Cas client
Design the target customer relationship operating model
À propos du client.
Insurance companies outsource claims assessment to a third party responsible for determining liability and evaluating the compensation amount. Hundreds of thousands of cases are handled every year. The key challenge for the third party is to qualify the claim in order to decide whether a remote assessment, a video assessment, or an on-site assessment is required. This is followed by scheduling an appointment with the policyholder, conducting the assessment, and delivering the report to the insurer, who will then decide whether to proceed with compensation based on the coverage provided in the contract. The company we supported is the leading expert assessment provider in France. It employs over a thousand experts in France and abroad, and operates several operational centers—one central and five regional—which coordinate interactions between experts and policyholders.
HOW DID YOU APPROACH THE PROJECT?
One of the key requests from top management was to be disruptive—to challenge long-standing paradigms that the company had taken for granted. Additionally, and crucially for the entire approach, in order to free the team from the human and social consequences that our conclusions might entail, management made it clear that no one would lose their job as a result of implementing AI. While individual roles would undoubtedly evolve, employment itself would not be at risk.
We assembled a working group composed of middle managers and members of the executive committee (CODIR)to explore potential future scenarios and ultimately recommend a preferred option for executive arbitration.
The process was structured in four key phases:
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Discovery phase: on-site immersion to understand the roles in contact with policyholders and experts, meetings with all operations center managers, and the main leads for different claim types (responsible for coordinating the expert network);
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Scenario-building phase: identification of around fifteen significant hypotheses, leading to the development of four desirable future scenarios;
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Detailed description of the selected scenario: outlining operating models and impacts on existing roles, projected claim processing flows and the target policyholder journey, and forecasting resource impacts;
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Executive alignment and adoption: presenting the target scenario to the CODIR, gathering and addressing objections and additional questions in a group setting, and facilitating a second session to explore likely consequences.
SETUP
1 Consultant and 1 Partner
WHERE DID YOU START FROM?
The company began developing AI solutions in-house five years ago. The primary goal of this investment was to improve expert productivity, and the results have been nothing short of remarkable. Today, an expert report can be generated in just a few minutes, based on field observations entered via smartphone, with only a quick review by the expert before it is sent to the policyholder.
Another example: 30% of case qualifications are now handled by an AI. Policyholders receive an automated SMS upon the receipt of an assignment order and are then connected to the AI, which asks them questions to understand the situation and determine which expert should handle the claim.
Top management is now reflecting on the future customer relationship model if AI usage were to become systematic. The challenge is to fully integrate the technology into the customer journey, rather than confining it to isolated activities.
Some journeys will be handled almost entirely automatically (aside from the expert appointment), others will still require human involvement, and a significant share will rely on staff where technology is not suitable—such as for emotional support, internal coordination, follow-up on commitments, and maintaining the relationship with the policyholder.
This raises critical questions: What will be the impact on roles, on relationships with policyholders, insurers, and experts? And ultimately, how will this transformation affect the company’s productivity?
AND WHAT WAS THE SITUATION WHEN YOU FINISHED?
Top management is extremely satisfied with the collective reflection that has been carried out. It has also developed a clear conviction about a transformation target for the company within the next 12 to 18 months and is now exploring ways to implement it. The Executive Committee (CODIR) is somewhat unsettled—both by the target itself and by the sense of a “back to the future” that the chosen scenario evokes. Together, they are realizing the true impact of the AIs they’ve created, which are changing everything—because they finally make it possible to fulfill an old ambition they had never been able to achieve: dedicating human interactions to personalized relationships.
One impact we may not have fully anticipated: the shift from managing operational flows to managing individual customer experiences deeply changes what drives motivation and the sense of accomplishment for employees and frontline managers. Satisfaction no longer comes from the volume of tasks completed, but from the satisfaction of the end customer. This might mean that the people who thrive in this “new” job may not be the same ones as before.
IN YOUR OPINION, WHY WERE YOU SUCCESSFUL?
If this mission was a success, it is partly thanks to the company’s culture, which is highly conducive to change. Employees have strong trust and appreciation for top management, particularly regarding the evolution of roles and the company’s positioning in a market that fully embraces technology.
On the other hand, Talisker’s support enabled the company to grasp a transformation they had struggled to fully achieve on their own in previous attempts. Through various working sessions, we succeeded in building a credible target model that aligns with the company’s ambition while addressing the key concerns raised by the management team.
As a result, the leadership now has enough confidence in this model to test it in the field in preparation for broader deployment. Talisker continues to strengthen the organization’s adaptability, ensuring this transformation can truly take shape.