Why do claims adjusters hate traditional customer communication management (CCM) tools?

Is hate a strong word? Well, imagine there is a single tool that, if improved, could move your job satisfaction from a 6/10 to a 9/10. That’s what adjusters tell us the difference means to them, when upgrading from a legacy CCM to an AI tool like Voltaire.

Why is that?

How CCMs have been used as a “solution” for claims correspondence

CCMs excel with certain kinds of customer communications. Think standard form letters that happen at predictable times, for predictable reasons. Billing letters, for instance.

However, they struggle with complexity. Nevertheless, they have been used by claims teams for years.

What’s kept CCMs in use? Templates.

So. Many. Templates.

Every conceivable claims scenario may need a template, and anytime policy language changes or a new endorsement is introduced, another template is needed. New templates can take up to 40 hours to introduce, and they often require IT support to implement.

However, assuming templates are up-to-date and available, put yourself in adjuster’s seat for a settlement letter with a denial. You need to:

1. Know exactly the policy language is required, from hundreds of pages of legal documents so that you can…
2. Know exactly which template to use, out of hundreds

Now, that may work OK for some common scenarios. But it still requires a huge amount of up-front knowledge about carrier policy language. That’s impossible for CAT adjusters or inexperienced adjusters to learn quickly.

What happens when CCMs fail to deliver timely claims automation?

Imagine this scenario. You are an adjuster. You have a complex, sensitive denial letter you need to write soon because it’s related to a recent catastrophe. A regulatory deadline to communicate with the policyholder looms.

What do you do? You can choose one of two options:

1. Carefully review, read, and interpret base policy, exclusion, endorsement, and special provision policy language.
   1. In some cases, you may not even know some endorsements or exclusions exist prior to this claim.
   1. hen, open a dropdown list of templates, scrolling through hundreds of options until you find a template that seems to match your scenario.
   1. If you go the extra mile, you find a new endorsement that applies and meticulously, manually copy and paste from PDF to word and painstakingly fix the formatting.
2. Copy and paste a similar letter your peer used recently, which seems to be the same kind of scenario.

If scenario 2 means you get to go home on time and communicate with the policyholder by the deadline, there’s a good chance you choose #2. However, keep in mind that this is something of a many-times-a-day ethical dilemma, which can be a major source of on-the-job stress.

Potential issues with choosing to copy and paste:

• Leftovers from the previous letter, missed due to human error.
• Policy language for denial that wasn’t supposed to be there, making settlements of litigation more likely.
• Policy language that should be there not included, leaving the claim less defensible if it is escalated.

Any one of those mistakes can have serious consequences, especially as plaintiff-side AI creates more escalations.

What’s working better than CCMs?

Since you’re on our blog, you can guess Voltaire. Here are a few reasons why:

• Voltaire intelligently looks up and cite the correct policy language based on denied items and reasons.
• Voltaire perfectly formats the policy language.
• Voltaire handles all the other wordsmithing for the letter, which at this point is just a nice bonus.

If you think your adjusters being 50% more satisfied on the job sounds promising, contact us.