Insurers: customer feedback core to pandemic recovery

The value of private health insurance has been questioned by Australians for some time. Even prior to the pandemic, people had been questioning the value of their health insurance — particularly younger Australians.

As with other phenomena, it appears likely that COVID-19 may accelerate this existing trend in the health insurance sector. Given the economic fallout, we should expect to see an even greater number of people start to reconsider whether their policies are affordable, putting private health insurers in an even more challenging position.

Many health insurers have already signalled plans to adapt their offerings to suit the expectations of young Australians — offering more preventative services like skin checks and greater digital connectivity.

While these are likely to boost the appeal of health coverage, it’s imperative health funds also focus on and speed up efforts to ensure they are listening to customers in real time in an attempt to find ways to create more value for members.

Customer feedback the key to competitiveness

Prioritising customer feedback will enable insurers to capture and remedy potential systemic issues, while gaining further insight into existing ones so that root causes can be addressed. While the sector has made some headway over the last few years, there’s still room for improvement.

An area where useful feedback can be gained but is often overlooked is customer complaints. Health insurance complaints to the Private Health Insurance Ombudsman (PHIO) increased by 49% over the five years prior to 2017. Matters improved in the year to 2019, with the number of complaints reduced compared to 2018, but the overall number of complaints remained high.

Concerns about value for money remain a clear concern; however, the Ombudsman notes that complaints often mention issues with customer service, delays in responding to issues and challenges with escalation processes. “These can cause policyholders to become more aggrieved and dissatisfied with their health insurers,” the Ombudsman notes.

All of this has been taking place against a backdrop of premium increases. With premiums on the rise, those aged 30 to 34 have become the group most likely to drop their coverage this year in the three months to 31 March.

A cultural and technological shift is required

Many health funds acknowledge the issue of value for money and have been seeking ways in which to boost their appeal to their members, focusing on preventative healthcare measures and digital connectivity in an effort to improve how the value of health insurance is perceived. Further improving their complaints management processes and proactively seeking real-time customer feedback will complement these steps, making it more likely that savvy health funds will hit the mark with members.

Technological innovation can enable organisations to not only capture and record customer feedback and complaints but also undertake analysis, looking at trends and addressing feedback in an analytical way and in real time. A tool like natural language processing, for example, which identifies and picks up on certain key words, can raise red flags before they become larger issues.

The first step, however, is a cultural one. If not already doing so, health insurers can focus on supporting cultural change that encourages staff members and leaders to view all customer feedback and complaints as an opportunity for improvement and product development. They must also ensure that the customer feedback and complaints system is accessible for customers through all channels including website, social media, email and phone.

By using a complaints management system — that is not a standalone system but instead one that integrates with an overall management system — speed to resolution can be increased. This is because while many customer relationship management (CRM) system providers will claim to be able to provide customer feedback and complaints management solutions, systems whose core capability is real-time customer feedback or complaints management have greater interoperability with other management systems built in. This not only allows issues to be escalated appropriately faster but also enables staff to easily keep tabs on the level and status of complaints.

Making customer feedback and complaints core to what an organisation does can be a huge opportunity for the sector in these difficult times. Making the most of customer feedback will help to secure our health insurers and our health system for the future at a time when they’ve never been more needed by Australians.

*Vinay Chand is MD of Health Solutions at Civica, a leading provider of software and services to the PHI and health sectors. Services include iCasework, a cloud-based complaints and case management solution, and Civica Experience, a real-time feedback tool with natural language data analytics.

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