Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.
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
Streamlined
O...
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
peopl...
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
Intranet Any...
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
proces...
Advanced Document Classification
Techniques
• Symbolic (barcode)
• Document analytics
• Graphic-based
• Text-based
• Stati...
Fraud Detection and Prevention
Advanced data
mining Mobile Devices
Segment Risk
Predictive Modeling
Pattern
Spotting Self ...
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
Upcoming SlideShare
Loading in …5
×

The Intersection of People, Customers, & Technology in the Claims Process

2,629 views

Published on

The intersection of policy holders, insurance staff and technology offers significant opportunities in the challenging claims processing business:

Engaging and communicating with your customer base: Allow your policy holders to communicate with you following their preferences and fully integrate all communication channels including social media; in order to make this input valuable you want to find a solution that understand the true meaning of any type of text based input, regardless of structure, source, and format

Workflow talent management: Balance workforce expertise levels between aging experts and less experienced staff by allowing them to focus on cases or requests that align with their expertise while providing less experienced staff with a comprehensive, yet dynamic knowledge base

More efficient processes: Improve and where feasible automate your claims process connecting your mailroom, back office operations, and your service center

Fraud prevention: Focused data mining to detect and prevent fraud

Business growth: The automated and shortened handling significantly reduces the cost involved in the claims processing. At the same time customers are more satisfied and consequently more loyal. Agents are more motivated and have more time to focus on up selling, thus creating addition revenue.

Published in: Business, Technology
  • Be the first to comment

The Intersection of People, Customers, & Technology in the Claims Process

  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% Source: Dimensional Research, "Customer Service and Business Results: A Survey of Customer Service from Mid-Size Companies" sponsored by Zendesk, April 15, 2013 * Any company that was not large, well- known or a small local or online company. Factors that Contribute to Good and Bad Customer Service Interactions with Medium-Sized Companies* According to US Internet Users, 2013 % of respondents 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 LOW HIGH 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

×