A claim remains the ultimate moment of truth for insurance companies. If handled poorly, it leads to customer churn, reputation and profit loss.

It is therefore no surprise that insurance companies have put the optimisation of the claims process high on the agenda for the years to come. While the entire claims value chain deserves attention, there are a few low hanging fruits and domains that deserve a strategic focus in the oncoming years.

The low hanging fruits

Chatbots have proven their capabilities in the claims process. They seem to be particularly interesting in the FNOL stage, where they can guide the customer through the registration steps in an intuitive way. 

The main advantage chatbots provide is that they make sure to collect all necessary data. In doing so, chatbots are replacing a huge manual workload compared to the traditional process where insurers need to deal with retrieving missing values manually.

As chatbots can be implemented with relative ease and short-time-to-market, they are the ultimate low hanging fruit in the insurer’s journey to smooth claims handling.

The human touch

One of the most important challenges insurers face when implementing chatbots is the loss of human touch, which can lead to frustration for customers. 

The most obvious remedy is to foresee real-time connections to human help – preferably the known and trusted insurance advisor/broker. It is therefore imperative to incorporate the chatbot in customer facing apps and portals as well as broker portals.

Connected world: improving prevention, claims assistance and claims handling

From smartphones, to smart homes, from private cars to industrial machines – everything is connected. Insurers can benefit from this evolution, as these devices can trigger alerts to prevent a claim from happening (e.g. time to change car breaks, time for maintenance of gas boiler). 

When a claim does occur, a warning can be triggered(e.g. immediate call for assistance after a car breakdown or sending an ambulance after fall detection of an elderly patient). Insurance companies are in a natural position to play the role of facilitator for risk prevention and claims assistance. In doing so, insurers will claim an increasingly more important position in ecosystems such as mobility, health and home.

Leverage Real time info & data

Furthermore, devices that are foreseen from sensors and connected to the internet provide a source of real time info and a goldmine of data. While traditionally, insurers struggle with data quality and data that is dispersed over sets of legacy systems, this provides a real opportunity to gain improved insights in claims. As such, real time data can indicate the right domains for prevention (e.g. data about frequency and location can help define dangerous intersections) 

The challenge with collecting huge data sets is that they become difficult to maintain manually. This however, is where Artificial Intelligence comes in handy. 

In the insurance claims domain, Machine learning and Artificial Intelligence have proven their worth for fraud detection. The advantages of AI based fraud detection systems include less false alarms, which will significantly decrease the time and increase the precision for claims handlers. Ultimately this leads to lower operating costs, fewer errors and greater productivity for claim handlers.

Omnichannel leads the way for effective claims handling

When it comes to data and information, sharing is key. Only by making sure the right people are informed at the right time, the claim can be handled in an effective way.

Imagine a customer filing a claim, but his trusted broker is not notified? Or worse, the broker does not have access to the necessary details to help with the case? Imagine a customer having to call the assistance company, having to file the claim to the insurer, only to have to inform his trusted broker all over again? 

Foreseeing omnichannel claims processes makes sure that all info is shared to the right people at the right time. The most efficient way to do this, is to connect the main actors on one omnichannel platform – this avoids having to rethink all processes each time a small change is made – as customer, intermediary (broker/agent), claims handler/expert, assistance company and insurance company are already connected and have access to all necessary data to handle the claim. 

In doing so, the main actors are empowered to handle the claim and customers will appreciate the human touch when dealing with their claim.

Getting the basics right

Omnichannel platforms, chatbots and AI based solutions can easily be plugged in to the insurer’s IT landscape. By overlapping or replacing a set of legacy functionalities, they can be a quick win and way to achieve results. However, on the long term it pays off to get the basics right by implementing one (modular) tool that covers the claim value chain management from registration to verification, calculation and decision making as well as settlements.


When building the claims transformation roadmap, there are a few obvious low hanging fruits. Artificial Intelligence, machine learning and chatbots open the door to automation, efficiency and cost reduction. 

Nevertheless, striking the right balance between automation and the human touch is crucial, or insurers risk to alienate their customers, employees and distribution network. Connecting the main actors in the claims value chain on one omnichannel platform remains the easiest way to safeguard the human touch, while ensuring an efficient claims handling.

Author: Wim Van Wilderode, Business Development Manager

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