All creatures great and small

Published on the ANZIIF Members’ Centre: https://anziif.com/members-centre/articles/2017/11/all-creatures-great-and-small

If you’re one of the 63 per cent of Australian households that own a pet, you’ll know the pain of seeing your four-footed friend in need of medical attention. Leading pet insurance underwriter PetSure came up with a solution to take the stress out of processing claims for owners and vets.

Given the financial and emotional stress that customers experience during the treatment of their family pet, PetSure decided to develop an easier claiming process to minimise the time they spent out of pocket.

Its platform VetHub, a first in Australia and the Asia Pacific, is achieving nearly 80% of claim payments the same day as claim submission.

High maintenance claims

Consumer spend on pet care is over $2 billion each year and PetSure is one of the largest contributors to the industry

A high-volume claims business, PetSure processes over 57,000 claims a month. In 2016 alone, the company paid out $90 million in claims.

Historically, the majority of claims were processed using mail, email or a self-service portal. The average period between treatment and payment was 10 days including return visits for documentation.

To support PetSure’s claims assessment process, customers were required to submit a range of documents including an invoice with diagnosis and a medical history to determine pre-existing conditions.

If the customer submitted their claim by post they would also need to send in their claim form.

Customers demand better

Based on market research, PetSure recognised that vet customers want a human health insurance claims experience.

Meanwhile vets are spending 20 per cent of their time supporting claims processing for customers, such as chasing up missing documentation.

On-hold claims are delaying payments to customers and the administrative burden of collating and preparing additional insurance documentation is affecting vet practices’ ability to advocate for pet insurance.

‘PetSure plays a key role as a major contributor to the vet and pet industries and future category sustainability, by enabling pet parents to manage increasing pet care costs,’ says PetSure CEO Alex Thomas.

 ‘We pride ourselves on our strong customer experience focus, but when we analysed our claims experience, several areas were identified as opportunities for innovation,’ Ms Thomas says.

Busting the paper trail

VetHub addresses these challenges by streamlining the claims process.

It is an open source-based industry platform that links vet clinics to insurance providers using middleware and an API, to enable the sharing of claims documentation electronically between all the industry players.

VetHub also leverages European VetXML, a universal data language that facilitates electronic dialogues between practice management systems and veterinary suppliers.

By rolling vet clinics onto the platform, industry participants are able to connect and share data such as insurance claims and associated documentation in real time.

‘VetHub aligns the customer experience with expectations set by human health insurance, while reducing the time and cost of processing claims for customers and vets,’ Ms Thomas says.

‘The system minimises on-hold periods and the double handling of claims by PetSure to reduce the time it takes to make payments to customers.

‘Once the effort and workload required to support the claims process is reduced, vets are more likely to become advocates for pet insurance products.’

Change management

The successful development of VetHub required PetSure to apply a change management process of engagement with each of the different stakeholder groups at each of the relevant stages of the project.

Deliverables from the change management included providing a dedicated support desk to facilitate setup and configuration of VetHub, training PetSure’s claims assessors to assist vets as they submit claims and sharing a customer’s claim status in the self-service portal to them informed.

‘Sharing the status of a customer’s claim is an essential part of the process as it removes the burden of providing the updates from the vet,’ Ms Thomas says

‘We also provided vet clinics with training and material to help them submit claims.’

Effective risk and issue management was a key objective of the project to ensure that PetSure met its strategic objectives.

High engagement

Key challenges included motivating practice management to use the system, delivering support software during development and working with the vets’ practice management software providers.

‘PetSure ensured that the value to vet practices was clearly defined and thus supported their internal development work,’ Ms Thomas explains.

‘High levels of engagement with local vet practices was maintained throughout the project to ensure that they participated in submitting claims using the new VetHub system.

‘PetSure also trained the software providers’ sales teams and created an internal team to support connection and upgrade processes within each veterinary practice.’ she says.

VetXML was identified as a message standard in the Europe market and implemented for VetHub to assist with future vet practice management systems rollouts.

Figures tell the story

Ms Thomas says the feedback from vets is that VetHub has reduced the internal administration costs of claims by 20 per cent.

‘The positive feedback from vets clearly indicates advocacy is increasing regarding the value of pet insurance and thus the potential wider growth of the category,’ she says.

‘With over 145 locations [for VetHub] deployed at the end of 2016, growth is expected to continue into 2017 due to growing customer and vet advocacy.’

When channel usage is compared between 2015 and 2016, PetSure saw a significant increase in claims processed through VetHub by the end of 2016.

The system’s ability to consolidate and hold more complete documentation has reduced on-hold claims by seven per cent to around 13 per cent, versus an on-hold claims rate of 20 per cent through the other channels.

A nine per cent reduction in processing effort has also been attributed to the use of VetHub, since data streamlined in a single record is better structured and easier to read.

Glowing future

Ms Thomas adds that VetHub is the only platform of its kind in Australia being designed to be compatible with other players, including other insurance firms.

‘We believe that VetHub could easily be extended to facilitate connections between organisations that would benefit from sharing animal clinical data such as pharmaceutical companies, specialists and other value added services,’ she says.

‘In 2016 PetSure won the Asia Pacific Digital innovation award for VetHub reflecting the wider recognition that PetSure is gaining through its commitment to innovation.’

PetSure was a finalist in this year’s Australian Insurance Industry Awards.