Caller Identification System for Insurance Claim Workflow Automation
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Solution Overview
Problem
Insurance claim associates face significant cognitive demands when handling customer calls, often requiring them to manage multiple software applications simultaneously, leading to delays and data entry errors due to the difficulty in collecting and entering information.
Innovation Solution
A computer-implemented method and system that automatically identifies callers, retrieves customer information, and pre-populates loss reporting fields using a caller identification system, integrating multiple applications into a single user interface to enhance claim handling and reduce data entry errors.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If claim associates use multiple software applications simultaneously to handle customer calls and enter loss report information, then they can access comprehensive customer and claim data, but the cognitive demand increases and leads to delays and data entry errors
Solution Approach 1:
The patent merges multiple software applications (caller ID system, customer information database, loss reporting tool) into a single integrated interface. When a customer calls, the system automatically displays caller information and pre-populates loss report fields by combining data from different sources, eliminating the need for associates to manually switch between applications and reducing data entry errors.
Solution Approach 2:
The integrated interface performs multiple functions simultaneously: it identifies callers, retrieves customer information, displays claim status, and enables loss report entry all within one unified system. This multi-functional approach replaces the need for separate specialized applications while maintaining comprehensive capabilities.
2Productivity
If claim associates manually collect and enter information from customers while managing multiple applications, then they can ensure accurate data capture, but the time required to handle calls increases
Solution Approach 1:
The system performs preliminary actions by automatically retrieving and displaying caller information before the associate needs to enter it. When a customer calls, their details and relevant claim information are already fetched and displayed, and loss report fields are pre-populated, eliminating the time required for manual information gathering and entry during the call.
Solution Approach 2:
The system serves itself by automatically populating loss report fields with data from the customer information database. The system retrieves, processes, and enters information without human intervention, freeing the associate to focus on customer interaction while the system handles data entry automatically.
3Measurement precision
If claim associates ask customers to repeat information to ensure accuracy, then data entry errors are reduced, but customer frustration and call duration increase
Solution Approach 1:
The system provides automatic feedback by displaying retrieved customer information to the associate during the call. The associate can verify this information against what the customer states, allowing for accurate data capture without requiring the customer to repeat information multiple times. The system's automatic data retrieval serves as a verification mechanism.
Data Source
AI summary
In a computer-implemented method for facilitating handling, by a user of a computing device having one or more display screens, of a call from an insurance customer regarding a loss event, a caller identification system may be accessed by one or more servers to determine a phone number associated with the call from the insurance customer. The phone number may be used to automatically retrieve customer information associated with the insurance customer from one or more databases of an insurance provider. The customer information may include a name of the insurance customer and/or a policy number of an insurance policy of the insurance customer. A customer overview, including the retrieved name and/or the retrieved policy number, may be displayed to the user on the one or more display screens.