Leveraging Analytics to Improve Claim Accuracy and Customer Outcomes

Posted on

April 1st, 2019


Insurers have to go through a lot of information when working a claim. They receive notes from adjusters, details from customers, and then have to compare it all against fraud analytics. With each insurance representative handling numerous claims, there isn’t enough time in the day for them to sift through every piece of data they encounter.

With data analytics, insurance companies can better track claims escalation, priority, and potential fraud. The following are several ways data analytics can improve insurance claims:

  1. Fraud detection and prevention. Out of every ten claims that cross an insurance agent’s desk, one of them will be fraudulent. Prior to data analytics, fraud detection was limited to rules-based programming that fraudsters could easily trick. Now, insurers can use predictive analysis to apply rules, search databases, make models, and more for more accurate fraud detection.
  2. Handling litigation. Sometimes customers dispute claims and they end up in litigation. Data analytics can pinpoint factors that typically lead to litigation, which allows insurance companies to assign those claims to more senior agents. Their skillset can allow them to settle those claims faster and at a lower expense.
  3. Assigning claims. This isn’t limited to litigation. Agents have varying areas of expertise and ensuring claims are assigned to the best fit can be a challenge. Agents often receive claims based on very limited data. As a result, claims often end up being reassigned, which causes delays and irritates the customer. Data analytics can group loss characteristics to assign claims to the adjusters that fit best.
  4. Improving settlement accuracy. When claims come in at a regular pace, insurance agents can give each one more attention. Following a disaster, however, settlements often get fast-tracked to help customers sooner. However, issuing blanket checks can result in exorbitant or unfair settlements. Analytics can help balance settlements by analyzing claims against claims history.

Using data analytics can help insurance companies differentiate themselves from local competition. Data can also help improve the customer’s experience, boost retention, and save money. Contact the experts at Actec to learn more about improving your claims processes.