Do Customers Trust You Enough to Accept Your Advice?

Guest post by Adrian Gostick and Chester Elton

Adrian Gostick and Chester Elton are the authors of the New York Times bestseller The Carrot Principle. Their newest book All In: How the best managers create a culture of belief and drive big results, was a #1 Wall Street Journal and USA Today bestseller. Visit to learn more.


Three years ago, Ingrid Lindberg arrived at global health insurance giant Cigna and spearheaded an effort to help the company become truly customer focused. As the chief customer experience officer, Lindberg came into an environment that was certainly competent and caring. In fact, 10 percent of Cigna’s thirty-thousand-person workforce are clinicians—nurses, behavioral health specialists, substance abuse experts, and so on—who work to influence the well-being and health of employees (whom they call customers) in the companies they serve (what they call their clients).

The job of these clinicians is to reach out to people at risk—smokers, heavy drinkers, those with uncontrolled health issues—to suggest programs that could save their lives and reduce health care costs. What does all that mean? Let’s say your cholesterol is high and you have Cigna as an insurance company. There’s a good chance that after your doctor’s visit one of these nice folks will give you a call to discuss your options and make some recommendations on how you might take better care of yourself.

It’s all admirable, but Lindberg asked two important questions on her first few days on the job: “Is this what our clients want from us?” and second, “If they do want it, do customers trust us enough to accept the advice?”

Lindberg started talking with clients and customers and listening to their concerns. She even typed “Cigna sucks” into a few search engines and Twitter and then talked online to those who wrote the comments. The customers were shocked that they were talking to a real person who cared. She says, “They overwhelmingly told us, ‘We want you to be easier to do business with and more understandable. Period. After you do these things, then you can tell me that my cholesterol is high, and I’ll listen to you and trust you.’”

Hard to do business with and hard to understand—it probably sounds like an insurance company you’ve dealt with in the past. Lindberg was on a mission to fix that, and she started with the touch point where customers most often come into contact with their insurance company: the explanation of benefits, or EOB. That’s the form your insurance company sends to you after every doctor’s visit, explaining what medical treatments and services will be paid for.

“We asked how we could improve our EOB,” she says. “Customers had no idea what we were talking about. Some said, ‘Do you mean the “This Is Not a Bill” form?’” Yep, that’s the one. Like most insurance companies, Cigna had those five words emblazoned in twenty-four-point capital letters at the top of every page, as if that was the most important information their customers needed to know. The language they were using just wasn’t helping real families.

So Lindberg put through a mandate at the highest level. She instituted a policy, still in force today, that requires Cigna’s most senior executives to listen to one hour of live customer calls every week and then write a report on what they’ve heard. “They need to know how complex our business is for our customers,” she says.

And that listening drove compassion. Not only has Cigna rewritten all its forms and documents into plain English (winning just about every award possible in the insurance industry), they also became the first major health insurer to offer live phone support twenty-four hours a day, seven days a week. That kind of coverage wasn’t popular with a few inside the company, but clients and customers gratefully accepted it.

“When your toddler gets sick and you need to know where to take her for care, it’s usually not at three p.m. but at three a.m.,” Lindberg says. “So customers appreciate it. And clients love it because their people aren’t making insurance calls during work hours.”

Lindberg jokes that in the past Cigna phone lines had an automated response in the middle of the night that said, “We are open eight a.m. to five p.m., Monday through Friday. We are here to help, just not now.”

As a result of this renewed focus on customer needs, the insurer is not only saving lives but has seen an amazing 80 percent increase in people saying, “Cigna values me as a customer,” and a 50 percent rise in customers agreeing with the statement “Cigna has my best interests at heart.” In addition, customer trust scores have increased, helping Cigna truly deliver on its goal of improving health and wellness in all its more than sixty-six million customer relationships worldwide.

Oh, and one last note. Cigna in 2010 increased revenues by 15 percent to $21.3 billion.

Isn’t it amazing what can happen when you really listen to your customers and ensure everyone in the organization is attentive to their needs?