How to Achieve Best Health Insurance Claims Experience?

The GCC health insurance market size reached US$ 7.2 Billion in 2021. In future, the market is expected to reach 11.1 billion USD by 2027, exhibiting a CAGR of 7.5% during 2022-2027.

Given this growth rate, the degree of competition is only set to increase, and customer experience is becoming a key competitive differentiator. Nearly 60% of insurance executives rank a differentiated customer service experience as having the highest impact on market position.

In the fast-paced low-touch digital environment, claims handling is one of the most critical and meaningful touchpoints. Customers are usually distraught when they file a health claim and settling the benefit payouts on time is an important part of insurer’s value proposition.

For insurance carriers, this opens up an opportunity to strengthen their relationship with customers and emphasize the values of the brand. So, how to achieve the best health claims experience for customers?

Empathize With the Customers

Once a customer purchases a health insurance policy, they are likely to interact with the insurer only under stress when they need to make a claim – they may need to pay the hospital bills or cover various types of expenses.

If there is a lack of transparency or the processing is slow, it can easily tamper customer experience. Hence, it is important for the claims processing team to provide a personal touch while processing the claims faster. It is especially important that they identify vulnerable customers and ensure a heightened level of service with sensitivity.

Furthermore, it can be very inconvenient for customers if they have to communicate with multiple service providers and fill up several forms. This issue can be eliminated by leveraging advanced technology like process automation and digitised self-service interphases.

Offer Omnichannel Solution

An omnichannel solution which is easily accessible to customers can significantly improve customer experience. With that, a customer can file claims through their mobile phones or the web instead of contacting the agents or insurance companies. They can use their preferred mode of contact and upload the required details.

Additionally, using omnichannel solutions, insurance carriers can provide faster and more personalized customer service than traditional methods. That can also include claims tracking feature and maintain transparency about the stage of the claims request.

According to a Cognizant study, about 20% of the insurance carriers provided all modes (online, call-back feature, and forms) for claim notification. Plus, 30% of the insurance carriers who participated in the study provided claims tracking.

Have a Highly Efficient FNOL Process

It is vital for both insurance carriers and customers to capture claims requests and associated details instantly. Hence, an efficient digital tool for FNOL capturing and data management is necessary.

This tool should further be integrated with a claims management system that provides better visibility and greater control over data shared by customers and partner hospital. However, this will save a significant time in going back and forth.

Streamline the Claims Process

Eventually, the key area for improvements in the insurance claims experience is in the claims process itself. An intelligent claims management solution can improve the TAT for claims processes. This enables end-to-end digitization of the process starting from FNOL, benefit configuration, verification of schedule of charges, to the benefit payouts and settlement.

It also can enable straight-through-processing of standard health claims. It will notify the adjudicator only if a case requires a detailed look.

Closing Lines

Insurance carriers need to establish customer empathy while simultaneously enhancing the back-end processes. This way, they can ensure to give customers the best out of people and technology.

To enable the best out of technology, insurance carriers need to partner with insurtechs which will help streamline claims processes. Certainly, improve efficiency and give the claims team the required time to focus on customer experience.

Check out iNube’s CLAIMSLive Health, the industry-tested platform has enabled insurance carriers establish the best health claims experience for their customers.



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