FAIR Innovation Survey

Claims

Research suggests that a simplified claims process can be important for improving the ability of insurance to provide financial resilience to lower-income individuals. This involves reducing the amount of documentation required for a claim and increasing the speed at which payments are delivered. This not only increases trust in the product, it also greatly reduces administrative costs thereby reducing the overall product cost.

Current Industry Practices

The insurance industry currently employs a range of tactics to expedite the claims process.

a)  Online Claim Management: Policyholders can easily file insurance claims online and track the status of their claims in real-time through our digital platforms. This streamlined process eliminates the need for paper forms and allows individuals to initiate and manage the claims process quickly and efficiently, regardless of their location or accessibility challenges.

b)  Virtual Assistance: Offering virtual assistance options, such as live chat support and video conferencing, to help policyholders navigate insurance-related inquiries, policy changes, and claims submissions. This virtual support ensures that individuals from marginalized populations can receive personalized assistance and guidance from trained insurance professionals without the need for in-person interactions.

c)  Multilingual Support: Providing multilingual support through customer service channels, ensuring that individuals who speak languages other than English or French can access insurance information and assistance in their preferred language. Insurance representatives are proficient in multiple languages, and translation services are available for policy documents and communications.

d)  Adjuster Services: In the event of a claim, companies utilize technology to facilitate virtual home visits and inspections. This allows adjusters to assess damages remotely, minimizing disruptions for policyholders and ensuring timely resolution of claims, particularly for individuals facing mobility or accessibility barriers.

In the event of a natural disaster, insurance companies may employ a range of additional measures to expedite high volumes of claims including:

e)  Simplified Documentation Requirements: To expedite payments and streamline the claims process, insurers may simplify documentation requirements and implement expedited review procedures for weather-related claims.

f)  Upfront Cash Payments: Insurers may provide upfront cash payments to policyholders for immediate financial assistance, allowing them to cover essential expenses such as food, temporary accommodation, and other immediate needs.

g)  Coverage for Additional Living Expenses: Insurers may offer coverage for additional living expenses immediately after a weather-related event, such as hotel accommodations, meals, and transportation costs, to help policyholders cope with displacement and disruption.

h)  Community Reception Centres: Insurers may establish community reception centres in collaboration with other stakeholders, such as emergency management officials, NGOs, and government agencies, to provide in-person support and assistance to affected individuals and families. These centres serve as a hub for claims processing, information dissemination, and support services.

Ø  Extended Claims Business Hours: To accommodate the increased volume of claims, insurers may extend their claims business hours and enhance customer service availability to ensure timely assistance and support for policyholders.

i)  Immediate Financial Assistance: Insurers offer immediate financial assistance to policyholders to help cover any immediate expenses. For instance, if their home is damaged and uninhabitable, insurers provide funds for hotel accommodation, food, laundry, and other essential needs upfront.

j)  Direct Payment to Vendors: To expedite the restoration process, insurers often make direct payments to vendors, such as contractors, for their services. This means that policyholders do not have to pay out of pocket and wait for reimbursement, streamlining the claims settlement process.

Product and Service Innovations

a)  Automatic Payouts After an Event – In cases of mass damage such as severe weather or earthquakes, the disaster event triggers immediate payment to eligible policy holders without the requirement to submit a claim or proof of loss. Auto-triggered payments can be accomplished through technology-enabled claims verification, such as seismic activity.