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Difference between Health Insurance and Mediclaim

Until Health insurance came into existence in India, Indians were only aware of Mediclaim policies. However, I still know people, who use both these words interchangeably. I recently walked into a bank where they sold health insurance policies and the bank representative addressed it as mediclaim. I kept wondering, as the pamphlet stated Health insurance policy and not mediclaim policy.

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McGriff, Seibels & Williams

McGriff, Seibels & Williams, Inc. operates as a separate, wholly-owned subsidiary of BB&T Insurance Holdings, Inc. McGriff/BB&TIH is the 5th largest brokerage firm in the U.S. & the 5th largest worldwide, with over $1.9 Billion in combined revenues.

Are motor claims in Europe about to rebound?

Article | July 14, 2022

The COVID-19 pandemic has caused unprecedented disruption to the insurance industry overall, dramatically curtailing business activity, upending the everyday lives of employees and customers, and more. However, companies that derive a substantial portion of their business from motor insurance have enjoyed stronger bottom-line results during the pandemic than in previous years. That’s because when sudden lockdowns kept drivers at home and off the road (see exhibit), claims plunged by 60 to 80 percent almost immediately. As restrictions began to lift, claim volumes subsequently bounced back, although they remain 20 to 30 percent lower than they were before the pandemic. The corresponding drop in payouts for claims was only partially offset by the refunds on premiums that insurers paid to customers to compensate them for traveling fewer miles. Are motor claims in Europe about to rebound? As of mid-2021, motor claims volume remains suppressed—at least for the time being. For insurers, this offers a short-term window to pursue or accelerate strategic initiatives aimed at establishing claims excellence, a key driver of profitability. These initiatives include transforming claims processes to improve customer experience, building digital capabilities, leveraging advanced analytics to improve decision-making, and reducing long-standing sources of leakage. Acting now will help insurers be prepared when vaccination rates across Europe accelerate, economies reopen, and both mobility and motor claims rebound. Even as the pandemic recedes and business returns, insurers are likely to confront three persistent challenges that can be addressed—at least in part—by transforming claims management to improve profitability. Top-line pressure will continue. Pandemic-related top-line pressure will likely continue for the foreseeable future. If history serves as a guide, commercial lines, which suffered from a temporary halt in business activity in the tourism, aviation, entertainment, and local business sectors, may be slow to recover. During the 2008 financial crisis, for instance, commercial lines took significantly longer to recover than personal lines. As for personal lines today, declines in everyday commuting have altered customers’ perceptions of the value of insurance: if they drive less, they expect to pay less. As noted above, some insurers have proactively offered their customers premium paybacks for reduced car usage—a change that could endure. Digital is here to stay. Because of the pandemic, people shifted many everyday activities to remote channels and adopted new digital tools. For example, across Europe, 60 to 70 percent of consumers moved some of their shopping online, and most intend to perpetuate the new habit after the pandemic ends. This shift in customer behavior extended to engagement with insurers. In the United Kingdom, claims notifications filed via digital channels doubled during the pandemic, and insurers received 30 percent more digital inquiries than in the past. However, customers’ growing expectations for an end-to-end digital experience—with 24/7 service, instant feedback, and a user-friendly interface—still place most insurers in the position of playing catch-up. The large majority of customers still prefer to place a call rather than use digital self-service; in Europe, for example, more than 50 percent of claims are initiated when a customer contacts an agent. This preference could indicate that insurers have yet to fully digitize the claims handling process. Inflation will affect claims costs. Insurers anticipate increased pressure on claims costs from multiple sources. First, car repair shops have suffered the knock-on effects of the COVID-19-induced drop in claims volume. Many received government help, but they also responded by increasing labor rates and margins on spare parts. The claims inflation rate currently sits at 4 to 5 percent. Ongoing cost pressure means repair shops are unlikely to reinstate their pre-COVID-19 price levels without some restructuring in the sector. In one scenario, insurers could step into the role of ecosystem orchestrators, significantly consolidating repair volumes and offering strong incentives—including extending insurance services to include maintenance and offering negotiated prices for parts and labor—to repair shops to participate. Meanwhile, insurers can analyze increased volumes of claims data to continually assess the performance of repair shops and then use those insights to guide customers to the best deals. Even before the pandemic, insurers had made strides in improving the bottom line by increasing productivity and optimizing technical excellence, particularly via pricing. Now is the time to tackle claims. Claims organizations can use this period of lower claims volume to plan their strategic investments in advanced analytics transformation, to devise new digital talent strategies, and to improve their understanding of customer needs and expectations. A complete suite of analytics and updated process automation—prerequisites for accurate, end-to-end automation—constitute the backbone of the new claims and customer experience model. The tools are evolving, driving automated decision-making along the entire claims handling process: routing, triaging, liability negotiation, cost estimating, deciding to repair or write off damaged vehicles, cash settlements, and fraud detection. All these areas will increasingly use digital and analytics as opposed to manual labor, changing the entire claims operating model. Responding to customer demands for a seamless claims experience is a top priority. The pandemic has proved that customers are eager for and accepting of new digital experiences. They expect full transparency throughout the claims journey; minimal effort on their part (for example, very little engagement back and forth with the agent to get the claim resolved and receive payment); faster resolution of claims, perhaps including automated payments; and the ability to move seamlessly between the digital and physical worlds. Furthermore, insurers can work to reduce leakage and improve the bottom line. Leakage takes many forms, including replacing rather than repairing a vehicle, offering a luxury replacement vehicle rather than a car that matches the customer’s vehicle class, and incurring costs for in-person loss assessments even in obvious cases for which pictures would suffice. Tackling leakage will entail enabling efficient detection of anomalies, selecting claims for detailed review, and empowering the claims organizations to efficiently close claims that cast no doubt. Accomplishing these critical objectives will entail a shift from a scattered and often siloed approach using unintegrated digital and analytics tools to end-to-end digital- and analytics-enabled claims processes. On the front end, insurers will need to establish tools on par with the top digital services their customers use every day (for example, ride-hailing apps, social media, and digital banks). On the back end, claims organization will need to invest in a suite of analytics engines to support automated decision-making to cut costs. The opportunity starts with claims prevention—using telematics and the Internet of Things to issue safety warnings and damage prevention tips—and continues throughout the claims processing journey, from providing customers with an easy digital first notice of loss interface and improving claims cost accuracy, to digital selection of a repair shop and automated payment processing and invoice checks. This relative lull in activity also gives insurers a good time to provide teams handling claims with the training they need to learn new processes and operate new digital tools. Claims are already rebounding, so the clock is ticking for insurers. Building end-to-end digital and analytics solutions requires significant investment and will take substantial time. For claims organizations, it is critical to act now or risk missing the opportunity to emerge from the pandemic stronger than competitors.

