Customer Analysis / AI Strategy

The Challenge and Case Study

Customizing the insurance claim experience for customers and users is becoming increasingly important in today's market. Users want less white glove service and more ability to act quickly and self serve. They are looking for more direction connection to their agents and with full awareness of available plans and options for there policies. Chubb Insurance is currently not setup for that self service feature set and through its history, has always provided direct customer agent assistance. The insurance policy holder has limited awareness and visibility to the status of a claim!

The Claim Steps

1. Claim Assignment: Once the insurance company receives the FNOL (First Notice of Loss), they will assign a claims adjuster or specialist to the case. The adjuster will be responsible for investigating the loss, determining the cause and extent of the damage, and assessing the coverage under the policy.

2. Investigation: The claims adjuster will conduct an investigation to gather all relevant information about the loss. This may include interviewing witnesses, reviewing police reports, assessing the damage, and verifying any supporting documents, such as medical reports or receipts.

3. Coverage Assessment: After the investigation, the adjuster will assess the coverage under the policy and determine the amount of compensation that the insured party is entitled to receive. This may involve negotiating with the insured party, the claimant, or any other parties involved in the loss.

4. Payment: Once the coverage and compensation have been determined, the insurance company will pay the claimant. Depending on the type and amount of the claim, the payment may be made in a lump sum or in installments.

5. Resolution: After the payment has been made, the insurance company will close the claim and provide any necessary documentation to the insured party.

• Faster Claims Processing. Analyzing the data provided through prompts will help reduce the time it takes to resolve a claim.

• Improved Accuracy. Using A.I. prompts, can help ensure all the necessary information has been provided for a claim. With details such as the date of the incident, the location, photos, and the extent of the damage. This will lead to more informed decisions and better outcomes for both the insurer and the claimant. Will also identify misses and outliers in the process

• Enhanced Customer Experience. AI prompts can be used to provide personalized and proactive communication with claimants, keeping them informed throughout the process and providing timely updates on the status of their claim. Chatbots can aide the interactions and communications.

• Reduced Fraud. By analyzing the data, AI can identify patterns and anomalies that may indicate fraudulent activity. This can include things such as claims made for pre-existing damage or claims that appear to be exaggerated or falsified. 

• Cost Savings. Chubb can reduce the time and resources required to process claims, leading to lower operational costs. Additionally, by identifying and preventing fraudulent claims, they can save money on payouts, be more transparent and accurate on claims and avoid reputational damage.By keeping a tool for communcation and correspondence, they will enhance the customer experience, reducing fraud, and generating cost savings to better serve their customers and improve their bottom line..