'100 years in hands of claims managers'

NYSE-listed Genpact says its partnership with Claim Genius is providing a crucial “claims triage” and optimising decision-making with the backing of a century of claims data as insurers battle over 100,000 claims from this month’s flood catastrophe, eclipsing bushfire claims from the 2019-20 summer.

Genpact VP Insurance Steven Raynor tells insuranceNEWS.com.au its “augmented intelligence” decision-making tool offers claims managers the best path to resolution, based on the perspective of what has and hasn’t worked previously to back up choices and speed recovery.

“You are putting hundreds of years’ worth of experience in the hands of the claims team at lodgment to help support the decisions,” Sydney-based Mr Raynor said, noting that catastrophe events often see people of varying experience handle clients and claims.

“The more consistently you can manage claims and get those decisions right, the more likely you will get a good claims outcome.”

Mr Raynor, who formerly spent 13 years at QBE where he finished as COO in late 2018, says insurers have hundreds of thousands of former claims in their database that can be grouped and “codified” and Genpact can deploy technology such as text finding solutions to mine the claim files and see how they were resolved.

“All of a sudden you’ve got this rich data about how claims were handled. We are able to help insurance understand that claim history – turning what is essentially unstructured claim information into something structured, and almost freeze the data,” he said.

“Our IP is able to structure the data the insurance companies already have.”

Insurance is one of the four sectors served by Genpact, which last month revealed its platform is integrated with Claim Genius’ AI-based claims solution for auto insurance.

It also counts retailers, manufacturers, Facebook, Google and Netflix among its customers and Mr Raynor says techniques taken from other industries can be applied in insurance.

“A lot of the analytics solutions, a lot of the segmentation work, a lot of the customer sentiment analysis work that we do in other industries – we are able to apply in insurance and it is very relevant irrespective of the industry.”

Mr Raynor says the Claims Genius partnership is critical because it gets information about the incident and the event that has happened in the hands of the people who make the decision and will take “all the pain out of the assessment process using imagery to triage the claims in the right way”.

“That is really the thing that all insurers need to be focusing on because if you send out a loss adjuster and it is not needed, a lot of time and effort can be wasted in the claim and you prolong getting the builder out.”

He says the “power of the crowd” – in which historical claims are matched and evaluated for cost and customer outcomes – augments the nous of the claims manager.

“You still want them to have ownership but if there are 50 examples of a similar claim that have gone down a similar path and they have had a good claims outcome, you would probably pick that,” he said.

“It speeds the process up, it guides people, it gives people a perspective on claims. It is not taking the human out of the process, it’s augmenting humans with machine learning.”

Genpact employs around 600 in Australia and 100,000 globally.