Over the course of this series, we’ve discussed how claims analytics—data, predictive models and machine learning—can help insurers retool the claims process. However, insurers need an appropriate culture and environment to unleash the full value of these insights.

Fostering a claims analytics environment

There are three levels of claims analytics maturity. Which one best describes your organization?

  • Level 1: You use claims analytics to identify potential fraud and subrogation opportunities. Today, these applications of claims analytics are table stakes—necessary for survival, and no longer an enabler of competitive differentiation.
  • Level 2: You use predictive models for advanced assignment logic, such as predictive modeling to route claims for best customer satisfaction, or to advise adjusters on next-best actions. Insurers at this level should consider how they will build on these predictive models in traditional spaces, and apply them to capitalize on new and emerging opportunities.
  • Level 3: You use predictive models extensively throughout the claims function and leverage data from internal and external sources. You are beginning to use data from the Internet of Things and have plans to increase that usage as more becomes available. Insurers at this level should consider how to get ahead of the curve by thinking about how machine intelligence can enhance their capabilities.

Some keys to success include:

  • Fostering a culture of continuous iteration and improvement, and openness to innovation.
  • Having the proper tools, teams and governance structures to focus on finding new insights.
  • Dedicating a team with accountability for gathering improvement requests and empowering them with the means and systems to react to them effectively.
  • Investing in the claims function to find new insights, not to satisfy traditional KPIs.
  • Bridging business and IT functions, so that insights can be leveraged in workflows and processes in both functions.

I hope you’ve enjoyed this series on how predictive analytics can help insurers reimagine the claims process. If you have any questions, please email me. I’d be happy to discuss how Accenture can help your organization better leverage data and analytics in your claims function.

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