THE FUTURE
OF CLAIMS
THE FUTURE
OF CLAIMS

Delivering on the promise ofinsurance with empathy andefficiency

Intervening with Empathy in theMoments that Matter

A CASE FORCHANGE

Shifting focus: Fromprocess to people
A seamless, empathic, and fairinsurance claim experience is the single
most valuable service that an insurer
can provide. It is the fulfillment of theinsurer’s promise to their customer
and an opportunity to build andreinforce lifetime loyalty. Despite this,customer churn is often driven by poor
claims experiences. Why is this the caseand how can insurers overcome thisissue?
The driver of a poor claims experienceis that insurers emphasize theoperational aspects of the claims
process rather than the customers
experience – and dedicate resources
on facilitating claims processing overcustomer care.
Customer-centric design coupled withintelligent technology can instead
create benefits on three levels:• Enhanced customer experience• Improved employee experience• Increased cost benefits for insurers

Customer needs andemployee experience
are linked
Capgemini Invent has worked withmany of the world’s leading insurancecompanies to study the root causes ofchallenges within the claims process.
We discovered that customers
frequently identify the same pain
points as employees.
We observed that digitalizing andsimplifying the claims experience, anddesigning with the claimant at thecenter, have a positive impact both onclaimant and employee experience.

Insurers can realize
bottom-line cost
improvements
Claims process simplification anddigitalization yields both top-line andbottom-line benefits.
Our Future of Claims transformation
approach is designed to drive resultsthroughout the claims organization.

Exceptional claims
experiences can translate
into top-line benefits
Each insurance policy sets anexpectation that legitimate claims will
be fulfilled – and each claim createsan opportunity to build loyalty andstrengthen brand resonance.
At the same time, the world has
become increasingly digitalized andcustomer expectations have evolved –and yet not all insurers have kept up. In
the claims environment, claimants aremost challenged by delays, perceived
poor claims decisioning, and a lackof transparency.
Our Future of Claims transformation
approach is designed to help insurers
effectively harness digital solutions,selected with the claimant in mind, toprovide a streamlined, simplified, andeffective fulfilment service that canstrengthen retention and build longterm customer loyalty.

2Future of Claims

3WHAT PAIN POINTS DOES THE
FUTURE OF CLAIMS ADDRESS?

WHAT BENEFITS CAN THE FUTURE
OF CLAIMS CREATE FOR INSURERS?

The three key areas claimants cite as issues with insurance claims service delivery are delays, poor quality decisioning, and a lack oftransparency. Claimant concerns can quickly become pain points if they’re not addressed quickly or adequately. When we drill
deeper into customer desires in relation to claims experiences, we discover that what they truly want is to be heard, to be treatedfairly, and to understand that the carrier cares about their needs.

An investment in a future-ready claims program has the potential to yield benefits both for the top and bottom line.
Improvements in simplification and digitalization may translate into retention benefits that set the foundation for ongoingrevenues. A focus on delivering an exceptional claimant experience, regardless of the claim outcome, ought to be a key focal
point for all insurers and a key metric for determining success. It’s a contributing factor in decisions related to operational
efficiency. We focus on supporting Insurers to streamline costs and operate as effectively as possible without sacrificing
customer experience.

Benefits for insurers

Customer-desired claims features

CONVENIENTPERSONALIZEDClaimants are interested ina quick, easy, and fast claims
processing journey.

Claimants want to be served
24/7, but also want to decide
when to talk to humans andwhen to go virtual.

TRANSPARENTPREVENTATIVE

Claimants want a simple,
transparent (ideally real- time)process that allows them tocollect what they feel they areowed.

Claimants want insurers to be
more thorough and proactiveon their behalf to prevent andavoid high-risk incidents.

4

Future of Claims

REDUCED LAE

IMPROVED CYCLE TIMESCreate opportunities to reduce LAE
and ULAE costs, legal charges, fines,
and penalties.

Manage and consolidate internal
processes of the claims value chain.

