This is the eighth of eight every-other-week blog posts excerpts from my book: “Stone Tablets to Satellites: The Continual Intimate but Awkward Relationship Between the Insurance Industry and Technology”. The publication date for this eighth post is June 15, 2022. The seventh blog post excerpted from my book was posted June 1, 2022. This is the last blog post of excerpted content. Wells Media will publish the book on June 28, 2022 as a hard cover, paperback, ebook (Kindle), and audio book.
The excerpt of this 8th post is from the Insurance Commerce Section of the book. This section includes seven chapters which encompass a discussion of risk landscape perspectives; of customer perspectives; of carrier perspectives; of product development perspectives; of channel management perspectives; of producer productivity perspectives; and of claim management perspectives.
Let’s get to the excerpt …
Claimants and customers should share the ‘center’ of insurance carriers’ attention
It is de rigueur for insurance industry professionals to be told that their strategy, tactics, and business operations should become customer-centric. Whether discussed in terms of customer focus, customer relationship management (CRM), or customer experience (CX), insurance professionals are continually advised to think first-and-foremost of the customer and either become customer-centric or strengthen their current customer-centricity.
This advice is good as far as it goes but it is incomplete for the insurance industry. Yes, the customer belongs in the ‘center’ of everything that the insurance industry does. But equally, the claimant also belongs in the ‘center’ of everything the insurance industry does.
Why?
The insurance industry essentially exists to create and service the objectives of potential claimants. Going back to basics, the insurance industry societal value-add is managing or otherwise mitigating risk. The industry offers society this value-add by selling insurance policies. However, when an insurance carrier sells a policy, it is simultaneously purchasing a potential loss and must be able to satisfy the needs of claimants (per the terms, conditions, and restrictions of the policy). That is why both customers and claimants should share the center of insurance industry strategies, tactics, and business operations.
Throughout the book, I’ve discussed the ‘intimacy / awkwardness’ dynamic that permeates the insurance commerce applications of technologies supporting customers, carriers, product development, channels, and producers. One of my persistent lessons is that there is very little intimacy and too much awkwardness for customers, external insurance market participants, and internal insurance carrier business professionals regarding the use of the portfolio of technologies and applications of the technologies available to quickly and easily conduct insurance commerce. Whatever intimacy exists in the commerce of insurance is experienced by the information and telecommunications technology professionals.
That same intimacy / awkwardness dynamic permeates claim management. Claim management cries out to be supported by the technologies and concomitant applications of the Fifth Technology Era to help increase the intimacy and decrease the awkwardness for all participants involved in the claims processes.
Specifically, successful claim management demands an immersive environment of capabilities and information deployed as a web-accessible, cloud-enabled mobile app for the myriad of participants bound together to fulfill the claimant’s objectives of receiving payment, having property restored, and/or receiving the necessary physical – or medical – rehabilitation triggered by the loss event.
Re-perceiving the genesis of claim management for insurance carriers
What is the beginning of claim management for insurance carriers?
The genesis, or beginning, of a claim management process tends not to be discussed among insurance professionals. Almost all industry professionals believe that the claim management process begins with the claimant’s First Notice of Loss (FNL, which I prefer, or FNoL depending on the reader’s age and entry into the insurance industry). Regardless of the abbreviation, this is a myopic industry belief that hampers how insurance carriers approach and manage claims.
It would be better if insurance carriers viewed the claim management process based on lessons from phase transitions. Specifically, “Phase transition is when a substance changes from a solid, liquid, or gas state to a different state. Every element and substance can transition from one phase to another at a specific combination of temperature and pressure.”
Interpreting this for insurance carriers, there are four insurance states of an insurance consumer and three phase transitions that are specific to claim management. The four states of an insurance consumer are: prospect, customer, claimant, and ex-customer. The three phase transitions are:
- An insurance prospect becomes an insurance customer and has no claims for the duration of the policy
- An insurance prospect becomes an insurance customer, at some future time files a claim becoming a claimant, and after the final resolution of the claim to the satisfaction of both the claimant and the carrier remains a customer
- An insurance prospect becomes an insurance customer, at some future time files a claim becoming a claimant, and after the final resolution of the claim the customer becomes an ex-customer because neither the claimant or the carrier were satisfied regarding the claim or the resolution of the claim.
As important as the insurance states of an insurance consumer and the phase transitions are to be considered, the forces that trigger the transitions transforming prospects into customers, customers into claimants, and claimants either into recurring or ex-customers are equally important.
The forces, in turn, are shaped by how an insurance carrier monitors and manages the changing risk landscape, including the:
- dynamic risk appetite of a carrier
- legal instantiation of the risk appetite as expressed by underwriting practices and concomitant pricing of policies for each insurance line of business
- nature, number, geographic spread, and insurance expertise of the producers within the carrier’s sales and distribution channels
- nature, number, geographic spread, claims management expertise of the carrier’s internal and third-party claim adjusters and fraud investigators.
Now I can answer the question of ‘where is the beginning of claim management?’ from the carrier’s viewpoint:
The beginning of claim management is the insurance carrier’s strategy to manage the changing risk landscape.
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The is the last blog post of excerpts from the book. Wells Media will publish the book on June 28, 2022.
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