Personalisation is constantly raised as essential if carriers are to remain competitive with emerging service providers. Not just in product development, distrunution channels, Quote & Buy and Mid-Term Adjustments but also throughout insurance claims from simple accidental damage to complex property claims and CAT events.

EY categories nine types of customer.

You can read about these categories in detail via the link at the bottom of this article. They key point is that insurers need to understand the different personas, motivations, requirements if they are to retain customers never mind grow them. 

A recent conversation with Katherine Walker added new insights. Katherine and I have collaborated on insurance claims transformation for a carrier before she  co-founded Startup Sherpa helping the next generation of entrepreneurs and innovators. She has just finished writing this report to be published  October 13th which reveals the motivations of Gen Z and Gen Alpha - your future insurance buyers. 

See the annoucement by Aviva here

With customers having so much choice from traditional annual policiies to UBI products, embedded insurance, subsription services from all kinds of service providers with insurance included personalisation becomes a key differentiator. 

EY goes on to say: -

"To satisfy new demand, engage new customers and retain existing ones, insurers will have to overcome their reputation for delivering sub-par experiences and emphasizing standardized policies and traditional channels over customer needs and preferences. That requires fully operationalizing customer centricity, embedding it deeply in every function and promoting teaming across the organization, as leaders in other sectors have done. We’ve structured our latest NextWave Insurance report around nine key customer types that will define the market on the road to 2030. The report provides insights for insurers looking to seize the growth opportunities these changing expectations and behaviors present, with recommended actions to prepare and optimize operations across the business, including purpose and mission, people, teams and culture, and technology and data. We believe those insurers that take an open-minded, proactive approach to change and remain agile in their innovation efforts will enjoy sustainable growth and se cure market leadership in the decade to come despite challenging economic conditions."

Now, it is one thing to have the vision, strategy, capabilities and people to inniovate and personalise but what about thye technology?

It is hard with the complex systems and platforms whuch have immense depth and breadth of functionality which comes at the cost of less flexibility, low agility and consequently less ability to personalise and iterate. Let's look at core systems and claims platforms. Both are important as it is rare that a carrier, broker or MGA that chooses a core platform soes not find the need to also deploy a claims platform to cater for the wide range and depth of claims from General Inaurance, through Speciality to Commercial. 

Core Systems

These include the old legacy, mainframe driven systems still prevalent across incumbent insurers. Large insurers may have 15, 30, 50 or more technology stacks inherited over years of M&A around the globe. Then there are the more modern legacy core systems like Guidewire and new modern architecture CoreTech like EIS and Genasys.

These core systems are the central computing brain, heart and muscle of insurers.

Old Legacy

Old legacy systems show that mainframes are still relevant whilst at the same time the skills and people able to maintain and upgrade them shrinking. We all have seen cases of bank legacy core systems literally failing during upgrades as one or more links in the high number of workarounds, many times undocumented, fail. Customers without banking for days and even weeks at a time!

Technology partners can create ‘digital wrappers’ around them and integrate at various points of the system. But at the heart of matters you still have an old and vulnerable set of often incompatible mainframes, AS400s and UNIX servers chugging away like steam engines in our current digital worlds.

New Legacy

That gave the opportunity for Guidewire which formed in 2000 and went for IPO in 2012. It underpins over 450 insurers globally and is the gorilla in the market and Gartner Magic Quadrant Leader for North America and Europe. Duck Creek, Sapient, Majesco and others have established themselves in the market since 2000.

Why do I term them new legacy? Because they are rooted in a traditional server platform. They may have deployed to the cloud but no more than stuffing a large, inflexible, and traditional enterprise app which behaves the same. Like the on-premises model it is dependent on armies of Systems Integrators, Consultants and Developers to help scope, spec and deploy them. The result is hard-coded, complex, and generally inflexible platforms that involve expensive and long-winded upgrades every three to five years. There is no dynamic scaling up or down capability by specific products, markets or lines of business as demand changes. It’s an all or nothing deployment on the cloud.

But they work, are comprehensive, have international coverage and cope with high volume transactional models required by Tier One to Tier Three insurers and brokers.

