Health Insurance Claims

Yuvraj M
Sep 2, 2017
2 min read

Market research points that among all businesses, Insurance remains as one of the least trusted by customers. Within Insurance, Health Insurance seems to be regularly towards the bottom of these lists. Why should it be so?

Reasons could be any of the following, or more:

Agents or Brokers sold the insurance policy with little regard to the need of the client or worse, only with their commission/ incentive as the drive.
The insurance product is "too complex" and with so much left unsaid between the sales brochure and the legal policy document, the customer had no clarity of what they bought.
Perceived, if not entirely accurate, view that insurance companies do not want to pay out claims as it hurts their profits.

I look at the third reason in this list today. Having worked for so long in the industry, the first categorical opinion - this is not a reflection of the vision of any company I have worked with.

Assuming this is the case, there must therefore be another reason, something between the vision and the practice of our industry. There are many actions the industry must undertake if we have the slightest intent to improve our customer's trust. Here I focus only on the areas around Claims Service I have consistently seen to help.

Information (clear and timely): Focus on tools and methods, digital or otherwise, to explain what is covered and what is not - encourage customers to ask for details. This should be done throughout the policy duration, starting as early as the sale.
Remember, customers don't need health insurance.. they need to keep in or get back to good health: This means that any and all claims processes that require an action from the customer to initiate a payout/settlement are a burden they do not like. Integrate technology within the organisation to offer services such as cashless networks, automated data exchange, smart contracts, automated decision systems and payment connectivity.
Build organisation based on empathy: Customers rely on health insurance during very troubling time, make sure that your teams (from call centre executives to sales officers) are trained not just on the technical details but also with an understanding of the personal and social impact of the claim events.