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Claims Personalization contracts customer grievances

Sharad Mathur, MD & CEO, Universal Sompo General Insurance and Sanil Basutkar, Co-Founder & Head – Product & Marketing at Healthysure, deep dive into claims personalization:

Claims Personalization contracts customer grievances

Mehul Dani: What is the overall approach of the personalization of claims at your company?

Sharad Mathur: Understanding customers expectation is a key to providing customized claims services. A hassle free, pleasant customer experience at time of claims settlement helps win loyalty and trust. Personalized claims services make customers feel contented and is an opportunity to improve customer satisfaction and retention. At Universal Sompo, we have devised customer centric strategy. We analyse data to understand and meet specific needs of our customers.

Turn-around-time is a key factor since occurrence of the claim event. Prompt response to claims queries of customers and maintaining transparent communication throughout the settlement process enhances the customer experience. Our in-house dedicated customer services team is well experienced and empathetic. By actively listening and addressing to customers concerns, we strive to enhance overall customer satisfaction. The feedback from policyholders also helps us further enhance our claims settlement processes.

In addition to the claim settlement, we provide several value-added services that cater to unique needs of the customer. This could include offering additional support, such as access to best service providers, discounts on repairs or replacements, or complementary services to help policyholders recover from loss. Our inhouse-feet-on street surveyors provide a personalized claims experience, explaining key requirements and deliverables under the policy in case of motor claims. Our self-help portal for easy upload of claims documents, self-survey application for minor damages are few initiatives taken for speedy claims processing.

From sending personalized messages to our health customers on weight-management, wellness tips, regular updates on claims status and doorstep services to our customers, to offering over-night repair for our busy customers, who need their vehicle repaired by next morning, we make honest efforts to provide a delightful experience. Needless to add, our employees, engage in crop cutting experiments and educate farmers in various processes of maintaining and increasing yield. Our personalized messages to farmers in local language also helps us develop a strong bond with them and win trust.

Sanil Basutkar: We strongly believe that claims is a sensitive subject specially around life and health insurance. At such a time, sending emails or chatting through chatbots drives a very poor experience and also leads to frustration. We understand the need of the claimant to have a reassuring voice to ensure that there is full clarity on what the process is. We therefore focus our process with a human touch at the centre. This is then supplemented with all possible automations and analytics that helps our team provide a rich experience to the claimants.

What software have you developed/procured for this?

Sharad Mathur: Salesforce Platform provides us with a 360-degree view of customers and empowers us with valuable insights. We use advanced analytics techniques to identify patterns and predict future claims outcome and offer personalized settlement options based on individual circumstances. We also offer customized coverage options to customers to select specific benefits and limits that suit their needs at renewals, by tailoring policies to individual requirements. We also leverage real-time data through various sources which provides insights into customer behaviour, risk factors, and potential hazards, allowing us to personalize the claims settlement process appropriately.

Call centre data source is also tapped for identifying areas of improvement and regular refining of our personalization effort that the claims settlement process. Following this comprehensive approach, our constant endeavour is to enhance customer satisfaction, improve retention rates and build long term relationships by providing personalized claims settlement experiences.

Sanil Basutkar: Healthysure has developed internal tools that are also exposed to the wider ecosystem of intermediaries. Any partner can use our tools to get status on their customer claims. Our proprietary software integrates with insurance companies and TPAs to get real time information on the claim status. We use the best-in-class communication tools to keep the claimant updated on their claims. We supplement this with a 24×7 helpline that enables people in emergencies to reach out to us and get their issues resolved.

How have the people been structured for handling claims personalization?

Sharad Mathur: At Universal Sompo, we have tailored our claim settlement process basis the needs of individual policyholders. Our dedicated in-house assessors, who specialize in loss adjustments, personally engage with the insured individuals, addressing their queries and assisting them with the necessary documentation.

This personalized approach not only fosters trust and customer satisfaction but also ensures that all concerns are thoroughly addressed. Our team is trained to extend empathy and support during planned hospitalization. This helps in making our policyholders feel truly valued. Satisfied customers are more likely to remain loyal, renew policies and recommend us to others. Personalized claims settlement further strengthens the relationship with customers. In the event of a fire, our dedicated claims officers ensure a visit to the location themselves. They provide the much-required support and information to clients during these tough times and assist in claims processing requirements. Timely assistance goes a long way in building trust and loyalty.

Sanil Basutkar: We have a dedicated team of experts that look after the process and handle each case with care. They have an array of software tools with them to make their entire process smooth. This ensures that they only have to focus on solving the claim complexities and providing a personalized support.

What benefits of personalization have been observed, for the company and for the customers?