They have partners and marketplaces to help insurers integrate best-of-breed point software like Shift, Tractable. All have cloud versions, but these vary in completeness and Gartner may, for example, warn that

“XYZ does not offer a true SaaS model. The application is not deployed multitenanted, and the vendor’s contract requires commitment to minimum terms and minimum volumes. Insurance CIOs will need to ensure they do not overcommit to volumes and capabilities to ensure they are not overpaying for the solution over the term of the agreement.”

Gartner may question the capabilities to execute well particularly the further from their core home markets e.g., North America.

Size has its advantages and I have included an indicator in the table below i.e., the number of deployments in North America and Europe. The data is supplied to Gartner by vendors for 2021 and where you see N/A the vendor does not appear in the 2022 Gartner Insurance Core Systems (P&C) reports for an insufficient volume of deployments.  

Tellingly, many insurers implement one line of business, e.g. auto, with these core systems but not another like home. The time, cost and shear resourcing requirements can drain ambition, budgets, and people. That’s not to say insurers cannot run all lines of business on them- just that the cost and effort is high.

That opens potential for the cloud-native, serverless, micro-services and API architecture platforms that can be scaled up from one line of business and across all lines. Subscription licensing removes cost as a barrier especially as you can say goodbye to expensive upgrades. Every customer will be on the latest version of the software and that being so can be assured of competent support by the vendor. Deployed on public cloud platforms like Amazon AWS and Azure they are infinitely scalable and their large API libraries make them ideal for integration with 3rd party applications and data sources

Many new legacy vendors will say they have SaaS versions, but they are rarely complete and often a mix of vendor or customer hosted rather than public cloud.

CoreTech

This is a term coined to describe 100% cloud-native core platforms that can deliver the functionality of ‘new legacy platforms’ from serverless platforms like Amazon AWS, Azure, Google.

They can scale up to millions of transactions whilst starting on the initial steps of the "stairway to heaven". They can license specific modules and offer subscription licensing for cost-effective means to transform and move away from legacy and new legacy platforms  at the speed insurers require.

The list below is not exhaustive whilst giving a good indication of the choices available. You can read detailed SWOT reviews in the Gartner Magic Quadrants:

• Magic Quadrant for P&C Core Platforms, North America
• Magic Quadrant for P&C Core Platforms, Europe

Personalising Claims

70% or more of an insurer's costs are incurred in claims operations and payments and as claims inflation hits carrier's profits hard never has there been a more important time to choose the optimal technology partners to help you address these challenges.

Two years ago or more many carriers looked at digital claims vendors to help augment claims adjusters and transform customer experience. Too often, the price was high and the technology complex. Support from the C-Suite patchy at best. Claims a poor second or third to the glamour of online Quote & Bind, Comparison websites and distribution. Those same carriers are refocussing on claims transformation today and even those that made advances in one line of business are painfully aware that others like home, travel, pet and speciality are often woefully stuck in an analogue rut.

When they look again at the technology offered they often f'ind them grounded in older solutions that had never been challenged by the pandemic and work-from-home, supply chain constraints delaying repair and replacement and costs rising by the day for labour, parts and materials. Estimating packages rooted in times of stability and high availability are no use in today's world of uncertainty. Platforms that require major upgrades every few years at high cost in time and money. Platforms that lack the eFNOL. self-service and delightful customer experience that today's customers demand.

No one vendor offers a solution for every need and the fabled "end-to-end" claims solutions remains a fairy tale. So how best to choose the best option for your business? Find answers below

1. An introduction to the technology
2. The range of options on offer
3. Point Solutions essential to integrate with these platforms
4. The data sources that are vital for optimal decisions and outcomes
5. Start with a roadmap
6. Organisation and structure to innovate
7. The evaluation phase

1) The technology

It is telling that whilst all core technology platforms feature a claims module most customers license a separate digital claims platform. With circa 70% of an insurer’s costs tied up in claims, a key determinate of customer satisfaction and retention, this decision is sensible.

Just as with core platforms you have a range of options including Claims Ecosystems Providers like CoreLogic and Verisk and what you might term Claims CoreTech i.e., modern architecture, cloud native, public hosted, micro-services and API architected with low-code/zero-code self-configurability. Examples include RightIndem and Snapsheet.

Some technology partners specialise e.g., CoreLogic and Synergy (UK) with property, home and contents whilst others cover multiple lines of business e.g. -Verisk, 360Globalnet and RightIndem.

