Is It a Bot World? Can Digitized Claims Replace Human Touch?

Technology continues to evolve and many parts of our jobs are going digital. This includes solutions for third party administrators and claims managers. In this session at the 2020 CLM Workers’ Compensation and Retail, Restaurant & Hospitality Conference, panelists discussed the need for human contact with the claims professional and their skill for handling claims as well as generational differences in technology needs.

Speakers included:

• Jay Gates, Claims Advocate Senior at Arthur J. Gallagher & Co.
• Katie Hensley, Brokerage Claims & Safety Manager at Cottingham & Butler
• Patrick J. Sodoro, Managing Partner at Sodoro, Mooney, and Lenaghan
• Melissa Icban, Assistant Vice President Claims at Sedgwick

Artificial intelligence and other new technologies are being used throughout the life of a claim. There are advantages, challenges and best practices for all of these technologies. Automation of some processes can free up time for claims adjusters to spend on more complex or analytical tasks, but the benefits of preserving the human aspect of claims handling should not be ignored.

Claims Intake Process: When Robots Run Point

Chat bots and other automation technology can help streamline the intake process and make it more efficient. Automation can help speed up the process and eliminate human error. However, it does not allow for the human “gut instinct” and removes the opportunity to freeze statements and facts. Best practices require incorporation of human checks and balances. When more human touch is involved, there is a more complete story in the claims notes, which can be beneficial during litigation.

Decision Process: Accept or Deny

There are several steps in the claims process that require additional communication between human stakeholders and the decision to accept or deny a claim is one of those steps. It is important to have a full understanding of the exposures for the file. This means that claims professionals, defense attorneys and brokers should all be communicating in order to analyze the information available. Without this human aspect of communication and analysis, the complete picture will not be clear.

 Investigation

Best practices for investigation call for voice contact with the injured worker within 24 hours. Verbal conversations generally provide more detail than written communication. These conversations can make the injured employee feel taken care of and allows them to ask questions, reducing anxiety. This is not to say that technology has no place in the investigation process. For example, automated letters and packets sent to newly injured workers can provide information and help them navigate the process.

The Importance of Empathy

Human touch has always been a huge piece of claims handling. One of the most important roles of a claims professional is to help the injured worker navigate a complex process, outlining how that employee can move forward. Leaning on compassion and empathy while providing information and comfort is not something that can be replaced by technology. Advocacy cannot be replaced by a robot.

Communication Through the Process

We live in a digital world, but human interaction actually reduces the chances of a claim reaching litigation. Regular communication with the client as well as the injured worker is of paramount importance. Best practices suggest keeping the employer apprised with regular updates. Automated features can supplement this communication, including email and text communications to notify the client that there has been a change to the file. Communicating with the injured worker should also be consistent. Clear and timely communication is key, but it is more often the how you say something than what you are saying that makes the difference. Frequency of communications is not as important as quality and tone of the conversations.

It is also important to keep in mind that all people are different and may have different communication preferences. An employee who does not work in a sedentary environment, and is not accustomed to checking email every day, may prefer verbal communication. Giving the injured worker the option of verbal communication is important, but consistently providing a thoughtful and thorough pattern of communication is key. Technology and automation may very well revolutionize the process of claims handling, but the combination of technology and human touch offers the best of both worlds.