EXCLUSIVE: “Difficult Conversations” – Tara Shelton, The Cotswold Group in ‘The Insurtech Magazine’
Former hostage negotiator turned insurtech entrepreneur and now Head of Desktop Solutions at The Cotswold Group – an Allied Universal Company – Tara Shelton’s career has been one long pursuit of the truth
If you’re caught behaving badly, best hope it’s by someone with the temperament of Tara Shelton, Head of Desktop Solutions at UK’s The Cotswold Group, an Allied Universal company. Difficult conversations are her bread and butter and htaave been since she completed a psychology degree 30 years ago and entered the British police force. As a young officer, she says:
”I immediately fell in love with the job – talking with different types of people on the street and finding ways to connect with them”.
And she developed a particular interview style, based on her belief that ‘you can still have compassion when advising someone that they’ve done something wrong’. Her excellent conversational skills caught the attention of her superiors.
“By that stage I had built a reputation as a police officer of being able to negotiate with people whilst ensuring no one got hurt in the process. Of course, I think the psychology fed into that capability, that kind of mind set. But I can honestly say I feel naturally blessed with that ability also,” she says. Shelton passed the tough assessment to enter the most high-stakes conversation of them all – enrolling in the police national hostage negotiation course. She went on to deal with cases of international extortion, kidnap and ransom, as well as other major incidents, shouldering a terrifying degree of responsibility where every carefully weighed word mattered. “But I absolutely loved it,” she recalls.
When Shelton left the force after 15 years of service in 2008, she talked herself into a new but not entirely unrelated career as Founder and CEO of i-Cog, helping insurance firms – who in the UK face an estimated 300 bogus claims a day – navigate conversations with customers who might, or might not, be trying to defraud them.
“i-Cog’s business plan started on the back of a Post-it note in a Starbucks in Leamington Spa,” says Shelton. “It was based on the idea that in my opinion, claimants deserved a better customer experience when engaging with anyone asking questions of them about their claim.” This approach set out to help insurers identify those customers who were giving misleading information while simultaneously improving insurance companies’ overall customer service ratings with those customers who had nothing to hide.Shelton’s firm achieved this feat via three key services: claims validation, claim investigations, and staff training.
Technology was instrumental in the delivery of i-Options, the suite of services the firm would release back in 2014 – but it was in Conversation Management where i-Cog would excel. Here, Shelton’s background in handling potential wrong-doers the right way made all the difference.
“If you think of our natural human behaviour, no one discloses information they wish to keep private to those they don’t trust, especially if that person is perceived to be in a position of authority,” she says. “If you intentionally or unintentionally make a claimant feel like a suspect when working in that space, you’re never going to get to the heart of the matter. But if you make customers feel safe, they’re more likely to disclose insurance fraud to you. They will emotionally and morally connect with you and will be more likely to say, ‘actually, I think I’ve made a mistake – what should I do?’.”
“If you make customers feel safe, they’re more likely to disclose insurance fraud to you. They will emotionally and morally connect with you”
That about-face by claimants who might otherwise have doubled down on executing fraud, perhaps costing them their reputation, cash and even their liberty, while the insurance firm picked up a huge bill for investigating and prosecuting them through the courts, is a remarkable result from one single conversation.
“At the time, the market did not see how that was possible,” Shelton says.
But with her involved, 42 per cent of policymakers, on average, asked to withdraw their fraudulent claim. Some insurers accepted this offer, some invoked the fraud condition, but all had their policies voided.Success in resolving claims with little adversity put Shelton on the insurance market map. Doing it with an unprecedented 0.4 per cent complaint ratio made it an unmissable feature of the risk identification landscape. While it would be an oversimplification to say that the secret ingredient was compassion, it’s clear that i-Cog’s innocent-until-proven-guilty approach won the hearts of insurer clients.Insurance fraud is a thorny and hugely costly issue within the global industry.
In 2022, The Coalition Against Insurance Fraud estimated that fraudulent claims cost US consumers $308.6billion a year. It’s no surprise, then, that insurers invest at least £200million a year on technology to identify fraud.
Whenever families struggle to make ends meet, as in the current climate, insurers face an inevitable increase in fraudulent claims. But will they know it?
“Often, an external threat creates scenarios in which people do something they usually wouldn’t contemplate,” explains Shelton. “They’re under pressure and need to find money, as money pays bills. People can think, ‘I’ve never claimed on this insurance policy, if I claim on it now it’ll tide me over and I can breathe again.’
