Work with the Platform

Learning Objectives

After completing this unit, you’ll be able to:

• Identify the personas who use the Digital Insurance Platform.
  
• Describe how each persona uses the platform.
  

Key Players

The Digital Insurance Platform is a truly powerful solution. It makes work easier for many groups of people who work in the insurance industry. Both Cumulus employees and partners can reap the benefits. Who are these people and what tasks do they perform? Let’s dive in.

The key people who use the Digital Insurance Platform are:

• Customers
  
• Brokers
  
• Underwriters
  
• Sales agents
  
• Product managers
  
• Customer service representatives
  
• Claim adjusters
  

Customer

Remember Anna Murphy? She’s a valued Cumulus customer. Anna and other Cumulus customers expect modern, omnichannel experiences as they interact with their insurance provider. In their eyes, dealing with an insurance company should be simple and convenient.

Insurance customers often need to complete various tasks. Ideally, they want to self-serve online, for instance, to:

• Find quotes for best-fit insurance plans.
  
• Enroll in plans with minimal effort.
  
• Choose from different payment options.
  
• Update their policy, for example, to add dependents or insured persons.
  
• Cancel their insurance without fuss.
  
• Make a claim.
  

Broker

An insurance broker is an intermediary between a consumer and an insurance company. The job of the broker is to help customers find suitable policies. Brokers are also known as producers or independent agents. They sell insurance to individual customers, like Anna, but not only that. They can also sell insurance to companies like Cloud Kicks, who in turn provide their employees with group insurance. 

Brokers aren’t employees of insurance carriers like Cumulus. Instead, brokers typically represent an independent firm and act between the carrier and the customer. Customers often enjoy working with brokers because they can research plans across different carriers to find the best plans and prices. 

Broker tasks include:

• Working with the carrier and their customer to find best-fit insurance plans.
  
• Negotiating rates for their customers.
  
• Helping customers with contracts and renewals.
  

Underwriter

Underwriters are involved in the quoting process. Their job is to assess the risk of insuring a customer. They review applications and ultimately decide whether the insurance company should insure the customer, and under what terms. 

Underwriters are responsible for:

• Evaluating insurance applications—new applications and renewals.
  
• Gathering additional information about the customer if needed.
  
• Adjusting coverage amounts and premiums if needed.
  
• Working closely with the product administrator to help define the rules and workflow to support underwriting requirements.
  

Sales Agent

As they shop for plans, customers and brokers may need help. Here's where the sales agent comes into the picture, working as part of the insurance sales team. The main goal of the sales agent is to increase sales. They want to ensure that customers and brokers have all the information they need for successful plan enrollment. 

Sales agents often need to:

• Support customers as they shop for insurance plans.
  
• Answer customer questions about different plan options, enrollment requirements, and payments.
  
• Support brokers in selling plans.
  
• Help brokers with in-progress or submitted customer applications.
  
• Assist with other enrollment-management tasks.
  
• Create support cases for brokers, for example, if they see an issue with an application.
  

Product Manager

Cumulus Insurance has a wide range of insurance products. The brains behind the products are the product managers, who design, develop, and track insurance plans according to specifications. In fact, they manage the entire plan lifecycle. 

The job of the product manager isn’t easy. They must:

• Build components and plans based on approved design specifications.
  
• Set up business rules and ratings.
  
• Submit plans for approval.
  
• Launch products to market.
  
• Manage existing plans.
  
• Administer changes and version plans from one year to the next.
  
• Ensure that plans are government compliant.
  

Customer Service Representative

When customers like Anna need help, they often contact customer support. Customer service representatives support customers who contact the help center. They strive to provide outstanding customer service and satisfy customers, though it’s not always the case.

Customer service representatives are typically responsible for these activities.

• Supporting customers by answering questions about their insurance plan.
  
• Resolving customer issues, like billing discrepancies and payment problems.
  
• Updating customer details in the system, such as address and phone number.
  
• Logging cases based on the details that customers provide.
  
• Fostering solid relationships to retain customers and maintain product loyalty.
  

Claim Adjuster

Sometimes life happens, and customers need to use their insurance. Maybe the cook of the house keeps pouring bacon grease down the drain and clogs pipes. What an expensive repair. Maybe the teenage son carelessly backs up his flashy new car and hits the next-door neighbor’s mailbox… again! 

In these cases, customers can submit a claim to the insurance company to get reimbursed for their loss. Once they submit the claim, claim adjusters come into the picture. Claim adjusters assess, adjust, and process claims made by claimants. Typically, claim adjusters work for the insurance company, but sometimes, third-party adjusters play a role. 

Claims adjusters are responsible for:

• Reviewing the customer’s insurance policy to determine whether the plan covers the claimed loss.
  
• Determining the amount the carrier should pay out for the claimed loss.
  
• Writing reports about the events and damage related to the claim.
  
• Ensuring claims aren’t fraudulent.