The Intersection of People, Customers, and Technology

in the Claims ProcessDaniel Hughes, Enterprise Solutions Manager, Kodak Alaris

30% …of insurance customers worldwide rated their experience as positive

…is spent on fraudulent claims annually $30 billion

1 in 3 …cited poor claims handling as a major factor in their decisions to switch insurer

Are These Your Challenges?

Business Growth

Workforce TalentProblem

Reduce Fraud

Engaging with 

Customer Base

StreamlinedOperations

New and Developing Media for Customer Engagement

Social Transparency – Words Travel Fast

The problem was resolved quickly 69%I had to explain my problem to multiple 

people72%

The person who helped me was nice 65% The person I dealt with was unpleasant 67%

The problem was resolved in one interaction ‐ no passing around to 

multiple people63% My problem took too long to resolve 65%

The outcome was what I was originally hoping for when I contacted customer 

service47% The problem was not resolved 51%

Good Customer Service Interactions(n=1,004)

Bad Customer Service Interactions(n=565)

*Any company that was not large, well‐known or a small local or online company

Source: Dimensional Research, “Customer Service and Business Results: A Survey of Customer Service from Mid‐Size Companies” sponsored by Zendesk, April 15, 2013.

Customer Interactions – the Challenge

Source: Converseon, 2012

• Social media input arrives 24/7 • Most organizations are at the beginning of the maturity curve

Handle All Input Dimensions

Format

Source

Structure

Fax ServerScannerFile System

Mail Server

Image Paper PDF Email

Unstructured

Semi‐structured

Structured

Self Learning Expert ForumContent Repository

Across System BoundariesAny Content      Documents

Free Text SearchIntranet   Any SourceNo Administration VersioningDynamic Q&A Scripting

Workforce Talent Management

Data

www

Semantic Understanding Extracts Real Meaning

Graphically

Linguistically

Rule Based

Contains “Claim”

Streamlined Operations

• About 75 % optimization potential for extraction

• Current methods of data recognition and processing are inadequate

• About 80 % optimization potential for classification

• Existing automation approaches only apply to structured documents

Optimization Potential

Scan, Fax, Emails,  

eDocs, SMS, Social Media

Recognize Classify Extract ValidateExport Process Route

Correct / Incorrect?

Advanced Document Classification

Techniques• Symbolic (barcode)

• Document analytics • Graphic‐based• Text‐based

• Statistical methods

• Semantic understanding

LOWLOW

HIGHHIGH

PropertyClaim

PropertyUnderwriting

Customer correspondence

Car claim

Fraud Detection and Prevention

Advanced data mining Mobile Devices

Segment RiskPredictive Modeling

Pattern Spotting Self Learning 

Hard FraudCross Provider

Security Mechanism

Artificial Intelligence Opens New Opportunities

UNDERSTAND PROCESS KNOW

? i!

The Intersection of People, Customers, and Technology in the Claims Process

Presents significant opportunities for insurance carriers to secure their future

Engaging and communicating with customer base: Support policy holder communication preferences and fully integrate all communication channels including social media

Workforce talent management: Leverages the expertise of most experienced agents and offer a comprehensive, self learning knowledge base to new staff

Streamline d Operations:  Reduce manual steps and silos into end‐to‐end claims process automation 

Fraud prevention: Focused data mining and analytics

Business growth: Reduce cost and create additional revenue

Do you want to discuss further? 

See you at booth 110 in the exhibition hall

Contact me at daniel.hughes@kodakalaris.com