ACCURATE ESTIMATIONSIMPROVEDACCOUNTABILITY

Understand how well you manage
your loss cost triangle by putting
together the most effective
combination of expenses to produce
a suitable level of loss payments anddecrease reserve, so that capital canbe reallocated.

Continuously scan for operational
breakdowns, fraud, and problems thatmight cause reputational or financial
pain.

INCREASED EFFICIENCYENHANCED CUSTOMEREXPERIENCE

Assess unit costs and productivity to see
whether your processes are producing theintended and expected results.

Experience a significant reduction
in complaints and losses by keeping
claimants satisfied.

Some claimants want to be able to telltheir story while others simply want theirissue resolved
Design with the claimant in mind means that there is no
single “optimal path” for all. Insurers can address thischallenge by providing claimants with simple, omnichannel
options. Some claimants may seek to manage the process
themselves and interact solely via cellphone and chatbot;
others may seek to speak to a human representative. In all
instances, service ought to be personalized, well informedby solid data and reliable analytics, and involve a seamless
transition between channels as required.

Most claimants value risk mitigation advice
and guidance
Insurers are increasingly shifting focus from pure claims
fulfilment to supporting insured to mitigate the risk of future
claims. They understand insured needs and risk exposures toprovide guidance and support. Success starts with addressingthese risks and demonstrating they care, all while mitigating
longer-term exposure.

All claimants want a fair outcome
Insurers want this too. We work with carriers to optimize datacollection and analysis from various sources, plus explore
training and coaching solutions to ensure that claims decision
making is automated, where possible, and accurate andconsistent when channeled through claims agents.
5REGARDLESS OF WHERE YOU ARE
ON YOUR JOURNEY, CAPGEMINIINVENT CAN HELP BRING THE
FUTURE AND BUILD THE FUTURE
Our teams work with insurers to identify their North Star – their fundamental objective aligned to their target customer
segments and their needs. We’re equipped to help optimize your employee experience and operational cost targets, and tailor
purposeful, strategic solutions built on relevant technology solutions.

MOST INSURERS CURRENTLY FALL HERE

FUTURE OF CLAIMS CAN TAKE YOU HERE

Future of claims
transformation
journey

TRADITIONAL

FOUNDATIONAL

SELF-SERVICEAUTOMATION• Call centers forreporting claim• Core claims platform• Omnichannel communications• Automated assignment• Touchless claims• Digital claims intake• Manual processes• Claims status trackers• Intelligent assessments• Automated FNOL triggered• STP for simple or smallclaims• Remote assessment• Al-enabled estimates/• In-person inspections• Paper checks• Vendor integration• Automatedflexible payments

inspection• Third party
recommendations• Litigation/subro/fraud riskanalytics

6Future of Claims

NEXT WAVEby sensors and IoT• Autonomous drones• Smart contracts• Automated loss prevention
and control

7

EMBARKING ON THE CLAIMSTRANSFORMATION JOURNEY

THE FUTURE OF CLAIMS IN ACTION:
A CASE STUDY

A transformed claims experience with optimized processes will result in fundamental changes to existing roles and functions.
New technology solutions such as automation and advanced analytics augment and support existing teams’ skillsets
and capabilities.

platform modernization project in flight and wanted to understand the next steps to drive value from these efforts. Here’sCapgemini Invent partnered with a US P&C client recently to drive its strategic transformation. Our client had a core claims
how we developed a human-centered approach for its new Future of Claims strategy, step by step:

The extent of the change depends on the breadth of your vision and ambition. Our clients typically explore organizationalchange, capability and skillset change, governance and KPIs, and change to processes and tools.

Human channels• Provides choice forhuman interaction if
preferred by claimant

The claimant will be able to choose between self
service or human support. Human channels offer
deeper and more empathic connection, while digital
self service offer convenience and quicker handling.