You have the same challenges and opportunities we examined looking at core platforms. Do you put all your trust in a cloud-native, micro-services and API driven platform that has a limited number of customers, scaled only to modest claims volumes and may have shown focus in only one or two lines of business?

Or do you choose a proven “new legacy option” that has scaled across many large Tier 1 and Tier 2 insurers but has an amount of technical debt hidden in the various modules and tends to be expensive, more complex to deploy and require major upgrades every three/four-year period?

Fortunately, a few digital claim management platforms have scaled up and offer proven ability to deal with millions of claims per annum. And scale up from just thousands to hundreds of thousands of claims at a rate to match your own capabilities. That make it easier to prove the technology in one line of business and, once the technology and relationship is trusted, expanded over the whole business. That means you can offer customers a similar digital UX and satisfaction level across auto, home, travel, pet and all lines of business.

You will require assurance that each platform can integrate with core third party software to build out the functionality, digital UX and claims journey required for all lines of business, different regional/national compliance and regulation and different levels of claims complexity. Many vendors talk of their API documentation and ability to integrate but some lack the stamina and inhouse resources to fulfil the promise. Supporting an integrated ecosystem of technology partners and software is vital as no one technology partner delivers everything.

The fabled “End-to-End” claims promise is too often a case of “The Emperor without Clothes” and you know how that fairy tale ended don’t you?

You will need a claims platform that already passes data in real-time to and from these market leading applications; each one making a decision automatically for simpler claims or enhancing claims adjuster decisioning when human intuition and skills is necessary e.g. more complex and unusual claims. In each case, the claims platform ensures the evidence and decision is validates and passed to the nest step/stage for the next decision(s) to be made.

There are pros and cons for either choice and key to this is the trust you feel you can place in the people involved and relationships with each vendor. Geoffrey Moore is an outstanding advisor on the technology adoption lifecycle and on technology start-ups achieving scale. He emphasises that founders and managers of start-ups are often not the ones suitable to take innovators beyond the first few customers.

A recent research project by Sonr in partnership with EY rates InsurTech’s by a number of characteristics including the capabilities of the people involved. The result is the Insurtech 100 Report (see Further Reading at end of the article).

2) What range of options do you have?

Note: Listed in alphabetical order- no implied ranking of capabilities

Legacy Ecosystem Claims Management Platforms

• CoreLogic for property
• Verisk for property and auto

New Claimstech Management Platforms

• 360SiteView
• Claims Genius
• Claim Technology
• RightIndem
• Salesforce Industries (Insurance)
• Snapsheet
• Synergy Cloud
• Upptec
• Wilbur

No one platform will have everything an insurer, broker, MGA requires. You will need to add third-party solutions to deliver all the requirements an insurer, broker, MGA will demand. Whilst all vendors claim to have large API libraries and integration capabilities many will lack the resources and commitment to be able to connect the required mix of third-party apps and data sources we examine below

 3) Point Solution Software

Policy Admin, Claims Validation and Triage

• HUGHUB
• Iotatach
• Open GI
• Sprout.ai

SMS Communications Platform

• Hi Marley

Claims Damage and Cost Estimation (often combinations of these)

• Be Valued
• CCC
• Claims Genius
• ClickIns
• LexisNexis
• Mitchell
• SLVRCD
• Solera/Audatex
• Tractable
• Upptec
• Value Checker
• Verisk
• Xtract360

Property Repair & Restoration

• Next Gear
• Westhill

Liability Assessment

• BAIL

Counter Fraud

• 360Retrieve
• BAE NetReveal
• Frisk
• Shift

4) Key Data Sources for claims management

Insurance was founded by leveraging the best of data to price risk, provide protection and manage business. “Data-driven” is a familiar refrain but the question is which data and intelligence is best and how can I integrate it into my systems?

Some platforms are positioned as key data providers e.g., CoreLogic for home and property from selling to protection and Verisk for auto and property. Their offerings are most complete in their home territory, North America, and expanding in Europe especially the UK and DACHS regions.

Claims platforms generate data in real-time and are a prime source of intelligence for decision making, fuelling AI, machine learning and rules engines including counter-fraud.

In the New Legacy platforms AI and ML is generally “on the side” in different database silos as the operational database was not designed to support real-time analytics. Being separate the learnings from the AI/ML cannot be connected to the core claims platform. The newer ClaimsTech vendors deem data, data science and analytics central to their platforms.

