Andrew Sewell, Gallagher Bassett’s UK technical director, spoke to Insurance Times about insurtech and how the pandemic has demonstrated the sector’s importance, but a human touch is still necessary for complex claims.

He points to the desire to automate all those tasks that do not add value for customers but do add costs for insurers.  

"The big reduction in costs comes from eliminating every manual, live human being based process which does not either enhance the accuracy of the claim settlement or involve unique knowledge generally not available to AI-like applications. The primary place where we need real, live people is in handling complex claims which involve other real, live people.

The benefits of the human touch are real in those situations where we require investigation or—more importantly—human empathy. By designing coverages which make all aspects of the claim process transparent to all parties we can focus our use of experienced handlers in those instances where they make a serious difference."

Insurance Times 1st March 2021

Sewell identifies critical success factors insurtechs can deliver.

  • Enhanced Smart Intake
  • Auto-adjudication parameters
  • Fraud Detection
  • Real-time data integration

Enhanced Smart Intake

Validating routine claims in a one-touch manner to speed up decisions and settlement. Routine accident damage motor claims for example when a brief description together with photo and video evidence (plus metadata) submitted by phone or tablet combined with ability to triage booking vehicles into the repair network make all the difference.

Mind you, it is also vital to be able to identify potential large losses early and the devil is often in the detail. It might be a simple enough sounding injury as a RTA includes a wrist injury to a cyclist in collision with the car and it turns out she is a consultant trauma and orthopaedic  surgeon. The right personal injury analyser would immediately highlight that and identify a potential large loss and help avoid under-reserving.  

Auto-adjudicating parameters

To achieve a goal of 80% of claims 'untouched by human hand' requires document ingestion and scanning, reading, with automatic valuation or pre-determined outcomes based on the input delivered directly by a policy holder or third party claimant. The remaining 20% should be automatically routed to claims handlers with the right skills and qualifications. The end goal is faster and more accurate settlement

Fraud Detection

Professional fraudsters have access to as much technology as insurers and will seek out the vulnerable points in all digital and automated claims flows. They will change their modus operandi to stay ahead of algorithms . Insurers need to combine technology with the human intuition and anticipation of fraud investigators. The end results can be a ten to twenty times return on investment- and a lot less fraud!  

Real-time data integration

A digital claims management platform generates data in real-time and must be validated with external and internal data sources. The new 'whiplash reforms' will need insurers to rapidly implement new rules-based analysis of all these data sources to help ensure fraudsters do not find other ways to compensate for the new tariffs. 

Claims management platforms must be agile and end-to-end to help insurers and brokers innovate, transform and constantly improve through fast iterate-test and release functionality. New no-code platforms such as 360SiteView enable trained analysts in the insurer to deliver this faster time to value whilst also complying with regulations in different markets, States and countries.

The critical success factors optimising the mix of automation and human empathy & intuition Sewell describes are all found in 360SiteView now deployed in major insurers and brokers from Australia to the USA. Not just for Auto and Home but also customised and optimised for Pet, Travel, Business Interruption, Commercial, Speciality and all claims types and perils. 

No more ruinous licensing when you want to digitally transform another claims category. One digital claims platform delivers all this.