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Reimagine the Claims Experience with Enhanced Capabilities & Vendor Optimization

Darin Campana

Senior Manager, Insurance Business Consulting, EPAM
Blog
  • Healthcare
  • Financial Services
  • Insurance

Emerging from the global pandemic, we have seen insurers prioritize digital capabilities across the claim lifecycle driven, in part, by the remote work environment as well as the need to enable operational excellence and meet the changing expectations of their customers — all while ensuring profitability.

The key to enabling these prioritized digital capabilities is the use of quality claims vendors who support insurers delivering on the insurance promise. Vendors like autobody shops, law firms and third-party administrators, for example, enable insurers to provide seamless claim services to policyholders.

While the development and use of a robust network of claim vendors is not new for insurers, leading carriers are enabling digital capabilities that support straight-through and low-touch claim experiences and using data to optimize their vast claim vendor networks.

Key Business Challenges Insurers Face Today

As the claims process continues to evolve and transform into 2022, vendor selection and optimization can address traditional business challenges in the following ways:

Enabling operational excellence: Today, insurers driven by stagnant and/or increasing expense ratios are using data to automate the selection of the most appropriate vendor, based on business rules and claim data attributes, while more complex vendor selection involves presenting adjusters with vendor choice. The goal here is to optimize claim expenses and increase customer satisfaction.

Driving quality claim outcomes: Industry-leading insurers are enabling the inclusion of claim historic data with a constantly refined analytics approach to improve claim assignment, vendor selection and drive for quality claim outcomes based on data decisioning.

Modernizing platforms: Advanced integrations are needed to provide engaging digital front ends, analytics and implementation of modern DevOps processes, which unlock the full potential of modern insurance platforms with seamless claims experiences, leading to an improved customer satisfaction.

A Closer Look into the Direct Repair & Referral Program (DRP)

Let’s examine how one of these partner networks, the direct repair and referral program (DRP), is used in automobile claims to overcome business challenges.

In many states, insurance companies and autobody shops can enter business relationships with one another for the purpose of repairing vehicles damaged in accidents. The concept began in the late 1970s and has become more widespread today. Technology has enabled capabilities for autobody shops, car rental companies and insurers to connect and communicate seamlessly online.

The DRP program allows an insurance company to refer and offer choices to one or more conveniently located DRP shops in the insured’s area. DRP shops are carefully vetted by the insurer, which often requires DRP shops to meet repair quality standards related to equipment, training, service and pricing. These shops must connect to insurer core systems and rental car providers to extend claim services and communicate during the claim lifecycle. Many DRP shops have lean operations, which ultimately improves profits that are measured and incentivized based on customer satisfaction.

Benefits to the customer include online scheduling of estimate for repairs, a first notice of loss, the ability to capture and upload vehicle damage photos using one’s mobile phone, coordination with rental car providers who manage rental for the insurer, vehicle repair date, vehicle washing, constant customer communication throughout the repair process, via text, email or call determined by the insured and direct payment capabilities. These benefits, along with a lifetime guarantee on the workmanship, provide a compelling proposition to even most discerning customers. Ultimately, the choice of a repair facility is up to the vehicle owner. For insurers, enablement of a DRP program along with integrated digital capabilities support customer self-service, enable straight-through and low-touch claim experiences and drives increased customer satisfaction while managing the claim expense.

Digital Capabilities with DRP

Enabling Digital Capabilities: Why Third-Party Vendors Make a Difference

The priority to enable digital capabilities has arrived. For the insurer, determining how best to address the growing needs and expectations of today’s customer, improving the customer experience, enabling operational excellence and driving quality claim outcomes is paramount. The key to achieving these priorities is partnering with third-party vendors across the claims lifecycle and optimizing the vast network through a smart, data-driven approach to vendor decisioning across the claims process.

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