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Future Solutions in Customer Experience and Retention for Private Health Insurance

The ‘Future Solutions in Customer Experience for Health Insurers White Paper’ is a research paper developed to help Australian health insurers deliver greater customer experience and customer retention. This White Paper is aimed for CEO’s, General Managers, marketers, sales and customer service leaders as well as analysts, policymakers and researchers in the industry. It is a ‘how to’ guide for getting closer to the consumer from a more complete, holistic perspective in order to drive strategic and tactical decisions.

Insights in this Paper were compiled from analysis of in-depth interviews and presentations from representatives of 10 Australian Private Health Insurance companies. Australia now has a relatively mature Private Health Insurance industry with over 11 million members and over $21bn in annual revenue in 2015. However, industry growth occurs in an evolving Australian market, which is increasingly complex. Consumers have to choose between over 17,000 different policies currently available for sale and over 25,000 policies currently in the market.

 Download the White Paper

Lapse rates can rise to over 20% of customers with some insurers (13). This equates to lost revenue (or switching of sales) exceeding $2bn per annum from lapses of an estimated 940,000 members up to 2014. These considerably high lapse rates have a significant financial impact on insurers due to the relatively tight net profit margins of most funds. In addition, insurers and customers waste a significant amount of time negotiating and resolving issues related to poor purchasing and claims experiences.

Applying a Systems Thinking approach to this complex, problem, we find a Vicious Cycle occurring in the industry in relation to customer retention and experience. From the consolidated analysis of contributor interviews, the real reason for poor customer experiences can be summarised into these 4 major themes. These include customer perceptions of confusion and lack of value, regulatory and competitive forces, sub-optimal systems, processes and data management as well as health system dynamics.

Following the analysis of interviews with industry experts, themes of solutions were consolidated. The solution model must also be robust, resilient to unpredictability and enable an organization to learn over time. In short, its execution must be a ‘Virtuous Cycle’ of CX Solutions, which is as follows:

  1. Define & Refine CX with Vision, Strategy and Objectives
  2. Align Leadership and Culture with Change Management
  3. Implement Systems and Capabilities to support CX
  4. Translate Perceptions into CX Insights & Priorities
  5. Apply CX strategically across portfolio, product design and marketing channels
  6. Extend CX across healthcare ecosystem

For some organisations, the implementation of all these solutions may take months to years and significant financial investment. As such, for those organizations that are time poor and can only do ONE THING to begin moving in the right direction, it would be to start understanding their customer perceptions much better than they are doing now. Every step of the Virtuous Cycle is largely defined by having deep psycho-emotional insights into customer perceptions. It all begins with the customer in mind, or rather ‘the customers mind’.

About the Author: Dr Avnesh Ratnanesan

Dr Avi is a medical doctor with broad healthcare sector experience including hospitals, biotech, pharmaceuticals and the wellness industry. He is a leading expert who coaches and consults to senior executives, entrepreneurs, practitioners, organisations and governments.