Claims Processing Improvements – What’s left to do?

  • Bill Clausen

September 29, 2020

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The insurance industry is quickly realizing that today’s culture is driven more and more by instant gratification. In other parts of our consumer lifestyle, whether it’s talking to Alexa or Siri to immediately answer questions or perform a digital task, or having Amazon Prime or InstaCart deliver within hours instead of taking days to weeks to get your purchases, consumers are porting those expectations to their relationship with their insurance carrier, especially in their time of need, during a claim. Carriers have made significant financial commitments to improving the claims process, such as implementing AI initiatives and enabling claimant self-service capabilities starting with apps for FNOL. However, all of those efficiencies come to a screeching halt if, at the end of the process, the claimant still has to wait for a paper check in the mail.

Policyholders want their carriers to live up to their brand promise, and fulfill the trust placed in them, solidified by the premiums they pay. It is no longer reasonable to just handle their claim timely. Policyholders also expect the carrier to deliver the claim payment quickly. This is the true culmination of all the effort to improve efficiencies.

Both sides of the claim payment process – insurance carriers, as the payor, and the claimants, as the payees – have come to realize that the traditional method of transacting payments, via checks, feels as old-fashioned as having a rotary phone. Everyone in the ecosystem is recognizing valuable reasons to migrate off paper checks, such as:

  • Shortening the adjudication process

  • Reducing opportunities for errors and omissions

  • Limiting exposure to fraud during the printing, mailing, and depositing of checks

  • Reducing time and cost because it is inherently more efficient

  • Allowing payees to get access to usable funds quicker

  • Removing paper from the system

  • Reducing the need to track outstanding checks for unclaimed property

  • Providing a better client experience and improving client’s perception of the carrier

  • Increasing flexibility and scalability to offer more payment method choices to keep up with payee preference

According to SMA, over 80 percent of P&C insurers have plans and investments in digital outbound payments for 2020. The industry is past the early adopter stage of trying new payment options.

Guidewire makes it possible for carriers to easily enable an ever-growing portfolio of payment method options. Prelude Software, a Guidewire Solution partner since 2016, with its Guidewire ClaimCenter accelerator, offers both native payment capabilities and connections with best-of-breed, name-brand payment platforms via its PayPilot disbursement hub.

As a Guidewire Solution partner, Prelude Software’s clients have the benefit of leveraging our Ready for Guidewire accelerator to seamlessly enable ClaimCenter users to offer additional payment modalities right from the ClaimCenter UI. Prelude’s PayPilot disbursement hub makes it possible to enable a full range of payment modalities, such as MICR checks, eChecks, online deposits and PayPal.

These payment modalities can be provided via a payee portal, allowing payees to choose how they want to get paid. Prelude also provides the option of fully outsourcing payment processing.

Additionally, Prelude provides Guidewire clients with full support of attachments, such EOB’s (explanation of benefit) and EOP’s (explanation of payment), OFAC scanning, positive pay, reconciliation, and other ancillary processing.

To learn more about simplifying and elevating the claim payment process, check out Prelude’s solution available on the Guidewire Marketplace and download the Guidewire eBook Building an Ecosystem.