Sharad Mathur: Personalizing insurance claims settlement has benefitted both the customer and our company by improving satisfaction, retentions, efficiency, and providing tailored experiences that meet individual expectations. Universal Sompo has worked to enhance the customer proposition by taking a more personalized posture towards claims settlement. Some of the quantifiable benefits for the company include enhanced customer satisfaction as evidenced by the increasing positive feedback from customers.

The number of reported grievances has been reducing every quarter and today, Universal Sompo is amongst the best in the industry on grievances reported as a percentage of claims. The company has also seen a surge in customer retentions and a sharp positive trend in the number of retentions post claims settlement. This is testimony to the claims servicing experience provided by the team. The analysis done to ensure personalization of claims services assist in further optimization of efforts towards speedy claims settlement. Personalization also enables us to assess risks accurately and make informed decisions during the claims settlement process. It has also helped in mitigating fraudulent claims. Lastly, personalization of claims settlement helps us to differentiate ourselves in the market.

The personalization also benefits for customers as their needs are better addressed by customized services. Customers experience quicker claims processing, reduced paperwork, and seamless interactions with the company, leading to a positive experience during a stressful time. Personalization involves transparent communication between the company and the customer. Policyholders receive regular updates on the progress of their claims, understand the requirements, and have a better understanding of the settlement process. This improves the customer understanding about the claims process by making it transparent and reducing the anxiety about the entire process.

Sanil Basutkar: Claim support is the backbone of our company. The only true test of insurance is claims and that is what we have focused on to give exceptional customer support. We have been able to grow our customers mainly due to the positive recommendations we have had. We also solve the problem of scalability by having seamless tech enabled processes for our team.

Have you achieved the targets with regard to the personalization of claims for the last FY? What are the targets and plans of your company wrt personalization of claims for this year?

Sharad Mathur: We are working towards enhancing customer experience and the there are several matrices that are being tracked to ensure that we remain focused on our goal. Some of the key matrices that represent enhancement of claims settlement and personalization are the claims related customer grievances and turnaround time for claims settlement.

The higher the personalization of claims settlement, lower will be the turnaround time and lower will be the customer grievances.

For the last financial year, the company has met its target on both the counts. The company is amongst the best in class on account of number of claims related grievances (as a percentage of claims). For the current financial year, the company aims to continue to be amongst the top insurers with lowest claims related grievances (as a percentage of claims). Now we have also initiated a process re-engineering project to achieve a straight through process for claims settlement.

This will enable customers to embark on friction-less claims journey. To start with, this facility will be offered to a select set of customers and products. As the company gains meaningful experience, this facility will be offered to entire customer base and wide range of products.

Sanil Basutkar: We want to bring in further automations to our process while keeping the human touch involved. Even while bringing in automations such as chatbots and AI, we want to ensure that the claimants have a smooth experience with their claims. Personalization is a very important part for us that we don’t want to substitute with excess automation. For a sensitive subject like claims, there has to be fine balance between automation and personalization.

What data types do you find most useful in personalizing claims?

Sharad Mathur: Various data sources are tapped by us to understand the customer better. Policy data is core to the policy servicing process, with details of individual policy level information, the coverage limits, deductibles, and specific terms and conditions associated with each policy.

The following additional data is analysed for personalization of claims settlement:

Customer Profile Data: Customer profile data includes demographic information, such as age, gender, location, and occupation. This data helps to understand the characteristics and preferences of the policyholders, thereby enabling us to tailor the claims settlement process accordingly. For example, for sending health advisories to senior citizens, personal calling may be preferred, instead of SMS or voice-bot calling. Further, the social and professional background helps in providing services like doorstep servicing and overnight car repair.

Claims History: Historical claims data provides insights into a customer’s past claims activity. It includes information such as the types of claims filed and the frequency of claims. Leveraging the past claims history data helps to assess the specific requirements of the customer, under the given circumstances and this reduces the claims processing time. It also helps to identify patterns and streamline operations, in turn lead to faster and accurate claims processing, reduces administrative costs and improve efficiency.

External Data Sources: Data is gathered from various government sources on natural disaster, major accidents or any other major incident that may have impacted the policyholders. This data is leveraged to proactively look for impacted policyholders and extend claims services proactively. The recent train collision in Balasore is one such example, where the company proactively scrubbed the list of impacted individuals and proactively serviced our policyholders.

Universal Sompo team is also working on real-time data collection through various sources, such as Internet of Things (IoT) devices and telematics, that provide valuable information about the current circumstances of policyholders. Health data access through wearable devices is another data source. Such real-time data thereby enables us to hyper-personalize claims settlements, based on up-to-date information.

Our user-friendly digital platforms, indigenously developed mobile app an, personalized WhatsApp messages provide clear guidelines to policyholders with self-service options to track the progress of their claims and avail value-added services like list of customers preferred garages and hospitals etc. Transparent communication builds trust and policyholders feel informed and involved.

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