Challenges facing claims departments
Digital technologies, cloud computing and AI are having a positive impact on the claims
process. However, despite these advancements, risk managers and claims leaders face a
number of obstacles.
Table A highlights some of the challenges facing risk management and insurers' claims
departments.
To overcome these challenges many claims departments are adding predictive analytics and
AI to optimize claims process.
Rising inflation, continuing supply chain issues are having a
significant impact on the increasing claims severity
A shortage of expert adjusters and cost rationalization
issues have resulted longer claims duration and higher
costs
Litigated claims are becoming more frequent and typically
the settlement amount is at least four time greater when an
attorney is involved
Inability to recover loss costs from a third party can have a
negative impact on an organizations risk management and
claims profitability
Case reserves that are too low or too high can impact on
financial performance of organization
It's difficult to determine how to effectively prioritize claims
so that the ones requiring immediate attention can get it
Longer claims cycles and duration results in higher claims
settlement and loss expenses
Over 80% of claims data is unstructured, medical records,
emails, photos and video – making it difficult to identify
hidden patterns in the data
Growing claims
costs
Limited resources
Rising litigation
costs
Missed
subrogation
opportunities
Inaccurate case
reserving
I N D U S T R Y I M P L I C A T I O N S C L A I M S C H A L L E N G E S
T a b l e A
Inefficient claims
prioritization
Increasing claims
duration
Analysis of textual
notes and
unstructured data
OPTIMIZING CLAIMS | 2
