Student Dissertation

Agency : QRC Management; Health Insurance; Customer Experience

Objective : To understand the current QRC and the process of management Specific Objective: • To understand different Queries, Requests and Complaints of the customers. • To analyze and execute Queries of the Insured customers of ABHI. • To analyze and execute Request made by the Insured customers of ABHI. • To analyze and execute complaints made by the Insured customers of ABHI Study design: Cross Sectional Study and observational study. This study design will be appropriate as this is an observational study that analyses data collected from a population, or a representative subset, at a specific point in time- that is cross sectional data. Hence according to this study, it will cover all types, sub types and sub-sub types of Queries, Request and Complaints raised by different customers throughout their journey with Aditya Birla Health Insurance at that particular point of time and will help us to analyze those factors which are responsible in enhancing customer’s journey in Aditya Birla Health Insurance. Sample Unit: The selected universe of the study was the insured customers of Aditya Birla Health Insurance in Mumbai city. Sample Size: This study includes data from the MIS which is managed at Contact Centre (an outsourced agency) where they maintain all the Queries, Requests and Complaints raised by the customers of Aditya Birla Health Insurance through Inbound and Outbound calls done in Contact Centre and tagged under different stakeholders in head office of ABHI for their resolutions within defined TAT’s as per the SOP of Aditya Birla Health from 1st Jan to 1st of May 2017. A sample of all insured cases was selected from 1st January till 30 April 2017.

Background : Customer satisfaction and experience are important for every industry, and certainly insurance is no exception. For insurers customer satisfaction means not just the use of a policy product that was purchased from an insurance company for a cost, but also the satisfaction that is obtained when the claim is settled in full. In this sense, customer satisfaction does not happen simply by purchasing a policy product, but it occurs when customers get the expected benefits such as peace of mind during the product cycle and speedy payment when a claim is filed. Customer experience, on the other hand, is the positive feelings that a customer has when he or she goes through the entire cycle, right from purchasing a product to getting paid when a claim is made. Unfortunately, many insurance companies falter in providing the right customer experience because they get mired in overseeing claims and settling them. As a result, customers do not get the right response from agents or they have to wait too long to get their claims settled. Such situations have a negative impact on customer experience. And, this translates potentially into lost customers. Keeping all these scenarios in mind Aditya Birla Health Insurance never wants to compromise with the satisfaction level of customers. As described earlier Aditya Birla Health Insurance has launched complicated and advanced health insurance product. Hence, to reduce this complication of the product and make it easier and reliable as per customer’s understandings and perspectives, Aditya Birla Health Insurance launched QRC management programmed within the organization so as to render quick and effective closures and execution of the raised service requests by the customers, This is a new initiative by any organization to incorporate with customer’s satisfaction and deliver optimal results in resolving QRC, on quick and effective basis. Thus, to endeavor more effective results the study has been done to identify and understand the reasons behind dissatisfied customers and also work in setting process towards closure and execution of every QRC, raised by the customers at contact centre. Research Question: How is the QRC system managed in Aditya Birla Health Insurance in Mumbai City.?

Methodology : The secondary data were selected which was taken from the MIS maintained in the software of CRM (Customers Relationship Management) where tagging of different Queries, Requests and Complaints raised by the customers against different stakeholders and further processed and resolved by different departments of ABHI within defined TATs to the customers on a daily basis. Respondents’ Inbound and Outbound calls were tagged under different Request’s, Queries and Complaints whose record had been maintained in CRM by the agents sitting in our contact centre. Those QRC reports were daily sent from the contact centre to the HO and further managed by the Contact Centre Team by Tracking their ageing, coordinating with different stakeholders for quick Redressed/Closure/Executing of the QRC with a perspective to enhance customers experience in ABHI and further the feedbacks were also taken from the Insured Respondents frequently and were rated as NPS scores (Net promoter score). The Quick and Effective closure of QRC raised by the Customers leads to generate good NPS (Net Promoter Score) taken by the customer in the form of feedback ratings and further these ratings were analyzed in the software CRM (Customer relationship management) by the CSE’s (Customer Service Executives) and Customer Feedback status was rated under following parameters: • Highly Satisfied (Rating score:8-10) • Neutral (Rating Score5-7) • Poor (Rating score 1-4) These NPS ratings were taken by customer in following time durations: • Policy Purchasing Experience-After Issuance of Policy • Claims Settlement-After Claims processing and settlements • Closure of Service Requests - After closure of every Service Requests Tagged under Queries Request and Complaints. (SOURCE) Analysis of the reasons: MIS maintained by different Stakeholders. All raised Service requests were marked in mail to respective stakeholder asking the reasons to be explained against the particular raised Service Request. The Stakeholders maintained an MIS in which the Stakeholders track reasons for unsuccessful servicing of Policies. And these Reasons were further analyzed by QRC team, by adopting the quality tool named RCA (Root Cause Analysis) and further tracked toward its effective closures without increasing its ageing and execution of the same. Data Collection Instrument: • Secondary Data: MIS of QRC (Queries, Request and Complaints) Not only we tried to resolve the queries, requests and complaints of the customer but we also tired to execute them properly so that our other customer’s do not suffer from the same experience.

Findings : • There was no such defined process of action for the service request raised in the form QRC, s. • System CRM used to get hanged on frequent basis which used to incur a lot of manual work at the contact centre. • There was lack of trained CSC in the contact that used to create a lot of error in data entries such as non-availability of Comments, assigning SRs to wrong stakeholders, not giving correct information to the customer (Missselling). • The CSC at Contact Centre have lack of product knowledge which leads to incorrect raising of SRs. • Few additions towards execution of raised SRs, could only be resolved after getting it incorporated in CRM which is a Phase 2 requirement which would take time to settle with. • Due to lack of time all the top 5 queries and requests are not analyzed in detail. Limitations: • The available Sample Size was not adequate to identify and analyze the QRCs, for getting desired results. • There was lack of time availability due to which detailed analysis and execution of top 5 QRCs, didn’t take place. • The planned interventions are the part of study whose inputs are unable to be configured into this study as they are still pending for detailed analysis. • Due to lack of sample size in data collected for Complaints they are not analyzed.

Recommendations :This Cross-Sectional observational study on how can we enhance Customers Experience in Aditya Birla Health Insurance concludes that there have been following reasons for the customers being dissatisfied with health insurance industry. The effect of this disability also results in many negative shifts towards customer being diverted to some other health insurance products discontinuation of the product further. As the organization has started QRCs, Management from month of January, and till date this initiative has shown minimal improvements on a progressive basis, but there are certain challenges which were responsible in non-execution of few issues on which the organization is working towards.


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