As new forms of digital communication continue becoming staples in our everyday lives, claims organizations should look to leverage new digital pathways to communicate with not only claimants but stakeholders throughout the entire claims lifecycle.

Understanding Today’s Challenges and Expectations

Scott Plummer, Market Strategy Lead - Claims Administration at Origami Risk, who served as a co-presenter, teed off the conversation by highlighting two key challenges facing claims organizations today — communication throughout the claims lifecycle and operational efficiency in organizations.

Due to the number of stakeholders involved, managing a claim can quickly become complicated. “Effective communication with the injured worker is always central to a successful workers’ compensation claim,” said Scott, “but there needs to be strong consideration given to [the communication] with the other key personas,” which can include the risk manager, independent agent/broker, medical worker, nurse case manager, facility supervisor, claims manager, and more. Keeping these various parties involved throughout the claims lifecycle, obtaining key information, and keeping them involved with updates at the right cadence through the best channels can become overwhelming.

Today’s customers expect modern channels of communication. Traditional channels like phone, fax, and email create back-and-forth that can become costly and frustrating, though “phone is still a critical channel,” as Scott pointed out. “Nothing can calm a claimant like talking them through the process with a skilled adjuster early in the claims cycle,” though, given the cost and limitations to organizations utilizing phone channels, digital transformation should look to utilize phones where appropriate, and not use it to conduct business as usual. 

Instead, insurers should give strong consideration to the best digital channels for key updates and give an omnichannel experience to all stakeholders involved in the claim. That includes mobile access and portals, SMS/text, and email. Offering these experiences delivers communication and updates to stakeholders in manners most convenient to them.

According to a 2019 State of the Connected Customer report, 84% of customers say the experiences a company provides are just as important as its products or services while 73% of customers say “an extraordinary experience raises their expectations of other companies”.

“While [these broader studies] cover more than just workers’ compensation,” said Scott, “some of these findings really should be given full weight when you’re looking to plan a workers’ compensation digital engagement transformation,” meaning some of today’s biggest players in the tech space are setting expectations for interactions with all companies.

“While servicing a worker’s compensation claim is significantly more complex than ordering a car to the airport, the individual aspects of the claim should be fairly straightforward — filing the initial claim, understanding the status of payment — so companies like Uber and Airbnb are setting the bar for what those experiences should be with end-users,” said Scott.

A 2020 report gives new weight to the conversation with 80% of customers expecting companies to accelerate digital initiatives due to COVID-19.

Solutions in a Digital Era

Chris Bennett, President - Core Solutions at Origami Risk, who served as co-presenter, walked us through what the journey through the claims lifecycle should look like in an efficient system leveraging digital engagement.

Intake

Modern digital tools aid in collecting information related to a claim as quickly and seamlessly as possible, from employer and employee to nurse case manager and treating physician. “We’re giving them tools to let them quickly and efficiently walk through what happened,” said Chris,” so we can start to make a determination and take action as quickly as possible.” With this, we look at what an efficient intake could look like:

• A risk manager or injured worker files a claim via web or mobile portal
• The case is auto-assigned to the adjuster with the correct experience and expertise to service the claim on the backend, which shows up on the adjuster’s dashboard
• Through modern channels of communication, notification is sent to the injured worker via text or email confirming their claim is received and being handled
• Mobile access is given to the claimant to check progress, updates, and more at their leisure

“We want to reduce employee anxiety and make them feel like we are hearing them and taking care of them,” said Chris. 

Adjudication

Through digital communication channels, the adjuster can establish their 3-points of contact to get pertinent information back-and-forth in a mode that best suits each party, which could look like a text to the worker, auto-generated email to the supervisor, and an online portal for the physician to enter documents and more.

With an auto-generated email to the supervisor, for example, the adjuster can feed further details around the incident directly back into the system without asking the supervisor to fill out a secondary form or then have to manually enter a mailed, faxed, or scanned document back into the system.

Payment

“Injured employees want to be aware of when they’ll be receiving payment and feel that they’re being kept informed of what will happen when,” said Chris. Digital engagement allows the worker to receive notification via text and/or email and access a portal to see when payments are scheduled, their status, and more. With proper digital communication, “injured employees feel like they’re being appropriately compensated and taken care of financially,” without the hassle of phone tag.

Insights & Analytics

When digital channels are leveraged throughout the claims lifecycle through a centralized system, there’s a lot that can be done with the information that’s been collected:

• Data becomes immediately available for analysis and reporting
• The system becomes architected for predictive analytic insights to make real-time call outs to third-party systems
• Alerts can be automated based on individual and aggregated claims based on rules
• Persona-specific dashboards can be curated for actionable insights with the ability to drill down to specific claims

Results

When leveraged from a centralized system, digital engagement creates stakeholder satisfaction, both internal and external, across the claim lifecycle. More so, organizations stand to streamline and standardize processes, raising the bar so your organization can provide consistent excellent claims adjudication seamlessly. From that, operational costs are reduced and focus can be given to developing and maintaining new efficient processes to further stakeholder satisfaction.

To learn more about how Origami’s Claims Administration Solution Suite can help your organization to improve its operational efficiencies and leverage digital engagement across the claims lifecycle, start a conversation with us. To watch the webinar in full, click here.