Claims handling

PZU Group insurance companies offer both the ability to report a claim through traditional channels (by phone, at a branch or with an agent) and through remote channels. The online service for reporting claims and benefits zgloszenie.pzu.pl makes it possible to automatically calculate the claim amount and report a claim for foreign partners. The website upholds its emphasis on plain communication language and was awarded the “Plain Polish Language Certificate” by the Institute of Plain Polish at the University of Wrocław. Similarly, with moje.pzu.pl or myPZU app, a client may conveniently and independently report a claim and check its current status. At LINK4, claims can be reported by filling out a form at the website link4.pl/claims/zgłoszenie.

The PZU Group wishes to be there for its clients when they need support the most, often even before they formally report their claim. The Before-You-Call Service is a solution within the framework of which the insurer initiates contact with the customer and offers them actual assistance before the formal notification of the claim, putting both the client and their needs first. The Before-You-Call Service is intended for clients who have experienced an unpleasant random event in which their property was damaged.

After the occurrence of an insured event, such as a fire, gas explosion or tornado, an attempt is made to identify the client based on information from publicly available sources such as the Internet or radio. In cases where the injured person is positively identified as a PZU customer, contact with the client is established to provide actual assistance in the unfortunate situation (for instance, if the policy cover provides for a substitute apartment, it will be offered to the client during the first contact). Registration of the claim may be performed on a different day, at a time convenient for the client.

PZU was the pioneer in Direct Claims Handling (DCH) on the Polish insurance market. Currently, DCH is executed in two forms: at an individual level or under the agreement worked out by Polish Chamber of Insurance (PIU). DCH is offered by entities accounting for nearly 70% of the motor TPL insurance market, as measured by gross written premium. The said agreement, which is based on a lump-sum approach, has dramatically simplified the settlement of claim payments between insurers. Thanks to DCH, the claim following an accident is handled by the insurer from whom the TPL policy has been purchased. The insurer subsequently makes a settlement with the perpetrator’s insurer, without the client’s participation. PZU also maintained its own DCH solution previously introduced for clients injured by the persons insured in companies that are not part of the said agreement.

Catastrophic events occur seasonally, most often in winter and summer. This is due to the increased volume of claims handled and the measures and improvements taken enable quick claims handling. The simplifications used allow to determine the number of claims to be paid without the need to draft a detailed cost estimate. The implementation of automation allows compensation to be paid within one business day following the date of reporting the claim. An established team of experts follows meteorological reports and media publications about potential threats.

TUW PZUW has implemented a Catastrophe Claims Handling Procedure that supports the maintenance of a high level of quality and timely handling of claims from catastrophic risks. The purpose of the procedure is to ensure coordination of activities related to the handling of mass and catastrophic events, to effectively reach out to clients, to ensure efficient and comprehensive claims handling, within the shortest possible time from the event. Its essential element is also the monitoring of catastrophic events and the special mode of action taken

The main pillar of the model is broad cooperation among sales, claims handling and underwriting teams, in order to provide the best quality services for key account clients.

In this model, claims handling is based on an in-depth client analysis in terms of the size and structure of their fleet, the loss ratio, and advisory services as regards fleet-wide solutions designed to improve the client’s loss ratio. Each client has a designated claims handler who conducts meetings with client representatives. The necessary formalities in contact and communications are determined, and upon prior analysis, PZU suggests solutions to lower the claims ratio of the client. The above described solutions are founded on a broadly conceived business relationship and shared understanding with the client as regards implementation of solutions that can minimize the client’s loss ratio as well as costs.

PZU supports dealing with the entire claims handling process with the use of a smartphone. The affected client can use a smartphone to report the damage, call for assistance on the road and at home, and initiate the repair process at a Repair Network workshop. PZU deals only with the final stage in the claims handling process, i.e., determining the amount claimed and disbursement.

PZU introduced robotics elements at the stage of summarizing the claims report, sending out correspondence, making the claims decision and downloading police memos in order to speed up the payout of the amounts claimed. Robotics is used in specific claim types, e.g., motor claims, mass claims caused by weather phenomena, and handling of medical claims (medical treatment) and life claims (deaths and births). Robotic solutions supporting the process of writing insurance cover for cases reported have been introduced. Additionally, in ADD claims, robotization has allowed verifying information concerning the client’s report of the claim in another company (in cases where the client has consented to the exchange of information between PZU and PZU Życie) This solution ensures consistent service for various ADD reports of the same incident. Currently, work continues, in the area of process automation and concerns other medical benefits, such as surgery, and in the area of assessing permanent impairment for ADD benefits.

