Time-consuming manual processes hindered Amica Mutual Insurance Co. claims adjusters from providing the most efficient customer service.

By working with IBM to develop the IBM MobileFirst for iOS Claims Adjust app, Amica automated manual processes and empowered claims adjusters to perform their jobs more effectively.

Claims adjusters are the front line of customer service for insurance companies. After house damage or a car accident, the claims adjuster visits the site, documents the claim, submits the information to the home office and negotiates a settlement with the policyholder. An inefficient workflow leads to added steps in the claims process.

Amica faced this situation because of a claims-adjuster workflow that relied mostly on manual processes. With no mobile link into back-office systems, adjusters had to print claims and policy documents at the office, which could amount to hundreds of pages in paper files. If customers asked a question, lack of real-time information meant the adjuster had to jot down a note, research the answer at the office and call the customer back—a time-consuming and tedious process.

“It’s really important that we equip our adjusters with all the information they need to make decisions on the spot, so that they don’t have to return to the office and do further research before getting back to the customer,” says Adam Kostecki, Senior Assistant Vice President at Amica.

In addition, agents had to carry digital cameras, recorders, phones or laptops to take photos and record policyholder statements. Then they’d return to the office to download the content for storage within the claims management system, adding more time to the process. And lugging around redundant gear and thick paper files during a long day was a burden.

Amica executives determined that a mobile solution could reduce the items adjusters carried and streamline the claims process. They started with the idea of using the native functionality of Apple iPads for photography, audio recording and email, but they were open to other requirements that would be determined in an agile software development project led by IBM.

To develop the solution, Amica became an IBM Foundation Client in insurance to co-create an IBM MobileFirst for iOS app called Claims Adjust. Developers from the IBM iX design studio would take the lead in the agile project to quickly create a quality, customer-centric app.

The team first would develop an app customized for Amica claims adjusters. After deployment, the app would be available to other insurance companies, whose feedback would further improve it.

“This was a dream team for mobile software development,” says Larry Brown, Claims Innovation Officer at Amica. “Apple is best in class for mobile hardware usability and design; IBM is expert in app design, development, integration and managed support; and Amica brings world-class customer service from an insurance perspective.”

The agile project started when IBM led a three-day IBM Design Thinking workshop in which three Amica claims adjusters with varying experience shared a typical “day in the life” of their jobs. This helped establish their pain points and the app’s core requirements. Then a series of iterative agile sprints helped the team develop the app’s functions and user interface, followed by IBM integrating the app with Amica’s systems. It took just eight months from white boarding the requirements to deploying the app.

Amica received additional assistance during two upgrades to the Apple iOS operating system. As part of the collaboration agreement, IBM refreshed the deployed app to support the upgrades.

The Claims Adjust app connects to Amica’s claims management system and five other back-office systems. When an adjuster receives a new assignment, it’s pulled into the app with all details, such as the policyholder’s contact information, cause of the claim, the relevant policy, the claims history and other documents. As Kostecki explains, it contains “basically everything an adjuster needs to know before first contacting the customer for an appointment.”

In the field, adjusters can use the app to take photographs, record statements and automatically submit content into the claims management system. They can answer customer questions by consulting documents within the app, such as policy clauses and police accident reports. Further, mapping capabilities help adjusters create efficient appointment schedules, saving drive time and reducing energy use. And a prioritization algorithm brings important items to the top of adjusters’ to-do lists to help identify the highest priority tasks.

The collaboration between the Amica and IBM teams led to fast time to value—six months to develop and test the app and two months to deploy. By bringing Amica claims adjusters into the agile design process, the team addressed their pressing needs for ease of use, efficiency and automation. This helped ensure a high acceptance rate in the field. “After the initial deployment, we saw very high voluntary adoption rates. We estimate about 80 percent of our adjusters proactively incorporated the tools into their workflows,” says Kostecki.

The Claims Adjust app is designed from a mobile-first perspective. It’s intuitive and easy to learn, which helps new adjusters get up to speed quickly. The app also helps attract and retain tech-savvy employees, who often consider technology tools when evaluating prospective companies.

Further, the app benefits claims adjusters by making them more productive. Less time in the office performing manual tasks and more time in the field with automated processes helps them handle more claims. The automatic photo-upload feature alone could save thousands of hours, compared with manual uploads. “The app helps adjusters greatly improve their efficiency, which allows them to handle more claims on a daily basis,” says Kostecki.

Such gains offer a clear benefit to Amica customers. Assessing claims more accurately helps Amica deliver even better customer service.

 “Adjusters might be working on more than 100 claims,” adds Brown, “and from a single iPad they can access all the claim histories, financials and policies and share that information with customers in emails or in person. This significantly adds to the adjusters’ efficiency and increases their ability to satisfy customers.”

Established in 1907 and headquartered in Lincoln, Rhode Island, Amica (link resides outside ibm.com) is a direct writer of personal insurance with auto, homeowners, umbrella and marine coverages. Life insurance is available through Amica Life Insurance Co., a wholly owned subsidiary. The company had assets of nearly USD 5.4 billion as of December 31, 2017, and employs more than 3,800 people in 44 offices across the US.