How the Right Complaint Management Solution Can Help Insurers Optimize Claims Handling

The Australian insurance industry faces a multitude of challenges when it comes to claims handling, particularly in the domain of home insurance. The need to enhance customer satisfaction, while streamlining operations and ensuring compliance with ever-evolving stringent regulatory requirements are pressures enough. Add in other external factors, such as severe weather events, and it’s easy to see why the Australian insurance industry really is up against it now.

A recent review by the Australian Securities and Investments Commission (ASIC) really did bring all this into focus, shedding light on critical areas that require improvement. In no particular order, these include:

• Complaints Handling

• Communication

• Project Management

• Identification and Fair Treatment of Vulnerable Consumers

• Resource Allocation

With a focus on improving how complaints are handled, more insurance companies are investing in complaint management solutions (CMS) which are designed to meet the exacting requirements of the financial services industry and the insurance sector. But what some insurance businesses don’t realize is that these complaint management tools have a vital role to play in overcoming the other challenges they face daily, like addressing the issues raised by ASIC that are having such a negative impact on claims handling.

Complaint Management Solutions Manage More than Complaints

How can a good CMS help insurance companies to improve claim handling, rectifying the problems identified by ASIC?

By managing every aspect of the internal dispute resolution (IDR) process, the right CMS can make a real difference to how claims are handled, delivering the oversight, resource allocation capabilities and reporting functionality that insurers need to optimize claims handling across the board.

1. More Effective Complaint Handling - ASIC’s review identified that, in many instances, insurance companies didn’t dedicate sufficient resources to complaints handling. ASIC called for immediate action to address this concern to ensure that customer complaints are managed effectively. A good CMS has dedicated modules for complaint management, streamlining the end-to-end complaint process, automating key tasks and ensuring that complaints are addressed promptly and effectively in a direct response to ASIC’s finding. The right solution can help with this efficient allocation of resources to optimize complaint handling.

2. Better Communication - Many insurance companies were found to be lacking when it came to communicating with customers. Effective communication throughout the claims process is vital for a positive customer experience, going a long way to maintaining goodwill from customers even in the most challenging of circumstances. Complaints management systems can facilitate seamless communication between the insurers, policyholders and third parties involved in the claim dispute process, ensuring all stakeholders are kept informed. Ultimately, this leads to improved transparency and increased customer satisfaction.

3. Increased Project Management - As ASIC pointed out, few insurers appoint internal project managers, regularly leaving the complex and often lengthy assessment and repair process in the hands of consumers. A good complaint management system enables insurance companies to take a proactive approach to project management within the claims dispute handling process. By utilizing the task management and workflow capabilities of complaints management systems, insurers can oversee and coordinate every aspect of the assessment and repair process. This ensures that tasks are properly assigned, timelines are met and resources are allocated efficiently. In turn, insurers can deliver a smoother and more structured claims handling experience for the benefit of both their customers and their own business.

4. More Support for Vulnerable Customers - In its report, ASIC emphasized the need to identify, but also support, vulnerable consumers throughout the claims process—particularly in the wake of severe weather events. Again, using effective resource allocation functionality, complaints management systems can ensure that the right resources are allocated quickly and precisely, a particularly important capability in times of crisis. Also, inbuilt vulnerability detection functionality can help insurers to readily identify vulnerable customers, including those who are unaware they’re vulnerable or are unwilling to disclose their vulnerability. All this helps insurers to deliver the right level of support to vulnerable customers and to their own claims handling and dispute resolution teams, even when faced with extreme events and circumstances.

5. Enhanced Regulatory Compliance - Alongside improving claims handling, insurers need to achieve compliance with the ever-evolving and ever more stringent regulations laid out by ASIC. A good complaint management system can help with this, by generating the reports needed to evidence compliance with ASIC’s internal dispute resolution (IDR) requirements, delivering the transparent consistency of process that RG 271 requires.

6. Navigating External Challenges - The insurance industry isn’t immune to external challenges like climate change or evolving regulatory landscapes. Increasingly severe weather events, for instance, have led to a surge in claims-related complaints. Agile and adaptable, complaint management systems offer insurers a robust framework to effectively navigate these challenges. By swiftly adapting to changing conditions and regulatory requirements, the right solution can help insurers remain resilient and responsive.

Faced with a multitude of challenges from all angles, Australian insurers need to shore up processes to address the specific issues highlighted by ASIC's reporting. For many insurance organizations, a good complaint management system, like Aptean Respond, could be the missing piece of the puzzle to deliver the oversight and streamlining of processes that are needed to optimize insurance claims handling.

By embracing the right complaint management solution and placing it at the heart of the business, insurers can revolutionize the end-to-end claims handling processes, improving dispute resolution, enhancing customer satisfaction, treating vulnerable customers fairly and achieving regulatory compliance with even the most robust of requirements.

To learn more about how our complaint management system, Aptean Respond, can underpin insurance claims handling excellence especially in ASIC-regulated Australian markets, get in touch with our complaints experts today.