• Articles
  • September 2021
  • 5 minutes

Serving the People behind the Policies

Accelerated automation highlights the need for a human touch in life and health insurance claims

Human Touch
In Brief
RGA's Tina Paap and Terence Leong argue that people will always have an edge over machines in connecting and working with other people. Developing and deepening the skills to make that connection possible will enable insurers to meet consumers where they are, design better products, and ultimately fulfill the purpose of insurance.

Making Digital Connections

A common industry refrain regarding the COVID-19 pandemic is that the crisis accelerated the evolution of insurance. Market changes and technological advances that were expected to take years occurred in just months. With social distancing protocols limiting face-to-face interactions and disrupting associated processes, insurers were forced to adapt at every stage of the value chain: distribution became more digital, underwriting became more automated, and all functions became more – and in many cases entirely – virtual.

The many technological advances in claims management made in recent years have received renewed attention and greater adoption in the COVID-19 era. This includes efforts to ease the customer journey by automating administrative tasks such as data collection and entry and by speeding claims adjudication via sophisticated decisioning technologies powered by augmented intelligence. The future of claims processing is clearly going to be more digitally driven and claims analysts should prepare for this high-tech transformation. To learn more about the increasing value of advanced technology in claims processing, read: Out of Sight, Out of Mind? Digitalizing the Future of Claims.

Yet, perhaps ironically, as the industry has come to rely more heavily on data, technology, and remote working in navigating the pandemic, insurers have also rediscovered the importance and value of making human connections and serving the person behind each policy. Months of isolation have made people both more dependent on technology and more aware of the need for human interaction. This is why, alongside widespread technical reskilling and upskilling to adjust to a faster, more digital, and data-driven business environment, insurance professionals must also look to develop and deepen the “soft skills” so essential in serving people.

Best practices: Going soft can be hard

Insurance is far from being the only industry in which the human touch has grown increasingly important. In the words of Kevin Roose, author of Futureproof: 9 Rules for Humans in the Age of Automation: “We’ve been teaching people to become more machine-like – to major in STEM (science, technology, engineering, and mathematics), to become super-efficient, to optimize or life-hack their way to success. We need to focus on the more human skills that machines can’t replace.”

As a result, demand for soft skills training is escalating across various institutions. In a LinkedIn survey of 291 hiring managers in the U.S., more than 50% of respondents reported difficulty in finding applicants with suitable “soft skills.” Little surprise then that in a recent business trends article, “The Real Thing,” journalist Susan Horsburg comments that Melbourne Business School, for example, is developing a new course called Hybrid Leadership to help address this growing need. In addition, a 2017 Deloitte Access Economics report, “Soft Skills for Business Success,” forecasts a large increase by 2030 in professions requiring soft skills.  

This pandemic has accelerated this trend, with an increased need for interpersonal skills acknowledged by various industries even as people work and live more remotely. Within companies themselves, management is moving from a directive approach to a motivating and influencing model. Amid the demand, business training programs are quickly realizing that the label “soft” is a misnomer: According to the Harvard Business Review, skills such as empathy, integrity, and collaboration are the hardest to understand and to teach.

Claims management: Take it personally

Life and health insurance is ultimately a people business. As a result, treating each policyholder as an individual and relating on a personal level – even without meeting in person or even virtually – is a proven best practice. This is particularly true of claims managers, who are tasked with delivering on the very human promise insurers make to customers: that the insurer will be there to support them in their time of need.

Many outside the insurance industry assume the main goal of a claims adjudication is to find reasons not to pay on a claim. In reality, of course, the opposite is true. Reliably paying valid claims is arguably more important to an insurance company’s long-term sustainability and success than anything else – it is ultimately what they exist to do. Unsurprisingly then, in this era of artificial intelligence (AI), cloud computing, and big data, effective claims adjudication remains reliant on a range of traditional people skills that facilitate superior customer service, perhaps more than ever. Among them:

  • Integrity and openness: The need for clarity and transparency with customers about the claims process is essential to maintaining the value of insurance products. Clear communication and attention to detail can help avoid unnecessary disputes and speed up processing. Claims managers should also engage product developers to build transparency and consistency into insurance offerings. Such collaboration can help mitigate confusion and eliminate “underwriting at claims time,” a situation in which a customer purchases a product requiring only minimal questions at the underwriting stage but then must answer many more questions when making a claim. That customer might justifiably ask, “If these questions were so important, why didn’t you ask them when I bought the policy?”

  • Critical thinking + common sense: Today’s computers can process massive amounts of data and apply algorithms to translate that data into actionable insights. AI technology and other advances promise to make tomorrow’s computers capable of even more. Yet the human mind’s ability to both “read between the lines” and “connect the dots” will always bring a dimension to the decision-making process computers cannot duplicate. It is people who make claims, after all, and who better to understand their circumstances, motivations, and needs than other people, especially trained professionals with years of experience? The best claims analysts know when to trust their professional instincts and investigate aspects of a case that would fly right past any automated claims process.

  • Empathy: This is the most important quality of any claims professional. People making insurance claims are going through a difficult time in their life – often a traumatic, life-changing experience. Claims staff must be sympathetic to that. Even in denying a claim, they must acknowledge that the person is living through something real and address it at a human level. COVID-19 has escalated this need for empathy: Everyone’s COVID-19 experience will be an individual experience and claimants will have had their lives significantly altered. How can insurers best serve these individuals? It starts with understanding.

Technology is transforming claims processing in many innovative ways that will benefit policyholders tremendously in the years to come, and the industry should embrace the exciting possibilities of digitalization. At the same time, insurers would be well served to remember that people will always have an edge over machines in connecting and working with other people. These two seemingly competing approaches can and should complement one another. Developing and deepening the skills to apply technological advances while maintaining human connection will enable insurers to meet consumers where they are, design better products, and ultimately fulfill the noble purpose of insurance. 

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Meet the Authors & Experts

Tina Paap2
Tina Paap
Vice President (ret.), Claims, RGA Asia