How the $8.6 billion Claims Adjustments Industry is Benefiting from Digitization

Technology is the sole distinguisher for efficient, profitable companies. Excellent client service certainly plays a significant role as well, but without state-of-the-art technology, companies simply cannot operate at maximum efficiency – a cornerstone for profitability.

Without question, the claims adjustments industry ranks among those that have benefited tremendously from digitization. Time- and labor-intensive manual paper processes with a high margin for human error have been replaced by streamlined digitized processes that efficiently create, track and share documents, provide instant connections with third-party services and execute expeditious data exchanges through application programming interfaces (APIs) with carriers, bill review companies and fraud verification services.

Game-changing Analytics

From a management perspective, access to instant analytics has been a real gamechanger for decision-makers who can easily evaluate the performance of their organizations and identify problematic workflow issues. Taking that a step further, we’re seeing a trend for companies to have employees whose sole job is to streamline the company’s operations using those analytics, for example to pinpoint the workload of each adjuster and identify which adjusters are available and proficient at processing certain types of claims.

Third-party administrators are using analytics as an additional service to their existing clients and in their proposals to win more business from companies seeking to improve their marketability by having access to more tools that they can offer their clients. Real-time analytics is one of those key tools and a huge selling point. Access to qualitative and quantitative analytics made possible only through digitization has become the industry standard and is generally expected by most clients. Analytics also address the bottom line and whether work is profitable, and profitability is paramount for long-term survival.

Multi-faceted Efficiencies

Digitization brings with it a wide range of efficiencies – operational, cost, employee, time – and there are obvious benefits to having shareable digital documents.

A new level of granular reporting draws on analytics associated with all levels of efficiencies to dive into how an organization is operating by filtering for specific information. For example, reports can pull back data to determine the efficiency and performance of individual adjusters working claims. This allows a company to evaluate and rank adjusters on an individual level: how fast they respond to new claims, how many points of contact they have with the claimant, the timeframe from when a claim is opened until it’s closed and areas in which more training would be beneficial.

Insightful Management Information Reports

Thanks to the expeditious manner in which management information reports are now electronically generated and digitally distributed, new windows of opportunity have opened up for claims adjusters because of the widespread data that can be tied to each adjuster: claim counts, performance, communication, third-party adjuster usage, claim complaints, volume of claims examiners and fees.

Using a hurricane that impacts the Gulf Coast from Texas to Florida as an example, not only can claims get to adjusters’ hands faster and analytics run quickly on the damages in those states, but now management information reports tell how those adjusters are performing, identify how quickly they are acknowledging claims and distinguish adjusters that have less-than-optimal workloads. This same information is important to adjusters themselves, who can use that same information to make performance improvements to be more competitive.

Emerging Opportunities for Independent Adjusters

Independent adjusters are eyeballing – and seizing – opportunities to expand into the third-party administrator market. They realize that to be relevant in a digital world, it’s imperative to have a complete claims management solution that is (i) developed by an intuitive, experienced company, (ii) helps navigate new territory during and beyond the paper-to-digital pivot, and (iii) handles and merges both lines of business.

Let’s assume you own an independent adjuster enterprise that started with 20 adjusters under you, and that number has grown to 200. There’s not much wiggle room for growth in the independent adjuster market, but the TPA market is now highly attractive. So, instead of performing the work for a third-party administrator, you now expand into the TPA space and also keep the IA work for yourself. TPA claims are handed differently, and digitized processes help you pivot from a very simple business to a highly complex business.

Digitization and customization frequently go hand in hand, and Lloyd’s of London is a top-of-mind example. Managing and adhering to reporting requirements is paramount, and ClaimPilot builds out the template with data markers and labels it to comply with each syndicate’s wishes and the client’s specifications. Our system then generates the data based on those specific data markers. Without digitization, this reporting would be cumbersome, laborious and costly.   

The Digital Reality

Digitization isn’t just for the big players in the marketplace. In fact, it gives small players a huge advantage and positions them to compete with companies of all sizes.

Whatever your company’s size, failure to embrace digitization is a death sentence. Without digital technologies working to your advantage, there will be cost hurdles, processing and invoicing delays, a bloated staff and lower returns on investment that eventually deflate your ability to compete.

ClaimPilot’s customizable claims management software can seamlessly automate your claims processing, generate custom reporting and improve your service design and value creation. As a result of digitization, you’ll have more time to generate new business, expand your capacity, interact with clients and focus on differentiating your company from the competition. With ClaimPilot, you also have ongoing support for software, analytics, workflow automation and reporting from our experienced team of responsive experts.

Don’t get left behind. Ride the digitization wave that’s sweeping the dynamic insurance claims industry.