CLAIMANT• Address complex or
escalated cases• Digital is prioritized in
the customer journey• Parts of the claims
journey is digital
and automated toenhance convenienceand reliability• Ability to accessnecessary informationand status onoutstanding claims

INTELLIGENTPROCESSSES AND DATA• Taking care ofsimple claims

Policyholder

MachineLearning

Robotics
Process
Automation

Intelligent automation
serve both the self-service
channels for customers andtools for claims employees.

Capgemini Invent provides an end-to-end portfolio ofservices, from strategy to design to implementation to
ongoing management, including well-recognized andemerging design and technology solutions to suit your needs.

Future of Claims

ClaimsConversational AI

Designing and implementing a truly future-ready claims
function may seem daunting – but you won’t need to doit alone.

8Beneficiary

FNOL
agent

Specialty

CLAIMS EMPLOYEE

Self-service channels• Automation is used tocollect information anddata, and to facilitate
the claims process• Human intervention isneeded to complementand support
the automation• Cases with high impact
to insurer• Emotional or sensitive
moments in the claims
journey

Automated vs.
manualThe claims employee willserve as a problem-solver
for queries that cannot
be solved through selfservice, for claimants that
prefer human interaction,and for moments in thejourney that require ahuman touch.

• Experts in the claimsprocess should be
responsible for planning
the automation and data
models and ensuring
the automation isperforming to standards

Required shift in skillset
More socioemotional
More analyticalMore technicalMore specializedMore agile

At each step of the way, our multi-disciplinary engagement
teams work with our clients to anticipate the challenges
and navigate the transformation journey. Our collaborativeand human-centered approach ensures that we design anexperience that is tailored to your customers and employees’
needs, and allows for us to jointly work with you to plan andexecute a program that will achieve the business results thatyou expect.

123INSIGHTSROUNDTABLEDESIGNWORKSHOP

FOCUS ON THE
VISIONWe gathered intelligencefrom several interviews
with claimants, agents,and stakeholders todevelop a deeper
understanding of what
claimants need for an
outstanding customer
experience. These
learnings informed thesolutions we could craftfor our client and their
future state insurance
services.

Capgemini Invent experts
facilitated several design
thinking sessions withkey stakeholders within
the claims process todesign the future claims
experience. Our client
evaluated our researchas part of their deep diveinto claims experience
pain points and identified
the most critical areas inneed of overhaul.

We worked together toidentify key moments thatmatter in the customer
experience for claimants.
From there, we connected
the pieces to define thetech, people, andprocesses that support
our clients’ goals.

4ROADMAPPINGTHE FUTURE
STATE
We collaborated with theleadership team to define
an actionable roadmap
with clear next steps
towards an end statethat will deliver tangible
business benefits.

9CONTACT US
KEITH GAGE
Executive Vice President at Capgemini Invent
keith.gage@capgemini.com

LARS BOEING
Vice President at Capgemini Invent
lars.boeing@capgemini.com

10Future of Claims

11AboutCapgemini Invent
As the digital innovation, design and transformation brand of the Capgemini Group,
Capgemini Invent enables CxOs to envision and shape the future of their businesses. Locatedin more than 36 offices and 37 creative studios around the world, it comprises a 10,000+
strong team of strategists, data scientists, product and experience designers, brand experts
and technologists who develop new digital services, products, experiences and businessmodels for sustainable growth.
Capgemini Invent is an integral part of Capgemini, a global leader in partnering withcompanies to transform and manage their business by harnessing the power of technology.
The Group is guided everyday by its purpose of unleashing human energy through technology
for an inclusive and sustainable future. It is a responsible and diverse organization of over
340,000 team members in more than 50 countries. With its strong 55-year heritage and deepindustry expertise, Capgemini is trusted by its clients to address the entire breadth of theirbusiness needs, from strategy and design to operations, fueled by the fast evolving andinnovative world of cloud, data, AI, connectivity, software, digital engineering and platforms.
The Group reported in 2021 global revenues of €18 billion.

Get the Future You Want | www.capgemini.com/invent