Insurance companies are facing increasing pressure to reduce costs and improve operational efficiency — especially in the modern back office. The rising cost of claims, driven by climate-related events such as floods and wildfires, as well as macroeconomic forces like inflation, has intensified the need for change. These pressures expose the limitations of manual, fragmented processes that many insurers still rely on – processes that are no longer sustainable for maintaining profitability.

Unlike other industries, downsizing the back-office workforce is rarely a viable option in insurance. Claims processing is inherently human-centered, particularly during customer crises, where empathy and personal interactions are essential. This makes improving operational efficiency without reducing staffing requirements a complex challenge.

Workload automation offers a strategic solution. By streamlining resource allocation and enabling real-time visibility, it allows insurers to improve service levels and reduce operational waste without compromising the human element that defines customer experience in claims handling.

Workload Automation and Orchestration Drive Efficiencies

When people think of automation, they’re often thinking of front-end tools like chatbots or voice assistants that handle simple customer inquiries. While useful, these technologies represent only a fraction of automation’s potential — especially when back-office workforce management (WFM) is left out of the equation.

Workload automation takes a broader, more integrated approach. When run on the Genesys Cloud™ platform, it means a coordinated execution of tasks, improving processes and optimizing workflows across multiple systems and applications. By ensuring that the right tasks happen at the right time and in the right order — with minimal human intervention — workload automation brings structure and consistency to complex operations. 

For insurance companies, this is especially impactful. Back-office functions such as claims processing, underwriting, compliance reporting and customer onboarding are data-heavy and rule-driven. Automating these processes and the routing of tasks not only reduces human error, but also significantly increases speed and consistency.

Adding orchestration further enhances these benefits by managing interdependencies between systems, tasks and business rules. This ensures end-to-end process continuity and enables staff to focus on complex, high-value activities rather than routine, follow-on administrative work.

Ultimately, while manual processes strain under volume and complexity, a well-orchestrated automation strategy delivers scalability, transparency and a better experience — for employees and customers.

How a Lack of Automation Impacts Back-Office Performance

Without integrated workload automation, back-office operations suffer from three persistent challenges that compromise efficiency and customer service experience:

  • Fragmented work and resource allocation

Work is frequently distributed unevenly, leading to bottlenecks in some teams while others are underutilized. This delays service delivery, prevents effective resource allocation and hinders the ability to maximize team performance.

  •  Limited visibility into operations

When managers lack real-time insights into workloads, performance metrics and task progress, it’s difficult to identify issues early or respond to new demands. Workload automation solves this by aggregating data across systems into a unified view on the desktop – enhancing oversight and enabling smarter, faster decision-making.

  • Manual workload management

While many companies use automation tools for individual tasks, the broader coordination of workload distribution often remains manual. Assigning, tracking and prioritizing work items introduces delays, errors and even bias – such as task cherry-picking. This not only undermines productivity but also affects fairness and morale across teams.

As employees struggle to keep up and managers lack the back-office management software necessary to intervene effectively, customers experience delays and inconsistent service. These tools introduce business risks and contribute directly to increased churn and a loss of competitive advantage.

Delivering a Better Claims Experience

Claims are often emotionally charged and require empathy, yet a bad back-office process can wipe out all the positives of a good front-line interaction, or a claim initiated online. For the customer, there’s a lot at stake.

Let’s say a customer reports a new auto claim over the phone or by self-service using digital channels. When the claim is created in the claims management system, Genesys technology would create an auto claim work item. This work item is then automatically assigned to a claim handler with the appropriate skills. That claim handler becomes the internal owner of the claim.

With all necessary systems visible on a single pane of glass, the claim handler can track all their claims and all tasks through their list. And with automatic status changes and work item flows, supervisors can make sure SLAs are met.

By orchestrating the claims process, you’re improving operational efficiency. Customers are happier and you’ve made the process easier for handlers as you reduce costs. This automated processing also sets you up for proactive communication, essential to optimal customer experiences and reducing contact volume​.

Proactive Communications Boosts CX

From conversations with Genesys customers, we’ve found that about 40% of the calls received by insurance companies in their contact centers are related to existing claims. Proactive communications can reduce that number dramatically when you automatically send updates about a claim, for example, using WhatsApp email or an SMS.

Customer expectations have changed with the advent of Amazon, a leader in updating buyers at every step of the purchase and delivery process. For any business, preempting calls that are only for updates means more time for employees to talk to customers who need personal attention.

And yet, some companies still believe that it’s good enough to send customers in the middle of a claim to log into a website to search for an update. But that puts the pressure on the customer to stay on top of progress. Proactive communications eliminate this short-sighted approach.

Making Smarter Decisions on the Fly

In the past, when a customer had a question about a claim, they would call the contact center. The contact center rep would then call the back office or try to talk to the claim handler for an update and get back to the customer. More insurance customers now allow the customer to talk directly to the claim handler.

For greater efficiency in this more complex environment, your IVR should recognize the customer and know that the customer has an open claim — and that they’re likely calling to talk about the claim. In this case, the interaction should be routed directly to the claim handler or someone on that team.  

Having a single platform to orchestrate the back office and the front office tasks enables you to balance both Incoming customer interactions and back-office activities using a single engine that can also balance the workload for those back-office agents.

Even better, if an employee is handling a specific claim and a call comes in, supervisors can decide through the workflow whether you want to interrupt that claim with a different call.

A supervisor might also decide that when a lot of calls are coming in from customers, they can prioritize those calls by holding back-office tasks or activity that they were about to distribute to claim handlers or back-office agents. This ensures all customer support task-handling is completed on time and automatically transitioned to the next step in order of urgency.

When you have skilled claim handlers delivering a great initial customer experience and then it’s a disjointed, slow or chaotic experience down the road, you’ve lost your competitive advantage.

Work Automation Bridges Critical Gaps in CX

Insurance is a product sold and bought with the hope that it won’t be used. Customers don’t enjoy the product; they buy it because they need it. This type of product requires that you think differently about the nature of a good experience for customers: It should be an easy experience, effortless for the customer and less stress for agents.

When customers contact their insurers to report a claim, the first response is often from a human who listens and responds with empathy to the situation. But customer experience does not end with the contact center and the front office — and most customer dissatisfaction originates in the back office, with the inefficiencies of siloed systems and manual processes.

Rethink how you can deliver experiences that meet the expectations of a modern customer base, and they’ll reward you with loyalty.

Ready to transform the claims experience for your customers? See why companies around the globe invest in Genesys Cloud, the industry-leading, AI-powered customer experience platform to gain a competitive edge.