Automating your claims: how to do it effectively and yield the right ROI - Curacel

Automating your claims: how to do it effectively and yield the right ROI

June 2, 2021
Author: samson

Claims processing is the cornerstone of any insurance business.

Emerging technologies like telematics, automation, analytics, drones and a host of others – combined with changing customer preferences – are driving a remarkable transformation in insurance towards touchless claims automation and processing.

Africa is one of the hot regions for insurance according to this article by Mckinsey. However, when we talk about the Insurance business, penetration and acceptability in Africa, it is underdeveloped.

What contributed to this laggardness can be traced to the ‘customer experience’ – stories (testimonials) the users have heard or their personal experience from an Insurer.  

If a customer had a bad experience with an insurance plan, It affects his perception of others. For instance, if he had an auto insurance policy – because of government policy or he’s educated on the benefit, if he feels any pain at the point of claim – either delayed or denied, that sets a precedence for how he relates to other insurance products and plans.

Trust is down. It cost less to service a customer than to acquire a new one. You can read how to retain a loyal customer.

Curacel’s head of innovation – Innocent Uduegu, highlighted this in an article – how to reduce waste, fraud and abuse, these have contributed to the failings of insurance in Africa.

Read: Insurance Future: The 4 Products and Services Driving New Business Models

One way to fix this – Claims Automation

In insurance, automating the claims management process has evolved from “How can we achieve automation?” to “When can we achieve automation?”.

Many African insurance organizations claim processes still revolve around the manual use of Excel spreadsheets, lengthy documentation workflows, or in-house manual data entry.

All these processes lead to less efficient management throughout the claim’s lifecycle. This results in longer and delayed open claim times, less accountability, less accurate claim data and fraud.

Let’s narrow this down to health insurance.

The HMOs are like the insurance companies known as the health managers, they work with health providers, offering healthcare products and services0 to a user.

The Providers are the companies – hospital, pharmacies etc, that delivers the healthcare to a patient – the insured.

When it comes to insurance, customers want a digital environment in which they can manage their claims online and quickly get accurate and consistent responses from an HMO and the provider.  

Automating Claims

Claims automation will have a huge impact across all insurance claims operations.

Automation helps in eliminating time-consuming manual work, bulky spreadsheets, and lengthy workflow challenges. It shifts the process to work with its users, rather than against them.

This shift to claims automation presents a wide array of benefits to the insurer and the insured.

Manually handling claims is drudgery; it affects the delivery of quality services to a patient, leading to a bad customer experience.

When claims are handled manually, a provider would have to wait till an accumulated time to submit claims to an HMO. The HMOs are limited in human resources to handle the number of claims submitted by providers – seeing they deal with thousands of health providers.

Handling claims this way take a longer time to settle which means health provider’s payment is delayed.

The effect of this delay affects the patient who is the HMO’s customer because the provider won’t attend to the patient as he should until there’s a payment from the HMO.

On the other hand, the HMO can’t move as fast as they should because everything is manually done which puts the patient in a place to make a choice – change HMO or just stop subscribing.

start processing your claim | curacel.co
Read: Time to value: a better way to onboard and retain customers as an Insurer

Technology can help with claims automation

Over the years, insurtech startups have been on the rise, creating products that insurance companies can plug into.

For instance, technology companies, like Curacel – have created products to help Insurance companies with claims automation using their proprietary Ai.

However, some insurers are building their claims automation tools in house to have more control. We wrote a guide on how to work with an outsourced vendor.      

Benefits of claims automation

Increased client satisfaction

As an HMO, when you’re able to separate the false and fraudulent claims from the correct and legit ones using a claims automation tool, your providers will get their claims settled much faster. This leads to increased client satisfaction – provider and your users.

Increased employee satisfaction

Manual work comes with its drudgery. Using claims automation to handle submitted claims reduces the workload for employees. And there is a positive side to this. They’ll experience less stress and have more time to do work that really matters: selling insurance plans, onboarding new providers, investigating fraudulent claims and paying out claims.

Other benefits:

  • Better data access, better data Integrity and a better customer experience
  • Feeds your appetite for productivity
  • Frees you from painful paperwork and processes
  • Opens up more opportunities for revenue and user growth, and retention

To learn more about how Curacel can help with claims automation for your organization,  you can contact Peter Adeyemi – Head of Sales at peter@curacel.co or contact us directly and one of our sales representatives will contact you.

start processing your claim | curacel.co