As insurance companies grow, so too does the amount of claims they receive. Ultimately, this is a positive thing: more claims doesn’t necessarily indicate that more people are becoming sick or getting injured, but that increasing numbers are taking the time to assess their insurance needs, take out cover appropriate to their situation, and become better informed about what they might be eligible to claim for.

In an effort to ensure we’d be strongly positioned to meet the growing demands of our customers and their needs, AIA Australia has commissioned several reports in recent years assessing the customer experience and proposing measures to improve processes. Unsurprisingly, these reports have consistently shown that customers value and expect speed and transparency in a claims process[1]. At times when customers are experiencing significant life pressures, demonstrations of efficiency and visibility can therefore count for a lot, helping the customer to build confidence and regain feelings of stability.

Achieving greater claims efficiency with Assessor Assist

It was with precisely these goals in mind that AIA Australia launched Assessor Assist in February 2019. An automated Artificial Intelligence (AI) system, Assessor Assist draws on comparative claims data to help speed up and streamline the claims process, comparing newly submitted claims against a bank of 60,000 historic claims. After detecting and compiling the outcomes from similar claims, the program then formulates predictions on the likelihood of the claim in question being paid out, the length of time it will take for a decision to be made on it, and even a confidence score of its prediction.

Benefits of the Assessor Assist program extend to both AIA Australia’s Assessors and customers. Assessors gain an extra resource to check their own assessments against and measure their turnaround times to, freeing them up to pursue higher quality levels of communication with the customer. This in turn encourages more holistic assessments and faster decision-making on claims, creating greater opportunities for the customer to access occupational rehabilitation support and begin their return-to-work and wellbeing journeys sooner.

The resulting assessor-customer interaction is one that allows a better informed and more meaningful experience all round. For AIA Australia, the initiative amounts to one more way we’re trying to make a difference in people’s lives.

The score so far

For the moment, Assessor Assist has only been rolled out as a trial program to a select team of AIA Australia Assessors. It is, however, compatible with all funds, and AIA Australia is currently exploring opportunities to integrate the technology into the overall claims process. Since the program’s introduction, Assessor Assist has developed predictions on 1,871 Income Protection claims, with finalised claim assessment outcomes being reached on 889. Of these 889 claim decisions, only one has resulted in an outcome that was different to that of the prediction.

Needless to say, the process of reaching an outcome on claims is never something that should be rushed, skimped on, or delegated solely to AI. Any decisions that have the potential to significantly affect the security of people facing difficult times should always be arrived at via assessments that are thorough and comprehensive, tailored to the customer as an individual and sensitive to their situation. However, nor can it be denied that quick turnaround times on claims can save customers considerable stress and uncertainty. Utilising technology to expedite the decision-making process not only means customers may be able to receive financial support earlier, but that they could begin their journey back to wellbeing or work sooner – a win for everyone.

 

Copyright © 2019 AIA Australia Limited (ABN 79 004 837 861 AFSL 230043).This is general information only, without taking into account factors like the objectives, financial situation, needs or personal circumstances of any individual and is not intended to be financial, legal, tax, medical, nutritional, health, fitness or other advice. Before making a decision to acquire or continue to hold any product, individuals should consider the appropriateness of the information, having regard to these factors, and after viewing the PDS and any relevant product information and terms and conditions available at www.aia.com.au

[1] Forrester Consulting, Customer Centric Claims Assessment Final Report, 11 May 2018.

      Beddoes Institute, The Life Insurance Industry Performance Barometer. The Claimant Journey Study, November 2016.

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