In the Dutch health care system health care insurance is obligated for all residents. The government sets the basis package and insurers compete based on price and service. Customer service is therefore very important for every health insurance company; especially in the fast changing digital world. As a result customer satisfaction is the most important KPI. Complaints are related to customer satisfaction, because they have a highly negative effect on customer satisfaction. Therefore, it is crucial to prevent customers from having any complaints. Customers do not submit a complaint out of the blue: a complaint is a reaction to one or more occurrences in the past. The best way to understand the triggers, or root causes, it to understand the touchpoints prior to a complaint.

CZ aims for a method to prevent complaints (in order to increase customer satisfaction and lower churn). When taking the touchpoints of the customer journey into account, complaint root causes can be detected and CZ can prevent future complaints. Moreover, the touchpoints after the complaint give insights about an optimal follow up after the complaint.

Prior research development

Underlined works together with several companies like CZ, Aegon and SNS to build a generic framework in which all customer contacts are brought together as a unique dataset which is further enriched by Underlined with relevant analyses that can be linked to customer events. Underlined co-created customer journey mining algorithms, together with the TU/e (Bart Hompes and Joos Buijs from the Architecture of Information Systems group). This research showed that it is possible to distinguish the different journeys per customer. Moreover, in collaboration with the TiU econometrist department, a driver model has recently developed to distinguish relevant drivers and to predict the NPS-score.

In further collaborative research between TU/e, CZ and Underlined, the research focus will be on developing a predictive method on complaints, based on process mining techniques. The scope of the current master project will be developing a complaint driver model by taking into account the customer journey to detect root causes and follow up triggers. More precisely, after a proper preprocessing of the different types of data, the master project will start by addressing the following list of questions:

1. Can customers be segmented? Which distance measure is suitable for clustering customers such that similar customers can be grouped based on their behavior throughout their journey? How good is this clustering method when including the domain knowledge and/or internal quality evaluation measures?
2. What has happened ? What is the model of the current complaining process ? How does this differs among the different customers? Which sources of data are relevant to enrich this model?
3. Why did it happen? How does data from the different cases of each segment decides different paths within the model? Is this in line with the expectations of the business owner?
4. What will happen? Based on the above segmentation, can we predict the category of the current customer, using their characteristics and behavior ?

In the above-mentioned analysis, all available data will be leveraged. This includes logged data of the journey (workflow process data, call center data, online click trails, social media data), online and offline feedback and non-transactional data (product and background information).

Underlined has a proven approach and toolset for providing insights how to improve customer experience during the customer journey. Using data from customer contact channels, online environment, customer feedback and research response, we can reveal the actual customer journey and customer experience. This enables companies to measure the customer journey of their customers’ behaviour and emotions continuously and to manage and improve the journey across all channels. Underlined calls this Customer Journey Management. More information about Underlined can be found at our website: www.underlined.nl

CZ is one of the largest health insurance companies in the Netherlands. The core activity of CZ group is the implementation of compulsory insurance against medical expenses: the basic insurance. In addition, we also offer supplementary insurance for health risks that are not covered by the basic insurance. In addition, we offer specific products for employers, such as group health insurance and occupational health programs. More information about CZ can be found at our website: www.cz.nl

For more information, contact Marwan Hassani.