Putting customers at the centre of operations is the key to a successful claims function, experts told the Curium compliance conference.

“You can sell your product, get your client and then the claim comes and it all falls apart,” Clarion Claims CEO and co-founder Drew Schnehage told attendees. “You need to do it backwards – start with claims and decide how you’re going to deal with a claim when it comes.

“That is when a client is going to either buy another product from you or go away. The intake is critical – if you don’t get that right, it will go wrong the next day.”

She said the approach to compliance is crucial.

“Where does your compliance sit? Does it sit at the end of the claim [done] by hand on a spreadsheet, or is it bolted into your claims platform and driving the process? Because if [it isn’t], you are going to be sitting with the regulator more often and dealing with complaints.”

Luke Whenman, chief claims officer at Allianz Australia said: “Claims is super-important as often it’s the only time the customer interacts with the insurer besides the point of sale.

“So I take it up a level and think when we’re looking at a claims experience, how are we designing it for the customer? They must be at the centre of everything we do.”

Assetinsure head of claims and responsible manager Suneet Rangarajan says the key is to be “curious, not defensive when a claim or complaint lands at your desk.

“That’s when you learn most about your business. Claims sit on your business – you take it up to policy and pricing and underwriting, let them know what’s going wrong, how your policy reads. What the intention of the policy is and what is the written word. How will [the ombudsman] read it and the regulator? That’s where your design starts.”

The role of AI was also a key theme at the conference.

Mr Rangarajan said: “Two years ago, a complaint would be a one-liner – ‘I am not happy.’ Now I read five, 10, 50 pages of structured, sharp complaints, which have everything from regulation to case law and things I don’t even know. It’s amazing.

“So everyone has AI. If they put in the effort to use it to present an argument that’s well-structured, maybe we should do the same. I try to use it to analyse how the policy applies – I try to think outside the box and AI tells me things I hadn’t even thought of.

“But it’s down to the human – never take anything from AI as gospel – it’s all about your judgment and decision.”

Ms Schnehage said AI has a crucial role in speeding up processes, especially given 60%-70% of any claim will sit outside the insurer, with suppliers, repairers, assessors and building contractors.

“We’ve all been trying to get customers to lodge claims online and we know how difficult it is. When documents come in and you start ingesting claim forms, the emails and images, your AI has got to start doing the work for you and become an enabler.

“It needs to summarise, raise red flags, doing the liability and the triage for you so you can move quicker.”

Mr Whenman added: “AI is a bit like digitisation, automation and platforms of the last few years. AI enables us to meet those customer expectations where they are now.

“The big advantage is that it scales at a lower cost. You can start to put service propositions and products to clients. But for our people it potentially removes some of the friction that sales centres have had to endure over many years.”