Reinventing Claims: Pioneering a New Approach

by Karlyn Carnahan, October 13, 2016
Industry Trends
Global, North America

Abstract

Celent has released a new report titled Reinventing Claims: Pioneering a New Approach. The report was written by Karlyn Carnahan, a research director with Celent’s Insurance practice.

While a tremendous amount of activity is occurring in the replacement and modification of core admin systems, there is also considerable activity occurring all across the value chain of a claim. From utilization of new technologies, to a heavier reliance on analytics, to a growing influence of InsureTech, carriers are increasingly innovating in the claims processes.
 
Operational efficiency is still the main goal as core system replacement continues to be a high priority. Carriers are investing and transforming across all aspects of claims — which leads to significant investments in enabling technologies. Most innovation in claims relies heavily on improving decision quality, improving customer service, and driving process efficiencies. Continued investments in core systems, soaring use of analytics, and digitized services will drive the innovations in the next three to five years. Emerging technologies will create ways of engaging with customers while improving decision support.
 
"Claims is one of the areas of insurance where we see the most innovation occurring. There are significant returns to be gained by deploying leading techniques in the claims process," comments Carnahan.

"Staying on top of innovations in claims is going to continue to be a challenge as new technologies continue to proliferate. Building agility and flexibility into the culture will continue to be a competitive advantage for carriers who can pilot and deploy innovations quickly,” she adds.

Celent is a research and advisory firm dedicated to helping financial institutions formulate comprehensive business and technology strategies. Celent publishes reports identifying trends and best practices in financial services technology and conducts consulting engagements for financial institutions looking to use technology to enhance existing business processes or launch new business strategies. With a team of internationally based analysts, Celent is uniquely positioned to offer strategic advice and market insights on a global basis. Celent is a member of the Oliver Wyman Group, which is a wholly-owned operating unit of Marsh & McLennan Companies [NYSE: MMC].

Media Contacts

North America
Michele Pace
mpace@celent.com
Tel: +1 212 345 1366

Europe (London)
Chris Williams
cwilliams@celent.com
Tel: +44 (0)782 448 3336

Asia (Tokyo)
Yumi Nagaoka
ynagaoka@celent.com
Tel.: +81 3 3500 3023

Table of Contents

Executive Summary

1

 

Key Research Questions

1

Introduction

2

 

Key Research Questions

2

Key Carrier Trends in Claims

3

Trends Beyond Core Admin

5

 

FNOL

6

 

Assignment

8

 

Estimating

11

 

Reserving

13

 

Payments

14

 

Vendor Management

15

 

Recoveries

16

 

Customer Communications

17

 

Data and Analytics

19

 

Fraud

20

Predictions

22

Cool Technologies to Watch

24

Looking Forward — Five Steps for Carriers

26

Leveraging Celent’s Expertise

27

 

Support for Financial Institutions

27

 

Support for Vendors

27

Related Celent Research

28

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