Customer-centricity and reduced risk with pre-emptive claims

Published: May 29, 2018

At Virtusa, we identify ourselves as engineers. Our entry into the consulting and integrations market was by the split streaming acceleration of our work as engineers for various software vendors. Today, we implement transformations, and our promise is to "accelerate business outcomes". How does an engineering outfit deliver on this promise to accelerate business outcomes? Clinical delivery excellence, certainly. But also, our engineering DNA helps us prefabricate solutions. When Virtusa accelerates business outcomes, our delivery is not a $500K binder, it is a hardened usable asset.

Through our digital innovation hubs,  xLabs, and strategic initiatives teams, strategic business units, and practices, Virtusa has amassed a warehouse of assets, the size of an Amazon Distribution Center. These assets consist of anything from APIs, pre-educated predictive models, cognitive capabilities, AI, gadgetry, etc., all the way to fully baked hardened and deployable solutions.

An engineer's attitude is 'give me a problem, and by God I will solve it'. Here is the problem that has percolated to the surface of the P&C Insurance industry. Apathy. Specifically, claims apathy. The attitude towards claims is 'just don't blow'. Follow the procedures through adjudication and payment, and try not to irritate the policy holder in the process. We commoditize our claims response and apply little innovation to this area because we see it as a drag on our bottom line. Yet, we continue to claim that out focus is no longer policy-centric but customer-centric.

With a little creativity and the assets laying around in Virtusa's garage, we can change the game for claims.

Let's frame a use case, and let's go right to where we hurt the most. In 2017, the United States weathered $360 billion in disasters. Hurricane Harvey alone cost $198 billion. Some of these disasters are preceded by a period of imminence, others surprise us. If we have forewarning, we have a mad scramble of contractors and home owners preparing for the storm, maybe 72 hours prior to landfall. As insurers, we'll track which policy holders will be impacted, and we'll reach out providing tips and tricks to prepare for the storm and wish good luck in a blast email.

After the storm hits, the circus is in town. Homeowners have downed trees and holes in their roofs. They are disoriented and feel on the verge of ruin. Insurance carriers begin their process with the first notice of loss (FNOL) provided by the policy holder. There are too many of these claims to use captive adjusters, so we're forced to rely on response teams of independent adjusters that flock in from another state. There is so much work to be done that we are unable to pay attention to the experience levels, qualifications, and trustworthiness or track record of these adjusters. So, homeowners wait days/weeks for adjusters to turn up and assess the damage for a reasonable value to place on the claim (by the way, they still have a hole in their roof and a tree on their car). Then, the next wave of shortage and confusion. Now we need contractors. They too flock in from other states, and it's on the policy holder to pick the right contractor and wait in line for weeks before it is their turn. By the way, there is still a hole in the roof.

Our policy holders dread and fear storms like this, and in many regions in the United States, it happens every single year. In other regions, it is the Nor'easter that we dread, or the wildfires, mudslides, or sink holes, or drought. We can serve these policy holders better. We can make the claims experience a differentiating one. In the process, we gain a little more control over our own risk.

So what? That's life in the big city, right? Let's step into Virtusa's garage and see what we have lying around. I see mobile capabilities built for the logistics industry. Also, originally built for logistics, I can see I already have an integration with NOAA to track weather events. Of course, with all of the claims work Virtusa has done, I have vClaim, a complete prefabricated and battle-hardened claims solution. And then I come to something we built called the Strategic Resource Calculator (SRC). There is a lot of movement in Virtusa, and our product is engineers. We need to have the right engineer, at the right client, with the right skills, with the right track record, at the right time. Using predictive/adaptive decision automation, we know just the right engineer for the job. By the way, all these things I've found in the garage are built on the Pega7 platform.

Does any of this apply to our disaster claims word problem? Because all of these elements are on the Pega 7 platform and are built for change, we're altering and integrating the parts we found in the garage for the solution. We're starting a case based on NOAA feeds that is pre-emptive to FNOL. We're the concierge for our policy holders, deploying preparation contractors that we trust in an orderly fashion prior to the strike of a disaster. Since the case has been established, every interaction, every step taken in preparation, and even the sentiment of the policy holder is memorialized to influence claims handling.

If our policy holder navigates the storm without loss, our claims stub is resolved through service levels. If loss is sustained, we capture FNOL from the policy holder through omni-channel (mobile, desktop, call center, chatbot, etc.) and immediately mobilize a workforce of adjusters and contractors to respond with AI automation. All of these things extend the case that began prior to the event and tell the whole story, orchestrating the customer experience.

With the pre-emptive claims solution Virtusa is assembling on the Pega 7 platform, insurers can comfort and delight their policy holders in times of terrible doubt. Insurers can also obtain the ironclad assurance that preparatory measures were taken to reduce risk. And, finally, we can reward our policy holders for their preparedness by accelerating an organized workforce. A policy holder that might have had a hole in their roof for weeks, would now have a hole in their roof for only a few days with this accelerated claims process.

Insurance cloud solutions

Accelerate time-to-market and achieve true customer-centricity

Related content