Core Insurance, Risk Management

5 Essential Features of Policy Management Tools

Article | September 22, 2022

The worldwide marketplace is undergoing a host of structural changes and insurance companies are consistently working to capitalize on them. The past few years posed a number of new challenges. For an industry whose primary promise is to “be there when customers need us,” delivering top-notch timely services is not only crucial for business continuity but the most urgent goal. Inspiring trust through every process of the policy lifecycle is a significant factor for insurers to be able to maintain goodwill in the market. Recent pressures proved that the industry needs a systemic metamorphosis and digital solutions may be able to provide them. This is also why many industries are jumping on the bandwagon of digital transformation and insurance is no different. With a barrage of new technologies, solutions and software, it has become easier to automate processes and eliminate inefficiencies that hamper day-to-day-operations. One such area of transformation is insurance policy management. Forward-looking insurers today, can start by rethinking their policy management framework. The Importance of Automated Policy Management Simplifying all internal processes is a priority for many insurance providers worldwide. Much of the insurer’s business outcome hinges on streamlined workflows, seamless document management and effective use of different tools. In policy management, mitigating risk is another significant aspect that impacts the bottom line. Today, insurers are heavily investing in new technologies like artificial intelligence and machine learning, robotic process automation, data analytics and much more. Policy management entails the comprehensive process of administering policies. From pre-sale to renewal to claims, at every stage of the policy lifecycle, insurers must ensure a smooth process at every stage. Some of the stages of policy management that can be enhanced by using automated policy management tools which include: Member services Loss mitigation Risk assessment Claims processing Policy issuance Policy renewal Policy cancellation Compliance It’s clear that insurance policy administration system (pas) encompasses all the main business processes of an insurance company and the importance of policy management is enough to invest in high-quality solutions that span the policy lifecycle. The Must-Haves of Policy Management Software A smart insurance policy management simplifies the process for both the insurer and the insured. For insurers, it should be able to optimize resources and save time in administering policies. For example, life insurance policy management system can help a provider scale their operation, introduce flexibility and administrative simplicity. Here are the components of a policy management solution that is a must-have for every insurance provider. For the insured, the solution can help organizations not only provide a smooth experience Policy Issuance, Update and Cancellation The most significant must have that an effective policy management solution should have, is the ability to digitalize every aspect of policy administration. This includes being able to generate documentation, centralize records and oversee all operations across the policy lifecycle. For instance, everything should be synced so that any updates are made universally across all documents. This eliminates doing manual changes to all the records. In addition, with technologies like robotic process automation (RPA), repetitive tasks can be automated and reduce the time it takes to process documentation. Underwriting Underwriting is a process where individuals or firms take financial risk for a fee. In insurance, underwriters are responsible for evaluating the degree of risk to the insurer’s business. It is in essence a manual process that comprises extensive research and assessment of the prospective policy holder. For instance, medical underwriting consisted of ascertaining the charges to levy or even whether to provider coverage to them based on an applicant’s health condition. Even though underwriting is a time-consuming process, it doesn’t have to be tedious. Underwriters need to access data that is spread across a range of different platforms and sources. Automated policy management enables organizations to accelerate the process of data collection and collation. This is why, automation in underwriting functionalities is one of the most important features of a policy management software that is a must-have. Estimates and Quotes Holistic policy management tools are incomplete without quote estimate capabilities. Quoting allows insurers to generate leads. With automated quoting features, insurers can provide estimates without having to directly contact customers, saving time and money in cold calling. In addition, it helps insurers to gather the information they need to then target their leads and tailor solutions that meet consumer expectations. Quality policy management systems include these capabilities. They work by letting customer input their information and receive a quote estimate based on it. For insurers, in