Top Challenges in Claims Management and Revolutionizing Claims Outcomes

As the world is witnessing the uncertainties brought in by the coronavirus pandemic, insurance leaders continue to face new challenges every day that pose a threat to their survival. Insurance industry has long been struggling to deliver consistent and personalized offerings to meet the higher standards of customer experience. With rise of new Insurtech startups and race towards digital transformation, there exists a huge pressure on insurers to rapidly accelerate towards being digital - ready.

Insurers no more can simply survive in today's digitally evolving marketplace by depending on traditional ways of collecting information by investigators and claimants alone. With the advent and rise of new digital technologies like Machine Learning (ML), Artificial Intelligence (AI), Intelligent Automation, Internet of Things (IoT), Sensors, Wearables, Drones and Data Analytics, insurance leaders are forced to transition to these digital technologies for collecting and analyzing data and meeting customer expectations.

Challenges in Claims Management

A typical claims registration process is replete with huge paperwork, is data-intensive and is often repetitive in nature, which results in loss of time in claims resolution as well as create unwanted inefficiencies. It is also seen that assignment of claims adjusters often result in further inefficiencies as claim adjuster’s assignment is highly dependent on their availability, prior workload and location data. Human handling of claims is bound to be slow and regressive as huge amount of time is spent in preparing data as opposed to analyzing claims, which if left to the new technologies, can drastically solve the issue with ease. Fraud detection is another aspect where the new technologies promise huge potential to reduce cost for insurers and help prevent huge sums in fraudulent claims.

Insurers should aim to adopt a faster, analytics-driven approach to claims handling and fully automate the claims handling processes for clear and simple cases.

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Facing the challenge and revolutionizing claims outcome

Insurance leaders will need to embrace the new technologies to not just meet the rising expectation of customers but also to create operational efficiencies, reduction in cost involved and staying ahead of the competition. Depending on the challenges, goals and outcomes of an insurers, new innovations can be applied to smoothen claims management and revolutionize the claims outcome.

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Intelligent Process Automation

IPA can be leveraged by insurers to improve efficiency, increase precision and save time during assignments and investigation efforts for claims processing. IPA can help insurance companies in automating their rule-based, repetitive and frequent tasks such as assignment of claims adjusters by automatically detecting their availability, workload and location data. Intelligent automation can seamlessly help insurers in processing bulk claim payment which generally requires speed and efficiency and can thus be applied by insurers to clear their large backlogs of claims data. IPA can also turn beneficial for insurers in their effort of fraud management with their algorithms to detect frauds and manage fraudulent activities.

Machine Learning

Insurance industry is greatly benefitting from the gains of machine learning by overhauling their entire claims management process by making it more efficient, faster, better and highly accurate. Insurance companies can now achieve far better claims management by pre-assessing claims as they automate the damage evaluation process, understand patterns in the claims data, and drastically improve loss analysis. Machine learning is helping in both claims registration as well as claims settlement by automating the entire claims process. ML and predictive models can help insurers to better understand claims costs, saving millions of dollars, by proactive management, faster settlement, better case management and targeted investigations. ML can help insurers also helps insurance companies to estimate claims reserves and gives them confidence to make right decision on allocations to claims reserves.

Data Analytics

Data Analytics and predictive modelling has a huge potential for insurers to improve nearly every aspect of their business from risk assessment, premium calculations, claims assessments to claim settlements. Insurers are thus making significant investments in advanced analytics and this has been accelerated with the availability and abundance of data now sourced through Internet of Things (IoT), wearables, mobile applications, social media channels, drones and other connected devices.

Wearables, Drones and Connected Devices

Wearables are helping insurers with data that helps them to analyze the real-time movement, physical activity, monitor health and mortality risk profile. They are uncovering new insights on mortality risk of individuals and help insurers tailor life insurance premiums depending on the risk and behavior of each individual. Connected devices (IoT), drone and imaging technologies are helping insurers with data that can help them assess risk, ascertain damage and settle claims. With smart devices market to expand in the coming years, new streams of data will help insurers have deeper understanding of their customer risk profile, their own risk exposures, curate competitive premiums and identify growth opportunities. Incorporation of automation technologies, artificial intelligence and machine learning can help insurers to deliver at a faster speed, have a more granular view and at a much larger scale.

Leveraging Modern Technologies : For Revolutionizing Claims Outcome

Leveraging modern technologies will help insurers to have easy and automated access to new streams of real-time data for claims management, settlement and claims resolution, as well as, for better assessment of premiums, personalized and curated product offerings- delivering impressive customer experience and ultimately an improved business outcome.

Espire is enabling Insurance companies worldwide to revamp their digital experience management and CX strategy, resulting in up to 20-30% increase in revenue through new digital channels. You can reach our experts at Espire Infolabs for a quick consultation at For any query, get in touch with us at & subscribe to our blog to learn more for latest insights & updates.

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