Emerging Insight: The insurer that pays claims
4 September 2017
When Pioneer Insurance started offering insurance for low-income households in 2007, it had one distribution partner – CARD MRI. Today, after ten years, Pioneer’s joint-venture with CARD - CARD Pioneer Microinsurance – works with almost 100 institutional partners, issued more than 18 million policies in 2016, and generated Php 936 million pesos (USD 19 million) of premiums.
Pioneer attributes its focus on claims as one of two factors contributing to this growth (the other is client understanding).
To establish itself as “the insurer that pays claims”, Pioneer took a number of steps. It set up a unit dedicated to the micro-segment that had its own underwriting and claims settling authority. This allowed it to develop its own guidelines and standards, and to reengineer operations to respond to the realities of this market segment.
Pioneer realized that it could not do business from behind a desk: it needed to get close to the lives of its clients. The insurer made accommodations for circumstances unique to the low-income market. For instance, to submit a claim for a death that occurred in hospital, a death certificate was required from the hospital in order to pay the hospital bill. However, as the hospital would not release the certificate until the bill was paid, the client was left in an impossible chicken-and-egg scenario. Pioneer sent a representative to the hospital to verify the claim and then make the payment without the certificate.
As Pioneer grows, it is building the organizational, operational and technological foundations that will allow it to improve claims and services for its current 10 million clients, as well as the next 10 million. To learn more about Pioneer’s story, see the new Pioneer Microinsurance Case Brief.
Pioneer attributes its focus on claims as one of two factors contributing to this growth (the other is client understanding).
To establish itself as “the insurer that pays claims”, Pioneer took a number of steps. It set up a unit dedicated to the micro-segment that had its own underwriting and claims settling authority. This allowed it to develop its own guidelines and standards, and to reengineer operations to respond to the realities of this market segment.
Pioneer realized that it could not do business from behind a desk: it needed to get close to the lives of its clients. The insurer made accommodations for circumstances unique to the low-income market. For instance, to submit a claim for a death that occurred in hospital, a death certificate was required from the hospital in order to pay the hospital bill. However, as the hospital would not release the certificate until the bill was paid, the client was left in an impossible chicken-and-egg scenario. Pioneer sent a representative to the hospital to verify the claim and then make the payment without the certificate.
As Pioneer grows, it is building the organizational, operational and technological foundations that will allow it to improve claims and services for its current 10 million clients, as well as the next 10 million. To learn more about Pioneer’s story, see the new Pioneer Microinsurance Case Brief.