There is a frightening amount (circa 80% of unstructured data hidden in data silos, web forms, emails, SMS messages, voice files) that insurers must be able to access, normalise and analyse. Yet that data too often lies hidden and the value unrealised.

By the time the data is presented in dashboards, reporting or alerts it is often too late to take timely action and the costs of that failure are high.

New ClaimsTech platforms help address that issue and whilst New Legacy claims platforms will you must beware of the potential complexity, time and cost involved in connecting all those silos and especially delivering real-time insights.

In addition, insurers need to license external data to feed the AI applications penetrating all parts of insurance with a selection listed below. Again, you will want to ensure that claims platforms and core technology can surface and leverage these.

• Accuweather-weather data
• CoreLogic- manage property data for selling, financing, and protecting property
• Hazard Hub- property risk data
• ICEEYE- global flood earthquake and CAT damage data in near real-time
• KETTLE- house-by-house risk assessment across USA
• LexisNexis- vehicle, ADAS and home data
• McKenzie Intelligence Services Ltd wide range of connected data sources and data management
• Mitchell- Auto data
• SAFEHUB- building specific US earthquake damage
• Synectics identity, financial and fraud data
• Terrafirma property risk data
• Verisk- auto and property data
• WeatherNet- granular and near real-time weather data
• WhenFresh- wide range UK property data

5)  Start with a roadmap- Some advice from Geoffrey Moore.

“Let us assume we have a clear design for our desired future state. It won’t take you long to realize there is little chance that a single intervention can get you from here to there. So, the next major deliverable must be a roadmap organized around a maturity model, or what we like to call, a stairway to heaven. Each step up the stairway should be designed to deliver value upon completion, thereby allowing the organization to pace its change management, funding things as it goes, building its confidence, and reassuring its various stakeholders.

With such a roadmap in place, now you have a current-state/future-state accountability mechanism that can govern each stage of the transformation—the software and systems, the systems integrators, the process owners insider your enterprise, and the people responsible for executing the processes. As we have noted elsewhere, digital transformation is not a restaurant. You cannot simply pay for it and have it delivered to your table. It is a gymnasium. You still have to pay for it, but to get any value out, you have to actually do the transformational work yourself.” 

Geoffrey Moore

 6) Organisation and structure to innovate 

Running a business is a challenge and everyday operational issues can take up 70%-80% of time and attention span.

In February 2022 Russia invades Ukraine, cyber activity increases, and Australia suffers CAT flooding. The West’s financial sanctions against Russia impact capital, financial and insurance markets. There are always events soaking up bandwidth and the ability to make and execute decisions.

Nevertheless, innovation, in general, must be a core strategy, but the approach to it must also change, and it must be viewed with a bit of a different lens. When times are challenging for insurers, innovation is usually the first thing to go due to bigger priorities or limited budgets and resources. Carriers may not be able to afford to focus as much as they’d like on innovation during those times.

To stay relevant, however, they must find ways to keep innovative pursuits going and part of their portfolio. Easier said than done, however!

One way is to establish a transformation unit staffed with a mix of staff from the insurer and digital transformation expertise bought in from outside to avoid tunnel vision. Reporting to the CEO directly the Chief Innovation Officer must be able to anticipate disruption, new products hitting the market, new entrants to the market like NeoBanks, and the viable emerging technologies that business and commerce will adopt and deploy.

This team must also work closely with business units, central and business IT, marketing and sales, finance and counter fraud, procurement and legal. It must persuade, make sound business cases and ensure the insurer is not outflanked by competitors or disrupters.

This will help ensure a viable, world-class stairway to heaven plan that is bought in to by the whole company and driven by the digital transformation team. With that in place the insurer is better positioned and resourced to choose the right mix of technology partners

7) The evaluation phase

Gartner published a very useful illustration of the planning and evaluation to be undertaken when choosing technology partners. Combined with the advice above it will help find the right partners to ascend the "stairway to heaven".

Further Reading

The Future of Auto Insurance- Connected: Embedded: Subscribed

Transforming claims from a back-office reactive operation to the strategic asset 

Innovation | Identifying Unmet Needs in a Digital Age

Speed of settlement, customer satisfaction and AI 

 Stop Selling. Start Collaborating.