Paper short abstract:

We are going to explore how claim, a standard produced by insurance, become effective during day-to-day negotiations between claims agents and customers, how the claims management process automation serves to reinforce the standard, and what are the consequences on risk perceive and insurance role.

Paper long abstract:

My current research, based on 2 years of fieldwork in a claims management department, bears on how the world's leading insurance groups represents its relationship with its French customers and how it organizes the latter when presented with their loss.

At this very moment, any loss or accident that is recognized by insurance as a type will become a claim, that is an event for which the insured party can seek compensation.

The aim of my talk is to explore how claim categories produced by actuaries become effective once the given loss or accident occurs and how the automation of the claims management process, to improve efficiency, serves to reinforce the pre-identified standard too.

We are going to shed light on a somewhat contradictory approach of the interaction between insured parties and claims agents: on the one hand, the unexpected and singular nature of "day-to-day catastrophes" and on the other hand, the sifting of information to identify one of the claim types and to set into motion its corresponding set process.

By using the example of a claims management software re-engineering project, we are going to delve into how the claim notion has been completely re-examined and rethought at the head-office by some experts during the assessment phase and how the new categories have subsequently been frozen in computer codes. We are going to analyze the consequences of this IT system on agents cognitive work, on risk perceive, and on day-to-day negotiations between claims agents and insured parties.