business growth: Reduce cost and create additional revenue
  15. 15. Do you want to discuss further?  See you at booth 110 in the exhibition hall Contact me at daniel.hughes@kodakalaris.com
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