addition to providing leads, it lets them engage customers from the start itself. Policy Renewal Renewals is a critical stage in the policy lifecycle. Overseeing renewals and reducing customer churn is something every insurer must prioritize. Renewals handling amplifies the importance of policy management software that offer renewals management tools. Renewals management features allow insurers to alert policy holders about the ending of their coverage and provides a timely reminder to renew it. Since renewals management tools offer ready information for insurers to access, customers need to update fewer fields. It not only reduces customer churn but contributes to an easy, fast, and customer-friendly process. Claims Processing Claims processing is when an insurer reviews a claim process to verify and authenticate the claim made by the policy holder. As a core business process, claims management and processing needs intelligent systemization. Insurance policy management tools that integrate claims processing will enable insurers to automate the settlement process. Modern policy management tools sync different systems so insurers have a centralized database and can simplify tasks like assigning claims, detecting fraud, record payments issued and automatically generate reports. Regulations and Compliance Insurance is a heavily regulated industry and insurers must keep up with the many compliance and location-specific regulations to avoid hefty fines. Regulatory policies are also subject to change and can often realign processes to protect consumers. This may sometimes cause insurers financially. However, complying with new regulations is a business necessity and policy compliance management solutions help immensely. Insurers must be able to monitor any changes in global and local policies or keep an eye out for announcements regarding the change in rates or regulations. Many insurers have a team to do this but maintaining a team is costly and causes operational complexities. Modern policy management tools offer the automation capabilities that eliminate the need for extensive overhaul or insurers to keep up with new regulations. These policy compliance management tools help in detecting breach and minimizing it. They also enable better resource allocation as teams no longer need to monitor new and upcoming regulations and plan for implementing the change. Customer Support Customer support is one of the most critical aspects of policy management. Beyond software and applications, being able to meet your customers’ demands, address their concerns throughout the customer lifecycle is vital in order to meet business objectives on time. With digitalization transcending platforms and devices, policy management tools today need to be able to keep up to meet customer demands. This is why mobile-ready policy management solutions are a must. They allow insurers to respond to customers quickly and keep channels of communication open and flowing. In addition, features like quoting estimates and claims processing that accelerate policy administration and management in a streamlined manner are bound to keep customers happy and reduce churn. Some policy management tools come with marketing automation capabilities as well as a CRM that lets insurers deliver a great experience right from buying decision to ongoing support. Conclusion There is no denying that digitalization is the future and insurers need to be ready to adapt to new challenges and evolving demands from consumers. Policy management tools not only enable insurers to overhaul their core process but simplify it and eliminate operational inefficiencies. The importance of policy management cannot be understated. Age-old challenges and bottlenecks of managing millions of policies can be mitigated with comprehensive policy management solutions. The above components are the most critical process your organization should look to simplify. These essential features ensure you are able to optimize resources, improve operational efficiencies, streamline processes and translate all these into enhanced customer experiences. Frequently Asked Questions How does insurance policy management differ from other policy management tools? Insurance policy management is a specialized solution that caters to insurance companies and enables them to manage renewals, claims, underwriting and all other processes associated with managing an insurance policy for their customers. Other policy management tools help organizations frame policies and management internal policy documents. What is an insurance policy lifecycle? An insurance policy lifecycle starts with generating a quote for the customer, onboarding the customer’s application, and finally setting the payment of premiums and renewals. When a policyholder claims insurance, the insurer has to process the claim, verify its authenticity then accept the claim fully or partially or reject it. What are the ways the insured can choose to pay for the insurance policy? The insured can either pay a lump sum amount or choose to pay monthly, yearly or quarterly. These payments are called premiums and are calculated based on certain condition set by the insurer.