In-depth - claims: The tech frontline

How can brokers use tech to manage claims and help customers prevent them? Martin Friel investigatesPart and parcel of any claims proposition has to include a focus on fraud. Of course, brokers have always had a part to play here but their involvement in claims requires them to adopt a more fundamental role, particularly where they have secured delegated authority to manage claims beyond first notification of loss (FNOL).

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CCMSI

CCMSI is a leading third-party administrator for workers' compensation and property/casualty self-insurance programs. Since 1978, we've successfully administered and provided claim services to individual and group clients, nationwide.

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Insurance Technology

Security Think Up: It’s Time to Give a Thought About Cyber Insurance

Article | July 14, 2022

The rise in remote work during and after the pandemic has increased cyber vulnerabilities significantly. Cyber insurance protects your company from the financial consequences of cyber threats or data breaches involving computer systems and data. Credit card numbers, social security numbers, account numbers, health records, and driver's license numbers are examples of sensitive customer information. According to a recent SBA survey, 88% of small business owners believe they are vulnerable to a cyberattack. If your company is a victim of cybercrime, the cost of recovery can be prohibitively expensive, including specialized repairs and legal fees. One of the most difficult challenges is quantifying cyber risk. Although approaches and frameworks like NIST CSF, CIS 20, NCSC Cyber Essentials, and ISO 270001 aid in the development of cyber security capabilities, they do not provide the tools to quantify risk. As a result, leaders frequently overestimate their cyber maturity while underestimating cyber insurance premiums. Potential Cyberattack Types are: Breach of data: A breach occurs when critical information, such as personal financial information, is stolen. Cyber-attacks on computers:Your computer system is hacked and compromised in this type of cyberattack. Extortion via the internet:During an extortion threat to your company's computer system, thieves may demand ransom payments. To address these issues, a variety of approaches can be used, ranging from zero-trust models to multi-factor authentication (MFA) and end-point detection and response (EDR) (EDR and XDR). Protective monitoring, encryption applied to the most critical aspects of your network, and patch management processes can also provide insurers with the assurance they require. There are options for both small and large amounts of cyber liability coverage. A small cyber liability insurance policy could be added to the policy of a business owner. A larger cyber liability policy with higher limits would necessitate its own policy. Furthermore, they provide a real-time view of compliance through a risk-based approach that is consolidated, consistent, and aggregated across the entire organization. Workflow automation can help the IRM system become more efficient. By consolidating your risk management processes, you can ensure that controls continue to deliver on their objectives and demonstrate compliance with policies, standards, and regulations while having a lower impact on your day-to-day operational demands. All of this will make it easier to meet cyber insurers' requirements and give organizations confidence that their policy will protect them when they need it.

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Claims

Are motor claims in Europe about to rebound?

Article | July 15, 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.

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Automobile Insurance, Insurance Technology

Coronavirus and insurance: threat or opportunity?

Article | December 19, 2022

The world is facing an unprecedented situation like never before. In the span of a couple of weeks, a visually undetectable virus has wreaked havoc and driven everyone home. COVID-19 had led offices to close, the economy to slow down, and has isolated us in our homes. Zooming in on the insurance industry, the effects haven’t gone unnoticed here either. Since no one was prepared for a pandemic of this scale, people are scrambling to know what their insurance covers. Those who weren’t covered are enquiring if they can get covered now. Travel and health insurance are the specific types are making the most news.

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Risk Management

8 POS Software Trends for 2022: New Forecasts and What's Next

Article | July 11, 2022

Online shopping is quickly becoming the new norm in the wake of the COVID-19 pandemic. Most retailers had to migrate their businesses to the cloud in order to meet the current demands of highly tech-savvy consumers, and the use of POS software has become more important than ever. A cloud-hosted POS solution is no longer an option for small and large businesses, but rather a requirement. POS systems have provided retailers with a more efficient way to track inventory and manage sales, replacing the old cash register and traditional methods of selling. As ecommerce grows, POS solutions play an important role in increasing convenience for online customers and providing a customer-centric experience. To keep up with the latest POS system developments, there is a list of the most important POS software trends to watch for. By understanding current POS software adoption reports and key insights, you can maximize the potential of your existing POS solution or, better yet, have better ideas on financing trends by POS that can bring value to your retail business. Consumers had to reorient their purchasing toward needs like food, medicine, and other home items as the viral pandemic threatened everyone's health and safety. The US Census Bureau recently released a report that found that throughout the pandemic, retail stores providing food and beverages saw the biggest monthly growth in retail sales. To better understand how POS systems are assisting retailers in overcoming the challenges posed by the rapidly changing retail landscape, here’s a list of the most recent and important POS software trends: Cashless Transactions via Mobile POS Systems Adoption of Cloud-Hosted POS Systems Multichannel Commerce Customer Layout Programs Personalized Shopping Experience AI Integration in POS Systems Use of POS Data Analytics Simple POS Hardware Investing in modern POS systems and maximizing their rich feature sets can help your retail business go a long way, from attracting new customers to retaining a loyal customer base that can drive sales and support your long-term growth.

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Spotlight

CCMSI

CCMSI is a leading third-party administrator for workers' compensation and property/casualty self-insurance programs. Since 1978, we've successfully administered and provided claim services to individual and group clients, nationwide.

Related News

Valued Policy Law and Total Loss

inredisputesblog | May 21, 2019

Typically, a fire insurance policy pays a policyholder for the actual cash value or the replacement value of the property destroyed. But in 20 states, if there is a total loss, the amount the insurer must pay is equal to the value of the property at the time the insurance policy was issued. What happens if the policy covers a multi-building complex and one of the buildings is destroyed? The Eighth Circuit Court of Appeals recently addressed this issue. In Norwood-Redfield Apartments Limited Partnership v. American Family Mutual Ins. Co., No. 18-2618 (8th Cir. May 16, 2019)(Unpublished), the appeals court affirmed a judgment in favour of the insurance company denying the policyholder’s claim to recover the full value listed on the policy of an entire complex of buildings when only one of the buildings was destroyed. The policyholder sued its insurance carrier after a fire destroyed one of the buildings out of 32 in the complex. The insurance carrier paid nearly $3 million for the loss, but the policyholder wanted the policy limits of over $31 million.

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Valued Policy Law and Total Loss

inredisputesblog | May 21, 2019

Typically, a fire insurance policy pays a policyholder for the actual cash value or the replacement value of the property destroyed. But in 20 states, if there is a total loss, the amount the insurer must pay is equal to the value of the property at the time the insurance policy was issued. What happens if the policy covers a multi-building complex and one of the buildings is destroyed? The Eighth Circuit Court of Appeals recently addressed this issue. In Norwood-Redfield Apartments Limited Partnership v. American Family Mutual Ins. Co., No. 18-2618 (8th Cir. May 16, 2019)(Unpublished), the appeals court affirmed a judgment in favour of the insurance company denying the policyholder’s claim to recover the full value listed on the policy of an entire complex of buildings when only one of the buildings was destroyed. The policyholder sued its insurance carrier after a fire destroyed one of the buildings out of 32 in the complex. The insurance carrier paid nearly $3 million for the loss, but the policyholder wanted the policy limits of over $31 million.

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