It’s a thought process experts call ‘fraud rationalisation’ – rationalising doing something wrong as a necessity to survive when financial pressure truly exists.”
Such claims might take the form of organised fraud, when a policyholder does something deliberate to make a claim, such as intentionally destroying property. More common though, is opportunistic fraud, whereby a policyholder may exaggerate a legitimate claim with the intention of pocketing the pay-out. These are harder to spot.
While organised fraud is associated with criminality, opportunistic fraud is often regarded as a one-time behaviour from those whose profile wouldn’t usually raise red flags with insurance firms. Such opportunism is also harder to identify because the amount claimed tends to be low and the claimant does not possess a previous claims history. i-Cog’s goal was to make the assessment of claims commercially viable, regardless of their value. That meant rapidly settling genuine claims, using intelligence sources to check each one against risk triggers and fraud indicators, while riskier claims would be handed over to Shelton and her expert handlers, where her Conversation Management techniques would kick in.
i-Cog was utterly delighted to join The Cotswold Group in April 2020, with Shelton supervising her company’s integration under the title of Head Desktop Solutions. She felt the entire organisation of Allied Universal perfectly mirrored her morals, integrity and work ethic. i-Cog was by now a long way from that Starbucks Post-it note. The Cotswold Group has been providing claims investigation and intelligence services since 1990, working across all insurance industry sectors. The firm counts some of the world’s largest insurance companies as clients, delivering market leading results by using its desktop investigation process.
As a valued member of The Cotswold Group, Shelton is looking at how technology can be further leveraged to improve the claims validation process because, despite her focus on empathetic, human communication, she’s no Luddite.
As she puts it: “You can have the most qualified doctor in the world and who has the most impressive credentials, but that same doctor still cannot take an image from inside your body like MRI technology can. We need technology to be able to do things that we, as humans, can’t. We are naturally swayed by prejudice and bias, no matter how hard we try not to be.”
Trained hostage negotiators may know how to talk someone down from making a critical mistake, but they aren’t mind-readers. Nor is the latest fraud-screening technology, for that matter.But with the release of a unique, AI-enabled voice analytics technology from Clearspeed, introduced to the UK insurance market by Allied Universal in 2021, Shelton designed a new offering from The Cotswold Group called ‘i-insight’.
‘i-Insight’ is a revolutionary three-stage, end-to-end claims process that has been roundly hailed as a game-changer for the global insurance industry.Deploying Clearspeed’s technology at Stage 1 through an automated voice questionnaire, it simply and accurately performs the task of risk assessment, providing unique risk insight that complements existing data. As Shelton explains, this Stage 1 provides an initial screening of any claim to determine whether it requires escalating to i-Insight’s Stage 2.
“There is a danger of seeing technology alone as a silver bullet. Technology can lead to faster settlement on valid claims but I don’t see it ever replacing the unique human skills of being able to display empathy, build rapport, earn trust”
And with impressive results to date, The Cotswold Group is wholeheartedly shaping the market.
“Think of a metal detector at the airport: if it doesn’t beep, you’re safe to fly. If it does beep you understandably are followed up with by an agent. That follow-up process is what my years of experience and The Cotswold Group are there for. Combining technology and highly trained humans is the perfect marriage for a customer-centric claims validation process.”
That ‘airport beep’ is dependent on oral answers provided to a few questions, which claimants can complete at any time, in any place and in any language. With an above-97 per cent accuracy – unheard of in the industry, according to Shelton.The benefits of i-Insight for genuine claimants, meanwhile, are as important as the technology’s risk identification prowess.
“It’s all about convenience for the customer,” says Shelton. “If you pose no risk, you’re going to remain with your existing insurer, because you feel satisfied with the speed, convenience and self-serve approach.”
This chimes with Shelton’s compassionate interview technique – but will technology eventually come to replace it?
“There’s a danger in seeing technology alone as a silver bullet. Technology can lead to faster settlements on valid claims, but I don’t see it ever replacing the unique human skills of being able to display empathy, build rapport, earn trust and then morally influence the fraudster to make the right choice. Technology will, in my view, never be able to plan, hold, manage, assess and conclude a difficult conversation alone,” she says. “You cannot decline a claim based just on data. You still need an expert human to make those important decisions.”
The i-Insight process is breaking new ground and is impressing both insurers and their genuine customers alike. “I can see it becoming standard, the must-have across the industry. Why would you not want a process that meets customer’s self-serve expectations, clears claims to pay with superior accuracy, positively impacts customer surveys and removes all blind spots on opportunistic fraud?” says Shelton.
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