Sedgwick | The digital revolution: how technology is transforming claims

May 12 2023

Technology has revolutionised industries from banking to ecommerce, allowing consumers to frictionlessly transact with service providers. The insurance industry has yet to fully embrace technology but is working to close this gap.

As a data analyst at Sedgwick, I’ve seen the powerful benefits that digital claims platforms can offer brokers, insurers, and policyholders, and the challenges of driving technological change.

 

The analogue process

To understand these benefits, we must first understand the inefficiencies of the current system.

Imagine a property claim from an earthquake. The policyholder has to locate their policy information and email their insurer to describe the issue and attach supporting photos or documents. The insurer reviews the email and lengthy correspondence with the claimant will often ensue.

Subsequently, the insurer appoints a loss adjuster, who will separately liaise with the policyholder to arrange a visit, assess the damage and collect details. Meanwhile, each party will be in the dark over the status of the claim, leading to stress and time wasted on admin and correspondence. Updates are often provided via formal reports which may take weeks to develop.

This is a rough example, but the implication is clear. Manual claims handling involves significant admin, time lags, and stress – particularly for claimants. And when each party can have several claims in progress at once, these problems are multiplied.

 

The benefits of claims technology

Transparency and speed

At Sedgwick we have seen how applying technology can improve customer experience through greater transparency in the claims journey. This begins with Smart.ly, an intelligent platform that allows claimants to easily notify claims online using custom-built forms.

Once submitted, all relevant parties are notified simultaneously, allowing brokers, insurers, and loss adjusters to quickly identify critical paths for resolving the claim.

In situations where a physical site visit is not necessary or possible within a critical timeframe, our Clarity Connect system can establish a link to the claimant’s camera-enabled mobile device and receive a video feed, while we direct the claimant where to navigate around the site. Using Clarity Connect, relevant stakeholders and specialists can also join this virtual survey to review and assess the extent of damage in real-time.

Consolidation and efficiency

For brokers and insurers, simply having visibility of the status of all active claims can be a challenge.

When each claim is siloed in fragmented email chains, an up-to-date overview is time-consuming to assemble, and may contain inaccuracies.

That’s where ViaOne, Sedgwick’s configurable web portal for clients comes in. It allows insurers, corporates, and brokers to view details and real-time updates of their claims portfolio. Users can correspond with our adjusters using ViaOne, and also contribute to the claim file by adding notes and documents.

Claimants that are small businesses, individuals, or even third-party claimants, can be given access to mySedgwick, a web portal that allows them to track the progress of their claim and add notes or supporting documents.

Insights and data

Consolidating claims data into structured data sets allows insurers and brokers to extract valuable insights with much less effort and time lag, and with fewer inaccuracies compared to compiling data manually. Integrated platforms can automatically generate insights, allowing insurers to spot trends early, flag potentially fraudulent patterns, and identify inefficiencies.

By collecting data at all levels of the claims journey, data which was previously ‘invisible’ can also be understood. For example, in the past, claims that fall below the excess were often not logged, as claimants don’t proceed with the claim. But through integration with Smart.ly, even losses which are not progressed will be logged, allowing insurers to build better risk profiles.

 

Considerations and challenges 

Flexibility

As a large, longstanding industry, processes and technologies vary significantly across the insurance universe. Different companies, regions, and types of insurance have unique characteristics, so digital solutions cannot be one-size-fits-all. Adopting a flexible, API-based approach is therefore key when designing digital platforms.

We’ve seen the benefits this approach can have for our clients, enabling us to adapt our solutions to their needs without disruptions to their existing infrastructure.

In Singapore, a company using our Smart.ly system to submit claim notifications later implemented an incident management system for their internal use. To avoid double-entry of information, we were able to integrate their system with ours. Now, when they register an incident in their system, the same data is automatically transmitted to Smart.ly and a claim notification is submitted.

Similarly, in Malaysia, we collaborated with a major carrier to develop APIs that allowed them to integrate their claims management system with ours. This allowed details related to domestic home insurance claims to be automatically synchronised across both systems — ensuring that updates made by the carrier in their system, such as policy details, will automatically be reflected in ours.

Conversely, our updates, such as changes to reserves, are immediately reflected on their side.

Regulation, standardisation, privacy

Ensuring compliance with national privacy and data collection regulation is vital. The Asian regulatory landscape can be fragmented, obliging service providers to take special care when implementing solutions that involve moving data across borders. Through our due diligence framework involving technical, legal, data governance and information security expertise, we have successfully implemented such solutions, and are well positioned to negotiate the evolving regulatory environment.

Moving forward, the adoption of international standards for insurance data exchange will be key to realising the full potential of digital insurance platforms. Common standards will accelerate integration between stakeholders and service providers, in addition to fostering a robust environment where ecosystems can form and align themselves quickly to respond to market demand.

Data-centric culture

Technological change must be accompanied by cultural change. Integration is step one, but adoption requires buy-in and education across the business. The larger and more established a company is, the harder this can be. At Sedgwick, we have made cultivating a ‘data-centric’ culture a central priority.

This means ensuring that all employees not only know how to use technology, but why it is important.

Understanding the benefits to the business, and the time they will personally save makes it much easier to let go of old ways of working. Ensuring employees feel empowered to raise concerns and questions is important, and monitoring of problem areas allows resources and attention to go towards upskilling areas that need it.

Looking forward

Digital claims platforms may still be nascent, but we only need to look at industries further ahead on the digitisation journey to know that the pace of change will be rapid. As they mature, the integration of automation and AI will further optimise admin-heavy areas of claims processing, create efficiencies, and generate valuable insights.

Elsewhere, trends like embedded insurance will augment these capabilities, building more powerful datasets that allow for better benchmarking and risk management.

It’s an exciting time to be working on the forefront of the digital revolution in claims, but it’s important to remember that technology will not replace the human element but augment it.

Automating administrative tasks will free up time for claims professionals to work on the high-level, interpersonal tasks which remain paramount when dealing with a loss.

Irwin Wei
Data Analyst, Asia

Email: [email protected]
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