Insurance claim management with BPM

Experiencing a loss and filing an insurance claim is more tedious than claimed. In general, the claim process is nowhere a breeze and is a scary subject for many of the people. Additionally, the financial woes due to the loss situation are accompanied by the strong emotions. Notably, the life insurance loss scenario is far more delicate, and many times the beneficiary is not only in emotional shock but is also unaware about insurance coverage. In some situations, beneficiaries face several limitations in filing the insurance claim while some other beneficiaries need the claim amount on priority due to financial constraints.

All these are genuine real-life situations requiring special attention from insurance.
Customized BPM solutions for the insurance industry-
The needs of every industry vary, and a one-size solution can never fit everyon’s practical requirements. However the most desired yet unmet needs of insurance customers must be satisfied, especially when they are at the fulcrum of the business proposition. In this context, we will pick the top two unmet needs in the claims area and provide practical solutions towards meeting them.

Industry challenge 1 – The beneficiary of the insurance coverage is unknown
This is a significant problem, especially in life insurance. Many times, the insured dies and the beneficiary is not even aware about the life insurance coverage and the insurance policy lapse. Another scenario is, the insurer failing to locate the beneficiary after the death of the insured. Due to this, a lot of money lies unclaimed with state insurance department. In either cases the beneficiary is deprived of the claim amount, which was the sole purpose for buying the insurance coverage.
Solution 1 – Automatic survival verification and notification to the beneficiary with the help of BPM
The insurer should initiate periodic survival verification through BPM, based on triggers such as non-payment of premiums. In case of single premium policies or paid-up policies, there should be an annual verification of the insured on an opt in basis. Indirectly, this will help the insurer to establish a better connection with the insured. In situations where survival verification fails, the insurer should proactively reach out to beneficiaries and assist them in filing the claim. Many insurers are already doing this, however the stress here is to improve existing structures and minimize ongoing leakages. To this end, we suggest better loss tracking, beneficiary management, automatic and frequent life status recording, and notification to beneficiaries. A beneficiary verification key with which beneficiaries will be able to authenticate themselves seamlessly with the insurer can further help in streamlining the process.

Industry challenge 2 – Assistance is required during the claim process
Even the most straightforward claims process may hold complexities for some groups of people due to a variety of reasons such as age, location, time, or other priorities. As an example, an artificial intelligence enabled online claims process may be extremely complicated for an older person not familiar with computer, mobile, and internet technologies. In all these cases, there should be end to end help available to the beneficiaries throughout the journey of claims submission and processing.
Solution 2 – Support from a third party throughout the claim process with BPM
If a beneficiary needs help with filing a claim and associated activities including collecting documents, providing required inputs, and interaction with the insurer, insurers should provide a framework for a third party BPM to represent the beneficiary. The third party can help in completing all claims related responsibilities of the beneficiary. Moreover, the insurer can charge the policy holder additionally for this optional feature.