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Service as Competitive Advantage

When customers get to the point of calling an insurer, it is precisely because their inquiries are not the kind they feel can be handled by other channels, remarks Ben DiSylvester, management consultant and chairman of Robert E. Nolan Company (Dallas). "The customer is hoping that you understand their problem, you can fix it and you won't ask a lot of questions about information you should already have," he says. "Making sure that customer service representatives [CSRs] can access systems properly, and have scripts to better understand the questions and better answer them are all very basic and important things that companies need to do."

But insurers should think past the baseline to use customer service as an opportunity for competitive distinction, DiSylvester urges. Good customer service is one thing; customer intimacy is another. To ensure that they get a larger share of their target markets, insurers must appeal specifically to the individual customer within that segment, DiSylvester explains. "The issue is understanding the needs of the customer and designing the service model around those specific needs," he says. "The differentiation comes when customers are interacting with the company and they're hearing something different than they hear from another company, which leads them to say to themselves, 'This company understands me and it understands my needs.'"

If Humana has succeeded at that objective with its personalized SmartSummary documents, it is only after a long look at its systems and processes beginning in 2003. "Our work focused on a number of areas, including ethnographic research, following members home to understand how they managed their healthcare, how they made plan selections, how they budget and claim for health finance expenses," says the company's Nicholson. The goal, he adds, was "to provide members with the relevant information that they need to make those decisions."

During 2004, the carrier focused on determining which communication vehicles would best serve that goal, guided by four principles, according to Nicholson. The first principle, consolidation, focused on inventorying existing communications, such as periodic mass mailings, in order to concentrate them into one vehicle, he explains. The second, personalization, sought to increase the communications' relevance and impact by making it specific to the member. The third, distillation, aimed to synthesize the relevant information into language intelligible to the lay-reader. And the fourth, and perhaps most important, according to Nicholson, was actionability -- giving members clear direction as to what they needed to do with the information.

As Humana put prototypes before focus groups toward the end of 2004 through early 2005, it set about seeking the means to deliver the final product. "We realized we didn't have tools to provide the kind of personalized communications that our members were asking for," Nicholson recalls. The carrier evaluated about a dozen vendor solutions, as well as two tools already in-house, he relates. "We were trying to get a good assessment in terms of cost, flexibility, scalability and integration with our print systems and [data] outputs," Nicholson says. "We were looking for a broad solution that not only fit in the print space but also the Web."

By May 2005, Humana identified Exstream's (Lexington, Ky.) Dialogue product as its document creation and automation tool and signed a contract with the vendor. Humana then worked both to identify the sources necessary to produce the right member communications and evaluate how those sources could be integrated into Dialogue, according to Jackie Hardison, director, clinical guidance and pharmacy applications, Humana. Hardison notes that Dialogue draws data from 13 different applications. "From establishing exactly what information needed to be presented through to the first delivery took about six months," she says.

The first mailing of SmartSummary occurred in October 2005 to a group that included 17,000 Humana employees, according to Nicholson. Humana then conducted follow-up research to gauge members' experiences. "That helped us with planning for call center staffing and determining the kind of questions we were likely to receive, which in turn helped prepare us for a broader rollout in January 2006," Nicholson explains.

Anthony O'Donnell has covered technology in the insurance industry since 2000, when he joined the editorial staff of Insurance & Technology. As an editor and reporter for I&T and the InformationWeek Financial Services of TechWeb he has written on all areas of information ... View Full Bio

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