No one could have missed the huge impact digitalization has had on our society. However, one area within the insurance industry where digital transformation has not reached its full potential: personal claims management. In this area, many processes are still manually handled, and also routine cases are sent for assessments, something that could be automated with structured data and AI. We believe there is a better way.

Imagine a case handled this way:

To investigate if an injury has left any permanent pains, the Claims Adjuster just sends a link to a dynamic form, customized for just that type of injury, and not any of generic forms that are often used today.

The insured opens the link, signs digitally, answers the questions, signs again, and within minutes he receives an automatically generated decision on the degree of disability. The compensation gets played out and the case is closed without any more involvement of Claims Adjusters or Medical Advisors.

The decision is based on data from thousands of similar cases and we can’t imagine anything fairer and more effective. The work of the Claims Adjusters would change as they no longer have to handle every routine case. Instead, they can focus more on quality improvements and handling unique and complex cases.

The same goes for the Medical Advisors who can also focus on complex cases using the data to make more uniform assessments. This would ultimately lead to better customer service.

It’s a long way to get there. To automate something and create intelligence, the data must first be digital and structured. All handwritten notes, scanned documents, and free text must be replaced by dynamic forms and picklists, readable from a computer.

But do not despair. The journey towards the destination will bring huge improvements from the handling of today.

The first steps

Soon we will release several new features in our case management solution, laying out the foundation for this journey. We will digitalize the assessment basis in a structured format.

The first step will be to digitalize the communication with the insured so letters of authority and additional information easily can be handled with digital signage and dynamic forms. This will create a modern, user-friendly experience where the customer can track the case on a signed-in part of the insurance company’s website.

In parallel, we’re working on the next step; to digitalize the contact with the caregivers, making it secure and easy to collect medical journals and book patients to physical doctor appointments.

For example, to collect a medical journal in Sweden today, you must go through a manual and ineffective process, leading to long turnaround times and increased administration. By making the process digital, we can make it faster and with less administration. Both The Insurers and Claims Adjusters will benefit from this.

Having all the information digital will also enable better insights and advanced reports to optimize processes and find areas of improvement.

New intelligence

As the data volumes become large enough, the next step takes off using artificial intelligence. How smart and reliable the AI gets is directly connected with the amount of data it can access.

In the beginning, the system will notify you if an assessment differs profoundly from similar cases. In the next phase, it can provide you with fast projections and suggestions for the assessment. In the last step, the AI will be smart enough to give assessments on simple cases directly to the Claims Adjuster or the insured. By then, we would be close to reaching our vision for personal claims management.

Our part

As we work with almost all major insurance companies in the Nordics and handle an enormous amount of cases, Mavera has a unique position to create something really smart. We can develop a central process and collection of data from all insurance companies. That way, we contribute to more secure and uniform assessments for the good of the entire industry.

Do you share our vision of the future of personal claims management? We would like to have you with us for the journey. Please send an email to info@mavera.com and tell us what features you are looking for.