Differentiating between hype and reality


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It’s very easy to get caught up in the hype of the potential of digital technology. All day, every day we are surrounded by technology that makes tasks and services faster, easier and more often than not, just better.

Certainly, as an industry that’s an outcome we are all working towards. Claims, in particular, can be a very stressful time for our customers and we all want to create a better partnership with our customers that produces beneficial outcomes, in a quicker way and with greater ease or less “friction”.

But how do you differentiate hype from reality? How do you know if digital is the panacea that will help drive a significant part of this goal and, if so, where is it best utilised?


Our customer and member research is telling us that they want different ways to engage consistent with their experiences in adjacent industries. They want options and multi-channel outlets. They are asking if there’s a better way; can we move the insurance process from a traditional paper-based transactional approach to one that gives them other options including self-service?

Recently our CommInsure team ran a five-day workshop in CBA’s Innovation Lab with a variety of stakeholders, including customers, to design a claims solution that meets their needs. We wanted to ensure we weren’t designing processes that suited us but were designing processes that suited them.

What was our key insight?

Customers want to lodge claims online. Customers want to check the status of their claim online. However, customers still want access and someone to speak to.

They want options to self-serve up to a certain point, but also have that supplemented with the option to speak with a decision maker or a claims manager. It’s humans dealing with a human condition after all. Having digital capability, where you can lodge 24/7 for example, as well as face to face options that complement each other is critical.

That said, digital is a critical component of choice and we need to give customers choice across the spectrum, including tele-claims and tele-underwriting.

The digital investment to date has been mostly in the underwriting channel, the “front end”, and there is an opportunity to “catch up” in claims across the industry and complement this experience.

In claims, we know one of the challenges is the late lodgement of a claim, particularly with Income Protection products. There are many reasons for this (including that some customers are not aware they have cover for certain conditions). There is an avalanche of research that shows the longer you are off work the harder it is to get to back to work. We don’t want to be compounding that problem by not offering a multi-channel approach to lodging a claim.

Embracing digital capability will bring faster lodgement of claims allowing us to support the customer with return to work rehabilitation programs before the point where they have been off work for too long. Traditional processes don’t create an environment that necessarily supports this every time. Faster lodgement of a claim allows a case manager to connect with a customer quickly and start working on the type of support they need with their recovery.

We know from our dealings with customers that they are looking for more than just a payment. We can give them greater benefit in our support, care, expertise and access to wellness programs when claims are lodged earlier.

So, beyond self-service and online lodgement; what’s next?

The next frontier will include the creation of rules to allow more straight-forward or ‘typical’ claims to be “auto-adjudicated”. An example is a customer who submits a claim for Income Protection due to broken leg, a condition that has a typical recovery of around three months. Auto adjudication would not be suitable for a medical condition which requires years of recovery and rehabilitation. Customers with these types of claims are more likely to require the ongoing support of a case manager.

Once we get clear on what this risk threshold is, and is not, as well as how it is auto-adjudicated, the benefit we can provide applicable customers is a quicker claims experience and quicker return to wellness and work. For our case managers we can create efficiencies that give them more time to focus on customers who need ongoing support which could include more complex rehabilitation programs. 

Maximising digital capability is about giving customers the option to self-serve up to a certain point, supplemented with the option to speak to a decision maker or a claims manager. That intersection looks like the sweet spot where we can offer choice, efficiencies and, above all, the right care.


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Differentiating between hype and reality
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