Health insurance customer expectations are changing. If carriers want to retain business and grow, they need to deliver modern and convenient experiences, which may require new strategies and more sophisticated technologies.

Policyholders Want More

Technology has seeped into nearly every aspect of our daily lives. Whether you’re ordering delivery, shopping for electronics, or managing your finances, digital tools make almost everything easier. Why should health insurance be any different?

Insurance Business warns that the digital age has spurred drastic changes in consumer expectations. People want an intuitive insurance experience – and if they don’t receive it, they may switch insurers.

This is an issue for property and casualty insurers that sell home and auto insurance. It’s also an issue for health insurers. Medicare members and people who receive their health insurance through the ACA can switch every year. It’s fairly easy for an individual to change from one health plan to another, so the customer experience becomes a critical driver of customer retention and loyalty. Even worse for carriers, entire companies may decide to move their group health insurance to another carrier if they feel their needs are not being met or the carrier is delivering less than optimal experiences for their employees and families.

Expectations May Rise with Prices

Technology isn’t the only factor impacting insurance customer expectations – price is also an issue.

The cost of insurance keeps going up. Peterson-KFF says the average ACA Marketplace premium is proposed to increase by approximately 7% in 2025, while Aon projects increases of 9% in U.S. employer-sponsored healthcare costs. Most people are paying more – particularly for prescriptions – and they’re not happy about it. According to Ipsos, people are not empathetic when it comes to large companies raising prices. As prices rise, companies should expect demand for great customer experience and value to rise as well.

What Are Customers Demanding?

Customers want better customer service and modern experiences, but what exactly does this entail? Three things stand out:

  • Better communication. Communication is a two-way street. Customers need to be able to reach someone when they have a question. They also want to receive important communications – without being inundated with unimportant messages. Now that technology has enabled 24/7 communication via multiple channels, customers expect it. They are no longer satisfied with being on hold or waiting until traditional business hours to receive assistance.
  • Faster decisions. The time of waiting for days for a letter to arrive or a payment to clear is history. Technology enables instant results. Whether they’re submitting an application, requesting prior authorization approval, or inquiring about a claim, customers want an answer quickly.
  • Intuitive and convenient processes. Health insurance is confusing for the average person – but this isn’t an excuse for having confusing processes. Customers expect user-friendly digital interfaces that simplify complex processes. Needing to jump through hoops to apply for coverage, appeal a claim decision, or secure prior authorization approval is frustrating.

How Carriers Can Meet Expectations

Technology has changed customer expectations, but it can also help carriers meet those new expectations. However, it’s not as simple as rolling out an app. Having a mobile platform is useful, but a mobile app without a powerful system behind it will just lead to frustration.

To truly meet modern expectations, carriers need to focus on identifying areas and processes that cause friction or frustration for their members. Oftentimes these issues are caused by inefficient and manual processes, disconnected systems, and multiple or redundant data sources that provide conflicting information. Having an integrated system not only drives internal efficiencies and improves quality, but also directly impacts the customer experience. Carriers should utilize a platform that can integrate the entire member lifecycle, from plan and benefit updates, to pricing, claims processing, member portals, customer service tools, and member documents, to ensure customers have clear and accurate information when they need it and how they want it – whether it’s on the web, by phone, or on their mobile devices. This customer-centric approach is no longer simply nice to have; it’s a must for long-term carrier competitiveness and viability.

FJA’s cloud-enabled platform and product repository makes it easy to build, manage, and distribute complex insurance products. Our modular approach lets you customize a solution that fits the needs of your company and your customers. Plus, it can integrate with your other systems. Learn more.

About FJA

FJA offers a full suite of insurance technology products and services, powered by the FJA Product Machine Platform, that simplifies operations, automates business processes, and drives connectivity across your organization. FJA is part of the msg group, headquartered in Germany, which provides technology solutions across 34 countries.

FJA has been partnering with some of the largest and most influential companies in the insurance industry for 30 years, to support nearly half of the insured lives in the country.

customer expectations health insurance