The Repair Network repair shops apply an innovative technology using artificial intelligence algorithms which makes it possible to precisely analyze the photographs documenting the damage. It can also determine the scope of the damage and classify the given part for repair or replacement. The algorithms can detect more irregularities more quickly and accurately, and confirm that all repairs are carried out in compliance with the procedures and standards adopted by PZU. Before using artificial intelligence algorithms most cases handled by repair shops had to be analyzed manually. Thanks to implementation of this solution experts receive for analysis only selected cases while the remaining ones, which do not raise any doubts, are approved automatically or semi-automatically.

As part of the sealing of the process of securing recourse claims, the work of the Account Managers is supported by the work of a robot whose purpose is to type damages with recourse potential at the earliest possible stage of the claims process.

Typing is done on the basis of so-called “keywords.” In January 2023, the process of typing damages with recourse potential was supported by an artificial intelligence tool that is based not only on a keyword algorithm, but also on analytical models learned from a wide range of data including debt collection data. The result of the action/processing of the damage by AI is the marking of the relevant information state.

The potential and solutions of the PZU Group in claims handling are also used by LINK4 which avails itself of car wreck sales platforms (PPO), on-site inspections, and the moto-assistance service (PZU Pomoc). Thanks to this cooperation, since 2021, LINK4 has been providing vehicle towing services for all incident participants. It provides towing across the whole country, 24/7, for all types of vehicles, including specialist vehicles and trucks. The service contributes to building and strengthening relationships with the incident participants, irrespective of whether they are LINK4 client or not.

LINK4 uses the PZU Repair Network. The process of referring clients to the cooperating workshops is supported by the use of a dedicated search engine which, based on defined business rules, allows to select the optimum partner workshop, taking account of customer preferences, distances and repair costs. LINK4 has a dedicated hotline for cooperating workshops. The introduction of a new communications channel with suppliers facilitates service and accelerates the processing of reports.

The robots functioning at LINK4 have reduced the work time, improved efficiency significantly and allow the company to implement additional solutions to increase customer satisfaction. Currently, among others, they also support: automatic registration of motor and casualty and property claims, update of the provision amount and entry of costs of inspections carried out by third party suppliers, verification of a vehicle’s claims ratio, collection of loss documentation, handling of memos from the Insurance Guarantee Fund, handling of medical opinions, verification of vehicles with MOD insurance, the process of sharing claims files, sending claims decisions; they prepare payouts in the Direct Claims Handling process, and collect the documentation of inspections from the platforms used by the company.

At Lietuvos Draudimas, the claims handling process is centralized. clients can submit claims or contact the insurer through electronic channels (customer selfservice www.savasld.lt, www.ld.lt and www.ezalos.lt) and Customer Service Center.

The most important changes in 2023 were related to the implementation of automatic claims registration in health insurance and also fully automatic payment of private customer claims in the areas of property and casualty insurance. At the end of 2023, about 78% of private client claims were automatically registered.

In the area of motor, personal and home insurance in the mass customer segment, the benefit payment process has been automated. As part of the new functionality in the TIA system, after the customer agrees to the amount of compensation on the self-service portal www.savasld. lt, the benefit is realized automatically, thus there is no need to manually enter the data necessary for payment.

In 2023, Balta continued to improve its claims processes, including the online claims process. It is currently available for nine products, making online claims between 45% and 98% of all claims depending on the product. Balta’s mobile application, which complements the self-service portal, is appreciated by clients as a convenient solution, especially in the health benefits process. With the largest increase in online filings, the property insurance area saw the largest increase.

In the area of health insurance, the focus was on automating the handling of benefits. A number of improvements have been implemented, including OCR technology and the use of data analytics tools, resulting in smoother customer service. The Estonian Motor Insurance Bureau (Eesti Liikluskindlustuse Fond) has implemented an application dedicated to the registration of motor claims in the market. In June 2023, PZU Estonia launched an integration with this application to transfer data from it to the company’s insurance system. The application is used in about 40% of claims registration in the market, the solution provided reduces data entry errors.

PZU Estonia has implemented a self-service third-party motor third-party liability damage form to enable the reporting of an incident involving a third party, who is not a PZU customer, at the scene without the need to fill out additional documents. A fully automated auto glass damage solution has been launched with partner Carglass.

The implementation and development of Chatbot as part of the motor claims service for third-party and motor hull insurance has become a strategic advantage for the company in the Ukrainian insurance market. Integration of the damage valuation module with Chatbot has been launched, which allows automating the procedure of agreeing on the value of compensation with the customer.

The company PZU Ukraina Życie under martial law was forced to switch to accepting documents for payment in electronic form, as well as signing insurance contracts and letters to clients in the VCHASNO system. This required an overhaul of the claims handling process, but it was also a viable step toward the introduction of an electronic workflow in this customer service segment.