Page 232 - Ebook health insurance IC27

The Insurance Times

(c) Prompt Settlement of Genuine Claims - The customer becomes aware
of the terms and conditions mostly when a claim arises. Had the terms and
conditions being explained to the customer, at the initial stage of itself, the
claim process would have become smoother and hassle free with minimum
dissonance. The claim assessment process should be able to clear genuine
claims, identify and block fraudulent claims and minimize their recurrence.

(d) Consumer Education- Consumer protection and consumer education
complement each other. Consumer education helps the individuals to
understand the products, risks and market efficiency better.

e) Robust Technology - Technology plays a major role in making the systems
and process easy, quick and frictionless. A robust system should allow the
complete tracking of all details and status updates, via SMS and Email to
keep the customer abreast of the progress of their requests.

Regardless of the channel from which the policy is sourced, companies are
nowoffering theircustomers 24x7 toll-freehotlineaccess providing assurance
and confidence to the customer. The company can be contacted through
(a) e-mail, (b) Call centre, (c) Letters or faxes (d) Branches and (e) Website.

The customer requests may be related to cancellations, policy related,
endorsement related, product clarification related, claim renewals related,
etc. These requests can be resolved quickly at the contact points itself (called
First Call Resolution or FCR), or assigned to various resolution teams who
process these cases and update the status against the service requests raised
in the CRM applications.

236 Guide for Health Insurance