Greg Cole, Head of Claims, AND-E UK explains some of the initiatives that are moving the dial on customer-centric service.
Consumer Duty ultimately requires insurers to put the customer at the centre of their business, prioritising customer outcomes by ensuring fairness, transparency, and clarity in all interactions. Whilst this is mandated as part of the regulatory framework, it has also given insurers the opportunity to embed exceptional customer service and innovative practices that can drive long-term customer loyalty and satisfaction. This proactive approach not only ensures compliance; it can also position insurers as leaders in customer-centric service.
As the Claims Director at ANDE-UK, I see the transformative potential of Artificial Intelligence (AI) not only in helping us meet regulatory requirements; it is also enhancing that customer-centric approach.
A human/AI collaboration
Generative AI (GenAI) already offers insurers a powerful way to better support customers. The key is to deploy this technology where it can best support customers, rather than just focusing on operational efficiency. This aligns with the Consumer Duty principle of ensuring that customer outcomes are at the forefront of all business activities.
For example, ‘virtual agents’ can be highly effective in automating and resolving straightforward customer queries. With the right GenAI capability, virtual agents can respond to customers in a natural and conversational manner, while delivering precise answers whenever they need them. AND-E UK has seen 36% of calls successfully directed to virtual agents, freeing up human agents to deal with the more complex customer needs.
In addition, GenAI is helping handlers resolve issues more effectively. When combined with live voice transcription, AI can listen and provide handlers with answers and next best action recommendations in conversations with customers. This ensures that handlers have the information they need to provide timely and accurate support, directly contributing to positive customer outcomes as mandated by the Consumer Duty.
Similar technology can be used to summarise customer interactions, saving the handler having to complete extensive notes after a call and allowing them to immediately support another customer. The key is to ensure we achieve the optimum human/AI collaboration because nothing will replace the human touch when it’s needed most.
Identifying the customers veering off the ‘happy path’
AI also significantly improves our understanding of customer needs through advanced data analytics, enabling a more personalised approach. This is being applied to product design, tailoring insurance products and personalising recommendations to better meet the needs of our customers.
These enhanced customer insights also give us the opportunity to highlight to handlers and managers where a claim might be veering off the ‘happy path’, allowing us to quickly intervene and offer the right level of support. By analysing sentiment and identifying patterns across multiple customer interactions, we will be able to detect when something might be going wrong. For instance, if a claimant makes several calls expressing frustration or sends multiple emails indicating confusion, the AI system flags these interactions. This allows our team to intervene quickly and provide the necessary support, ensuring that any issues are addressed promptly.
Improving claims processing and fraud detection
AI can also streamline claims processing, making it faster and more efficient. Similar to the ‘happy path’ concept, more routine claims can be partially or even fully automated. This frees handler resource to deal with more complex cases, improving operational efficiency, as well as enhancing the customer experience by reducing waiting times and improving the accuracy of decisions.
Moreover, AI’s capability in fraud detection is unparalleled. Machine learning algorithms can analyse claims data to identify anomalies and potential fraud, which even the most experienced handlers might inadvertently miss. This ensures that genuine claims are processed swiftly, while fraudulent activities are flagged for further investigation, protecting us and our customers. In the last year we have identified over £2m of savings without compromising the speed to settle genuine claims.
A clear auditable trail of compliance
Compliance with Consumer Duty involves demonstrating that we are consistently acting in the best interests of our customers. AI can aid in maintaining and proving compliance by providing a clear, auditable trail of decision-making processes. Through natural language processing (NLP), AI can monitor communications and ensure that all customer interactions are transparent, fair, and within regulatory guidelines.
AI integration is essential not just for current compliance but also for future-proofing the insurance industry. AI systems can quickly adapt to evolving regulations, ensuring ongoing compliance without extensive manual adjustments. For example, AI-driven platforms in life insurance use data from wearables to offer dynamic policies that adjust to the policyholder’s health and lifestyle changes, aligning with the Consumer Duty’s focus on positive customer outcomes.
Consumer Duty presents an opportunity for insurers to refine their operations and improve customer outcomes. By leveraging AI, insurers can enhance their understanding of customer needs, streamline claims processing, detect fraud more effectively, and ensure compliance with new regulations. These advancements not only help meet the requirements of the Consumer Duty; they also position insurers as leaders in an increasingly competitive market.
It is important, however, to ensure transparency in the use of AI for decision-making processes. That’s where the human/AI collaboration is critical. By clearly communicating how AI is used to make decisions, insurers can build trust and ensure customers understand how their information is handled and how decisions are made.
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