Antiquated business rules - A tale of two insurance claims

Craig Reid

I recently had a run of bad luck. Not only did I lose my iPod, I dropped my digital camera and broke the lense. Luckily I'm with AAMI Insurance, and luckily I chose to take out their personal valuables cover. This allowed me to claim both items on my insurance.

What followed is a tale of process that will astound you!

I checked online to see if I could lodge an online claim - no such luck. Although AAMI has an online policy manager, there is no portal to submit an online claim. So I call AAMI and I am promptly put through to the claims section. The friendly lady takes the details of my claims. Note the plural - claims. She then advises me that my two claims will be handled by two separate case managers and provides me with their contact details.

Wait a minute - two claims managers - why?

The friendly lady explains that as one is a loss and the other is a damage claim they are under two different policies and this must be handled by two different departments and hence two different claims managers. I bite my tongue. She then asks me to forward proof of purchase for the ipod to one claim manager (via email) and to obtain a quote for repair for the camera claim and send this quote (via e-mail) to the other claim manager. I informed them that it may be a few weeks until I was able to obtain the quote for repair.

A couple of days later I e-mailed the purchase receipt for the ipod to the e-mail address provided and put the camera into the repair shop to obtain a quote for repair. Unfortunately they advised that this would take around 3 weeks.

On the 2nd of August I e-mailed the proof of purchase of my ipod to AAMI for processing of my claim.

About two weeks later I received 2 voicemails on my mobile asking me to call AAMI, then a couple of days later two letters through the post. Strange given that I had sent the details via e-mail and also had advised of the delay in receiving the quote for repair.

On the 3rd of September I received the quote for repair and e-mailed it through to the other claims manager. I heard nothing so on the 16th of September (6 weeks after my initial contact) I called AAMI to ask what was going on.

"We're waiting on your information Mr Reid" said the confused lady.

"But I sent it several weeks ago to the e-mail you provided" I said

"Oh because we are a phone based business we rely on you to call us up to tell us that you've sent the e-mail so we can check for it" said the lady, matter-of-factly.

At this point my head was filled with images of the 1950's - the last time any business on this planet was "phone based". At this point I also went on an irate diatribe about the benefits of process and basic workflow systems to which she replied impotently

"I'm very sorry Mr Reid but I can see your e-mail now, I'll just process that repair and we will send you the money".

"Can't you just refund it to the credit card you have on file for me or just process it as a credit on my account?" I said.

"No sorry Mr Reid we have to refund it as cash - can I have your bank details and that will be processed in 5-7 working days..."

So I did, but what about my other claim?

"Oh I'll just transfer you to the other account manager Mr Reid..." said she.

"But can't you just refund that along with the transaction you are about to process?" I said in amazement.

"No Mr Reid, I'm sorry but that's a different type of claim handled by a different area - I have to transfer you to your claim manager". And so she did.

"Hello this is AAMI, how can I help you?"

Cue repeat of previous long winded story. Needless to say she also was a convert to the new revolution in phone based businesses and had also chosen to ignore my e-mail until I called in an irate condition.

"I will process that for you now Mr Reid and someone from the store you bought it from will be contacting you within 5-7 working days" she said.

"What? Can't I just have a cash refund like the other claim I just made?" I spluttered.

"No I'm sorry Mr Reid, this is a different type of claim and we aren't allowed to provide you with cash - it has to be in the form of a voucher for the store you bought it from".

Eventually I was called by the store, was posted a voucher and the rest is history, but think of the pain involved for both sides:

  • A truly horrible and time consuming customer experience
  • A time consuming process for AAMI staff
  • Duplication of effort
  • Antiquated business rules causing more problems than they solve
  • Outdated technology that helps neither staff nor customer

Take the time and cost of two almost identical processes and the manual effort required and multiply this by the thousands of claims processed in a year and you quickly see millions of dollars going down the drain.

But here's how to fix it:

  • Look at the process from the customer's experience
  • Improve the customer experience and reduce moments of truth with a self-serve claims portal
  • Automate manual steps (breakpoints)
  • Challenge antiquated business rules that make no sense
  • Empower and cross-skill staff to handle different types of claims (if they are actually different!)

It's really not that hard or that complicated, but some people really have a talent for making it seem that way.



Reprinted with permission. Source.