The health insurer as a life guide

Often, health insurance companies have contact with their customers only when they sign a contract, or there is an illness. But how can insurers support their customers at all times? SWICA’s response to this question is a well-conceived customer journey revolving around the hospital stay. For this consultative process, the company was recently nominated for’s customer experience award. In an interview with us, the woman behind the journey, Kerstin Baldauf, project manager at SWICA, provides an account of the customer-centric approach this Swiss insurer is taking.

During the “Hospitalization” customer journey, you accompany your customers from the moment of cost assessment to the time they leave the hospital, and on request, even beyond that point. What is your motivation?

Our vision is to better support people who are dealing with a challenging life event, such as a hospital stay. Because we are more than a health insurance company: We are a health organization with strong consultative services. SWICA has been the Number One in customer satisfaction for years; yet, we do not want to lean on this success. It has been important to us from the beginning to make things easier and safer for our customers.

How did your customers respond to the new service for their hospital stay? Did it hit the right nerve?

Patient feedback has been consistently positive, which encourages us to continue on our path. Customers keep telling us that this was the first time that they were not a number at the hospital or for the insurance company but felt like a person. The positive feedback is also reflected in the results of the customer satisfaction survey SWICA conducted regarding their support throughout the “Hospitalization” customer journey: We are excited to have achieved a Net Promoter Score (NPS) of 70 in the survey.

During the process development, the CRM specialist then sits down with hospital practice partners and patients to design the process as customer-centric as possible.

Kerstin Baldaufproject manager at SWICA

Wow, that is quite something. Did you encounter any obstacles along the way?

Yes, the project was challenging. We had to retrain our “benefits” administrators as customer journey advocates. While before, they had been reviewing cost coverage and creating invoices, suddenly they were to have contact with customers and be in a consultative role. The principle “If we reject a benefit, there are other options we can offer the customer instead,” was one they had to learn to internalize first. We designed this change process proactively and provided training on the customer journey concept, the CRM process, and customer communication.

Also, during the customer journey development, process management experts, and SYRIUS and CRM managers and specialists worked closely together. To combine the functional aspects with the systems- and process-related aspects was a challenge and an opportunity at the same time – the result: services devised by customers with a focus on personal contact.

Easy for the customer, yet complicated for the system? How was the customer journey implemented technically?

The entire customer journey was mapped in BSI CRM. To ensure a smooth and customer-centric process, the CRM system, as the customer relationship tool, and SYRIUS, where the data from the service area are maintained, had to work closely together. The letter templates for establishing contact with the insured are stored in the CRM and are available at the touch of a button. If a customer journey advocate updates a customer’s e-mail address, for example, the change is made directly in SYRIUS.

The next best actions for follow-up contact with the customer are also stored in the CRM. They may include information on a consultation via Telemedizin santé24 by SWICA or the BENECURA app. Our employees approach the topics in the follow-up contact phase with empathy and expert knowledge and use all options offered by SWICA on all channels as per a multi-channel approach. Process monitoring for the customer journey is also done with the CRM solution. How many initial and follow-up contacts took place, and via which channel? Was the process completed all the way, and were the appropriate steps used?

What was the development process for this journey like?

Within nine months, we implemented two pilots with premium partner clinics to work out the details of the facilitating process. We made sure that not only us but our partner clinics as well would provide a single point of contact for our customers. Our main concern was to support our customers as well as possible. The Swiss-wide rollout of the “Hospitalization” customer journey then took place in June of 2017. On April 1, 2019, we opened our first customer counter at the cantonal hospital in Winterthur. With the SWICA patient service there, we established an additional touchpoint for our customers during their hospital journey, where we could support them locally and in person.

And what is next on the agenda?

There is so much more that happens before and after the hospital stay, where we can take action. Currently, we are expanding our website to include life topics to show our customers all the areas in which SWICA can assist them. And there are other customer journeys in the pipeline already. As you can see, we are not going to be running out of ideas any time soon.

About the customer journey

SWICA offers its “Hospitalization” customer journey to customers with semi-private and private insurance. As soon as a cost assessment is available from the hospital, SWICA contacts the customer, preferably by telephone, or by letter.

During the initial contact, customers are introduced to their personal contact person who will be supporting them throughout their entire journey. They receive information about the insurance benefits and the cost coverage for the hospital visit and get tips about additional helpful services in the SWICA portfolio of services. If the insured person would like a single room, but only has semi-private insurance, SWICA shows transparently what the additional costs will be. The trip to the hospital and back home is a discussion topic as well, since SWICA covers, for example, the cost of a taxi to the hospital. Also, we ask customers if they need any additional support: Do children need to be looked after? Does the cat have to be fed? In such situations, SWICA makes arrangements for a nanny or home attendant on request.

Two weeks after they leave the hospital, we contact the patients again to find out how they are doing and if they have been able to readjust well to home life or work. We ask if they encounter any difficulties or problems and if they need help with their follow-up treatment, for example, with selecting the right specialists. If so, SWICA can assist with the arrangements. A final step is a customer satisfaction survey to improve customer experiences continuously.

About Kerstin Baldauf

For more than 25 years, Kerstin Baldauf worked as a neuro-rehabilitation specialist and in hospital management. When the time came for a change, she did not want to switch to an insurance company. Yet when SWICA called, and Kerstin Baldauf learned about the innovative “Hospitalization” customer journey project, she changed her mind and accepted this challenge in 2016.