This content applies solely to Connected Claims, which must be purchased separately from the Appian base platform. This content was written for Appian 21.4 and may not reflect the interfaces or functionality of other Appian versions. |
The Connected Claims Customer Service module allows you to view customer records, access claim details, and collect customer feedback through integrated communication channels. You can quickly view and take action on active customer service cases to ensure your customers are supported throughout their insurance activities, improving their overall customer experience.
This guide demonstrates the pages and views available within the Customer Service module. Note that your specific implementation of the Connected Claims application may have more or less functionality.
Rebecca is a customer service representative for a large insurance company, answering phone calls for various customer needs. Many calls Rebecca takes require her to be capable of the following actions:
Rebecca receives a call from Harry, who is calling to check on the status of a claim. To properly handle Harry's call, Rebecca must pull up the appropriate information and navigate the data in Harry's file. Note that while the policy is for Toni, Harry is the one contacting the insurance provider. In this instance, Toni is the Account Name, and Harry and Toni are both Customers on the account.
From the Connected Claims home page, Rebecca clicks the CUSTOMER SERVICE card. This module allows Rebecca the ability to pull up Harry's customer information and any associated items that may be attached to Harry's account.
Once within the Customer Service module, the CUSTOMERS dashboard displays by default. This screen provides Rebecca with a view of basic customer information like names, contact information, case information, and a customer rating.
To filter the record table:
Clicking Harry's account from the NAME column brings Rebecca to the Customer Summary page, which provides helpful details, like contact information and a record table with claim history.
Before assisting Harry with his inquiry, Rebecca must first verify Harry's identity against his customer record. Harry indicates that his address has recently changed and he wants to update it. After confirming his identity, Lisa proceeds with updating his contact information.
To update contact information:
In some instances, Rebecca may need to create new customers or customer groups. When performing this action, Rebecca must know the difference between a customer and a customer group. The differences are:
Note: If the customer is an Individual, the Customer Group and the Customer have the same information.
To create a new customer or customer group:
The following actions are available through the tabs located along the top of a Customer Summary page:
As a large provider of insurance policies, Rebecca's company offers many options. To become familiar with a customer's policy and benefits, Rebecca clicks the Policies and Assets tab at the top of the Customer Summary page.
On the Policies and Assets page, Rebecca can view any policies active for Harry.
Clicking SHOW CLAIM(S) on a record displays all claims associated with that policy. Policies can also be filtered by their status: Active, Lapsed, or Cancelled.
The Cases associated with an account are accessible by selecting the Customer Service tab. All Cases are added via the CASES page accessed through the navigation bar.
Viewing and taking action on customer service cases is covered in detail in a full [Viewing customer service cases] section later in this guide.
Communications items include automated messages and exchanges between customers and customer service representatives.
Note: Self-service items are communications that are automatically generated and sent to the customer as a result of a customer-performed action.
Selecting a communications item provides a detailed look at the message transmitted. The COMMUNICATION THREAD screen shows the message, method, and details.
To create a new communication message:
Tip: Email and WhatsApp messages support file attachments. SMS does not.
From Harry's Customer Summary page, Rebecca can see a list of claims associated with Harry's account shown in the CLAIMS LOGGED record table. Clicking the hyperlink in the CLAIM # column opens the Claim Summary page.
For information claim records, visit the How to Settle a Claim guide.
Rebecca can view the feedback a customer has given for services they have received. Each feedback item provides insight into the customer's experience via claim-specific questionnaires.
Rebecca clicks the eye icon for the feedback item she wants to view. The lower portion of the Feedback screen displays the results collected from the selected questionnaire.
Rebecca wants to send Harry a customer feedback questionnaire once they have resolved any outstanding questions. Rebecca must configure the questionnaire to reflect the correct claim type, ensuring the form provided to Harry is relevant.
To add a customer feedback case:
Rebecca has the ability to access all the conversations by selecting Conversations on the navigation bar.
The Conversations page works in the same way as the Communications tab, in that an item provides a detailed look at the message transmitted. The Conversation item screen shows the message, method, and details. Rebecca can select other communications items associated with a case from the OTHER COMMUNICATIONS ON THIS CASE window at the bottom of the screen.
Conversation items cannot be created directly from the Conversations screen. Items can only be added by creating Communications Items from a Customer, Claim, or Case.
A set of step tasks allows you to create a checklist of actionable items to complete.
To create a list of step tasks:
Accessed by the CASES button located in the navigation bar, the CASES dashboard provides a detailed view of Case items registered in the system, including the mode in which a Case was filed, the owner of the Case, the type of Case, and the status of the Case.
At the bottom of the CASES dashboard is a breakdown of CASE STATISTICS, showing a graph of the different methods customers have used to file their customer service cases, as well as case handler information.
When a Rebecca receives a call from a policyholder, she has to create a new customer service case to record the interaction.
To create a new customer service case:
It is important that Rebecca fills out the Problem Statement free-form box and attaches any supporting documents - this will be helpful in the instance someone else needs to work the case.
Tip: This form offers the ability to close a case upon generation by selecting a check box located above the Problem Statement.
To update a customer service case:
Rebecca adds notes to cases to record relevant information that may become available later.
To add notes to a customer service case:
See the [Managing communications] section.
Clicking on the Audits tab from the Case Summary page opens the Audits page, showing all the actions performed on a case.
The Customer Service module offers the ability to view customer service metrics through a convenient built-in reporting tool. Click the ANALYTICS tab on the navigation bar to open the Customer Service Desk View, which shows a variety of metrics, including trends, open cases, and global distribution of cases.
Located on the ANALYTICS dashboard are two links allowing users to toggle between view options: KPI Summary and Customer Satisfaction.
Now that you have walked through the various steps demonstrating the ways in which you can manage customer information, you can start using the Customer Service module to support your customer base.
How to Manage a Customer Service Case