Personal Auto Claim

The Personal Auto Claim Microjourney™ in Pega Customer Service™ for Insurance provides insurance policyholders the ability to easily file a personal auto claim, also known as the first notice of loss (FNOL), within minutes of an accident occurring.

This use case reduces the time that it takes to file a claim by using geolocation, time, date, and a mobile device's photo library or camera. A fast and easy claim process increases Net Promoter Score (NPS). This Microjourney also uses the Pega Email Bot to save the insurance carrier thousands of hours of processing time.

The Personal Auto Claim Microjourney is available in web self-service and assisted-service channels.

Web self-service example: policyholders can file an auto claim from their mobile device or laptop within minutes after an accident.

Web Self-Service

Having an accident is a stressful time for a customer. This Microjourney allows a customer or customer service representative (CSR) to easily file a personal auto claim within minutes.

  1. Customer accesses self-service website from a mobile device.
  2. Customer specifies where the accident occurred. Geolocation can eliminate the need to enter the address. 
  3. Customer reviews the information and files the claim.

Assisted Service

A customer may file a personal auto claim by calling, chatting, or using other assisted service channels. The Customer Service Representative (CSR) would assist the customer in filing the personal auto claim by working in the Pega Interaction Portal.

  1. Email bot triages and processes the email.
  2. Email bot uses natural language processing (NLP) on the police report (PDF file) to view the past learned entities.
  3. Email bot reads the metadata within the PDF file and adds this information to the case without any agent intervention.

The Pega Email Bot requests the police report after the loss is reported. The email bot scans the police report email and attachment and processes the email without any agent intervention.

App Studio provides personas, stages and steps, and data objects in one window.

Personas

Personas help you to group users according to the cases they work on, the channels they can access, and the responsibilities they have within a process.

Stages and Steps

Stages and steps show the visual path of the business process. The image below details the stages and steps of this particular Microjourney.

Data Objects

Data objects organize and store data that your Microjourney requires. These categories of data have fields, field mappings, and connections to data sources.

Personas in this Microjourney.

Customer

The customer is the insurance policyholder who files a personal auto claim.

Customer service representative

The insurance customer service representative (CSR) helps customers by using assisted-service channels to file a personal auto claim.

Stages and Steps

This Microjourney includes the following stages.

  1. Customer Identification: a customer goes online or calls a CSR to verify their identity and that they are a policyholder.
  2. Initial Setup: a customer or CSR enters the initial claim loss details, such as time, date, location, and photos.
  3. Claim Details: claim submitted for processing, including information such as police report and towing details. 

Personas

  1. Customer: verifies their identity by signing into their account online.
  2. Customer: enters the initial claim details.
  3. Customer: where relevant, emails the police report and towing details.

Data Objects/Models

  1. Where customer record data is stored, which is typically the system of record (SOR).
  2. Where insurance policy data is stored, which is typically the policy administration system.
  3. Where the data is stored for the claims management system.

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Find more details and step-by-step instructions on implementation below.

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