Achieve big impact through a small process improvement

Health insurance: end-to-end digitalization and omnichannel capability of the offer and application process lead to more satisfied customers

Author: False

Health insurance premiums are communicated in the fall of each year. The customer journey of potential new customers begins with research into the products and prices on the websites of the health insurers.

  • As a first step, potential new customers often take advantage of a personal consultation. The new customer discusses his or her concerns with a customer advisor. This compiles an individual offer and sends the offer to the new customer.
  • Until now, the offer could only be sent to the potential new customer by mail or e-mail. It was therefore not possible for potential new customers to complete the offer and application process digitally. Either the new customer had to print out the offer or even wait a few days for the offer to arrive by post. 
  • With a seemingly small process improvement, potential new customers of a Swiss health insurance company can now benefit from a purely digital experience for taking out insurance. Immediately after the consultation, the customer can view the quote digitally via various channels, compare prices of the different products again, make changes to the quote and finally submit the application digitally. For the customer, the customer experience is significantly improved

For the health insurance company, digitally submitted applications open up immense potential for automation, which can reduce operating costs. 

  • Manual processing of applications submitted on paper is no longer necessary. 
  • The insurer also gains a competitive advantage over the competition because the customer has all the information and prices immediately after the consultation and can conclude the insurance policy directly.

Status quo: media disruptions and manual processes

The customer advisor compiles a quote for the customer in a consultation, which the customer advisor sends to the customer via e-mail as a PDF or physically by mail. The customer usually prints out the offer, makes any necessary changes to products and product criteria such as the deductible rate, and submits the signed offer to the health insurance company by mail. 

The signed offer arrives at the health insurance company and is scanned as the first step. Now the quote must be processed by a clerk. The originally configured quote must be adjusted in the system according to the quote submitted by the customer. Furthermore, the personal information provided by the customer and the health questions answered must be manually transferred from the document into the system. 

This is how the offer and application process has worked so far. The process leads to long waiting and idle times as well as to media disruptions for the customer and for the health insurance company.

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Figure 1: Status quo - media disruptions and manual processes

Small process improvement - big impact

Instead of sending a quote document to the potential new customer, a link to the online quote calculator is sent to the customer via any channel. The initial quote created during the consultation can then be viewed by the customer immediately after the consultation and adjusted again according to their own wishes. The customer can adjust the products and product criteria in the online quote calculator and check how this affects the price. Finally, the customer can switch to the application process and submit the application digitally. The application process is seamlessly integrated into the online calculator and thus runs completely digitally. Costly media disruptions are eliminated and the customer experience improves. The customer can access the quote at any time via different devices and channels. This supports an omni-channel presence for the insurer.

There are also improvements on the health insurance side. Subsequent processing of physically submitted documents by a clerk is no longer necessary, which saves a great deal of time. The application is submitted digitally and can ideally be policed automatically.

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Figure 2: The process runs completely digitally

Solution approach

  • Central to the improvement of the customer experience and process efficiency described above is that all front-end applications, such as the online quote calculator and the quote front-end used internally by the customer advisors, work on a common database and that the same business rules are used. This is the only way to guarantee that the business rules are applied consistently across all channels and frontends and allow an omni-channel approach.
  • From an implementation perspective, a microservice architecture can serve here. In this, a split service is implemented that covers the business domain of the offer and application process. Examples of such shared business rules are conditions that apply to the conclusion of a product. This allows data availability across all front ends. 
  • As part of the microservice architecture redesign, the business rules and process logic are defined and implemented outside of the application code. The BPMN (Business Process Model and Notation) and DMN (Decision Model and Notation) standards can be used for this purpose. In this way, these important artifacts and the business logic they represent can be transparently viewed and understood by the business side.

Business Value

With the implementation of the new offer and application process, business value is created at various levels.

Customer Value Case

The solution massively improves the customer experience. The customer can complete the offer and application process via various channels without media disruptions and waiting times.

Infrastructure Case

Existing systems are replaced by the solution, thus ensuring future viability and flexibility.

Cost/Efficiency Case

Efficiency is increased because the time-consuming, manual processing of physical applications is reduced.

Strategy Case

The architecture reduces the time-to-market of new insurance products, because with the chosen architecture changes can be put into production more easily and faster.iness side.

Key factors

  • Both the customer consultant and the customer can see the current status of the offer at any time
  • Co-browsing of the offer is thus possible
  • Media disruptions and waiting times are prevented
  • Continuous customer journey for the customer
  • User-friendliness is high, as the frontends react quickly by realizing a partial decoupling of the backend systems.

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