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Improving CX with analytics –
Case automated claims
processing in car insurance
Ilkka Huotelin
31.1.2017 CXPA Switzerland Event, Zürich
Agenda
1. Background
& Challenge
2. Requirements
3. Solution
4. Outcome &
Next Steps
Background & Challenge
Goal
Company
Challenge
• A European multi-national insurance company
• Over 3 million customers
1.Traffic insurance products are very similar with little differentiation
2.Needed to stand out from the competition
3.Customers dissatisfied with unpredictable processing times
4.Constant cost pressure
1.Have the highest customer satisfaction in the market
2.Decided to be the easiest insurance company to deal with
3.Promise: process at least 70% of claims within 24 hours and pay
immediately after
Requirements
1. Easy to use for the customers
2. Keep the customers informed
3. Process clear cases immediately
4. Concentrate human resource on the unclear or suspicious cases
5. Identify claims that are:
a) Not covered by customer’s policy
b) Incomplete
c) Unclear
d) Disputed
e) Untypical
f) Fraud
Solution
• New digital customer journey for
the car insurance claims
• On-line input by customers
• Automated processing (except
specific cases)
1. Rules based
2. Machine learning
• Automated payment or permission
to invoice (for garages, rental
companies …)
Process
Input
• The customer fills in an on-line claims form
• Sanity checks on inputs
Filtering
• Rules-based decision engine
• Check against the policy and deductibles
Analytics
• Supervised machine learning (Black Box)
• Outlier detection and segmentation
Payment
Automatic payment
Clear cases
Manual processing
Flagged case Feedback
loop*
Model
• The model is trained by previous cases flagged by claims processors
• Clear (can be paid automatically) “1”
• Flagged (needs to be checked manually) “0”
• Output is a propensity number between 0 and 1
• Setting the threshold is an optimisation problem between:
• False positives – someone is paid unnecessarily
• False negatives – additional resources are needed and lower customer
satisfaction
• To monitor model accuracy some clear cases are randomly selected
for manual checking
• The results of manual checking are fed back to the model
Outcome & Next Steps
• 90% (previously 73%) of customers either satisfied or very satisfied
with the automated claim process
• The insurance company wants to extend the new customer journey
to cover more insurance products
Improvement areas and the next steps:
Improve the touchpoints and the interactions
1. Improve the design of the on-line claim form
2. Import the customer data to the form automatically from the CRM
3. Add more automatic communications channels for updating the
customers on the status of their claims
Contact Information
Zürich Office:
Hungerbergstrasse 27
8046 Zürich
Switzerland
T: +41 78 884 6612
E: info@becustomersmart.com
W: www.becustomersmart.com
Geneva Office:
Plateau de Champel 20
1206 Geneva
Switzerland
T: +41 79 741 9577
E: info@becustomersmart.com
W: www.becustomersmart.com
Do you need more information?
We are glad to continue the conversation.

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5. Improving CX with analytics - case automated claims processing in car insurance

  • 1. Improving CX with analytics – Case automated claims processing in car insurance Ilkka Huotelin 31.1.2017 CXPA Switzerland Event, Zürich
  • 2. Agenda 1. Background & Challenge 2. Requirements 3. Solution 4. Outcome & Next Steps
  • 3. Background & Challenge Goal Company Challenge • A European multi-national insurance company • Over 3 million customers 1.Traffic insurance products are very similar with little differentiation 2.Needed to stand out from the competition 3.Customers dissatisfied with unpredictable processing times 4.Constant cost pressure 1.Have the highest customer satisfaction in the market 2.Decided to be the easiest insurance company to deal with 3.Promise: process at least 70% of claims within 24 hours and pay immediately after
  • 4. Requirements 1. Easy to use for the customers 2. Keep the customers informed 3. Process clear cases immediately 4. Concentrate human resource on the unclear or suspicious cases 5. Identify claims that are: a) Not covered by customer’s policy b) Incomplete c) Unclear d) Disputed e) Untypical f) Fraud
  • 5. Solution • New digital customer journey for the car insurance claims • On-line input by customers • Automated processing (except specific cases) 1. Rules based 2. Machine learning • Automated payment or permission to invoice (for garages, rental companies …)
  • 6. Process Input • The customer fills in an on-line claims form • Sanity checks on inputs Filtering • Rules-based decision engine • Check against the policy and deductibles Analytics • Supervised machine learning (Black Box) • Outlier detection and segmentation Payment Automatic payment Clear cases Manual processing Flagged case Feedback loop*
  • 7. Model • The model is trained by previous cases flagged by claims processors • Clear (can be paid automatically) “1” • Flagged (needs to be checked manually) “0” • Output is a propensity number between 0 and 1 • Setting the threshold is an optimisation problem between: • False positives – someone is paid unnecessarily • False negatives – additional resources are needed and lower customer satisfaction • To monitor model accuracy some clear cases are randomly selected for manual checking • The results of manual checking are fed back to the model
  • 8. Outcome & Next Steps • 90% (previously 73%) of customers either satisfied or very satisfied with the automated claim process • The insurance company wants to extend the new customer journey to cover more insurance products Improvement areas and the next steps: Improve the touchpoints and the interactions 1. Improve the design of the on-line claim form 2. Import the customer data to the form automatically from the CRM 3. Add more automatic communications channels for updating the customers on the status of their claims
  • 9. Contact Information Zürich Office: Hungerbergstrasse 27 8046 Zürich Switzerland T: +41 78 884 6612 E: info@becustomersmart.com W: www.becustomersmart.com Geneva Office: Plateau de Champel 20 1206 Geneva Switzerland T: +41 79 741 9577 E: info@becustomersmart.com W: www.becustomersmart.com Do you need more information? We are glad to continue the conversation.