Smarter Insurance Claims Processing with Microsoft Power Platform

Insurance claims processing is a moment of truth which neither the customer nor the insurer wants to occur. But in reality, when it happens, insurers need to ensure a seamless experience for their customers. Also, efficiency, accuracy, and fraud detection are crucial for insurers to avoid bad claims experiences. The processing of insurance claims in the digital age is also becoming increasingly complex, with more data and decision points playing a pivotal role for quicker processing timelines.

When a customer claims for the insurance, it is a vital touchpoint where insurers can handle the process effectively to turn the customer into a lifelong trusted business advocate. Though it looks like a transactional relationship, mastering the moment with customer expectations and technology adoption can boost loyalty. Will process automation, artificial intelligence, data and insight ensure a seamless insurance claims handling experience? In general, claims processing involves many data handling, repetitive processes, and humongous rules validation. Insurers can deliver the best experience with the right mix of insurance claims process automation and empathetic human touch wherever possible, says experts’ from EY.

Let me walk you through the key pointers for strategic direction in digitizing insurance claims processing:

Insurance claims process automation is not about costs but the centerpiece for trusted customer relationships

Most insurers initially opined that claims process automation could help them reduce costs. But automation is all about reducing processing times and increasing the transparency of processes for the customer. If you ask the customer to fill the forms online or through mobile, it gives them their preferred mode of communication with the insurer. It also doesn’t mean that you automate everything; lack of empathy can be catastrophic for insurers.

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Ensure experience that customers prefer

Unlike a few other industries, insurers need to serve millennials and the older population alike. They should be able to communicate through their preferred channels. A conversational chatbot might cater to millennials but may not ensure the same experience for the older population. And again, it is not suitable to be so generic about millennials and other demographics. Insurers must serve their clients through many channels to enable optimal experience and emotional connection.

Intelligent insurance claims processing covers automation, data, artificial intelligence, and an easily deployable application

Re-imagining and reinventing processes starts with analyzing underlying data. Understanding the customer journey in claims process is essential for creating a great experience, and basic customer touchpoint information is also important for streamlining processes. Evolving technologies like AI and No-code can help in creating ease and visibility through the systems.

Modernizing insurance claims processing is not about leveraging one aspect of the technology, but a holistic solution like Microsoft Power Platform can transform every stage of claims processing.

Microsoft Power Platform for Insurance – At a glance

Microsoft Power Platform has evolved from many banking requirements to cater to the needs of insurers like object detection, NLP, fraud detection, customer segmentation, and 360-degree analysis. The inclusions like AI Builder, Azure ML, and Common Data Model enable insurers to scale rapidly alongside swift decision-making capabilities and intelligent automation. The platform offers a holistic approach to analyze, act, automate and communicate the processes and interactions in the insurance ecosystem. Let me share a few more details about the individual solutions in the Microsoft Power Platform.

• Power Apps – Insurers need a lot of customer information, be it selling a new policy, claims processing, grievances, or underwriting. Leveraging the no-code approach and portals in Power Apps, all these applications can be created in no time.
• Power BI – Dataflows and preparation for AI models alongside interesting visualizations about business performance, sales, operations, claims, fraud, and underwriting.
• Power Automate – Analyzing the data does not reduce any processing timelines; repetitive processes, once created easily through a no-code simple drag and drop functionality, can ease the burden of all the stakeholders in no time.
• Power Virtual Agents – Customers, always need assistance for their information queries related to the policies, premiums, expiry dates, renewals, and claims. If the conversations are entirely powered by technology, insurers will lose emotional connection with their customers during traumatic events. AI-powered conversational chatbots can reduce the burden of the insurance support teams by addressing such requests.

Why Microsoft Power Platform for Insurance Claims Processing?

The Power Platform to easily integrate with other solutions in Microsoft stack to enable a holistic experience, drive insights faster and bring in more efficiencies. Using the Power Platform, any user can build powerful insurance applications to solve their complex challenges and analyze data for greater visibility and automation workflows to improve productivity without any technical understanding. As we discuss insurance claims processing, let us also relate the use cases to the Power Platform:

1. Power Apps – Insurance claims processing involves a lot of data collection through online and offline forms. This data must be fed without errors to the suitable validation tools to improve the processing times. Insurers can leverage Power Apps and portals to design such forms in no time. Most customers now prefer to raise their claims online or through mobile apps. With Power Apps, you can provide apps to answer any required claims questions and capture evidence in images, PDFs, or any document format. The object detection feature in the Power Platform aid in converting unstructured data from images and PDFs to structured format for further analysis.
2. Power BI – Data without insights does not add value to any process. As insurers process large amounts of data for each policy and function, it is difficult to get detailed information in a unified structure. With DAX and Power Query functionalities in Power BI, it is easy to retrieve the right information in no time. AI & ML capabilities are now easily integrated with pre-built models in Power BI. Talking about the claims process, visibility into the details of the process is key. Self-service dashboards in Power BI can be leveraged to understand claims status, general processing times, and customer feedback. It is a daunting task for insurers to analyze fraudulent claims; pre-built AI models in the Power Platform are very effective in identifying such transactions.
3. Power Automate – Enabled by low-code and multiple connectors, Power Automate can help you automate workflows without developer support. Microsoft Power Platform reduces costs and implementation timelines to improve business-critical processes. Once the customer information is captured using Power Apps, many validations need to be performed on the data. Several actions, alerts, reviews, accept, decline, and validation rules are to be completed in no time with workflow automation set up by Power Automate. Claims processing timelines seem to depend on the information capture, processing and validation. Power Apps and Power Automate may prove to be a comprehensive solution to improve processing time.
4. Power Virtual Agents – Insurers witness a large influx of customer calls when there is a trauma in the community. Such scenarios may not be the most common, but the volume of claims is usually high. Usually, the call centers are flooded with requests in such circumstances, and the wait times are long, impacting the customer experience. If an AI-powered chatbot can filter out the informational requests and assess the pre-set conditions for the claim, the experience does not alter. You may not worry about the human touch, too, as insurance support teams deal with the latter part of the conversations. This is just a one-off scenario, but chatbots can power the conversations with customers to improve satisfaction and experience.

Do you still have questions about improving your claims processing timelines? Our experts’ can walk you through a detailed plan. Get in touch with our team for more insights.