8 Insurance Claims Management Problems & Solutions

Insurance claims management is becoming increasingly complex. Claims are becoming more complicated, customer expectations are skyrocketing, and tech that was cutting-edge a decade ago needs to be updated.

In this article, we’ve collected the most common problems in claims management, and how to solve each. 

Solving the Top 8 Insurance Claims Issues

We’ve gathered together the problems that are prolific in insurance claims management.

1 - Multiple Touch Points

A single claim can go through many different departments and adjusters before reaching its conclusion. This process is important, insurance companies must follow standard rules, but it can lead to fragmentation. 

This fragmentation occurs both for employees, who have to handle multiple tasks, and sensitive information to make a final decision. It also happens to customers, who find it hard to track their claim and know when it will be processed. This leads to frustration during what’s normally a difficult time for them.

Solution: To help with this common issue, store all your claims documentation in a single web system. It should integrate smoothly and securely with your other systems. This can make a huge difference.

2 - Ensuring Data Protection

Insurance companies manage extremely sensitive data about their customers. So all insurance organizations must have robust security protocols in place. All data must be encrypted and protected. You must also have regular audits to ensure that all policies are being followed. 

Solution: Finding a secure storage solution is important. For a long time, companies have considered hard copies as the safe option. But in fact, using digital solutions ensures regulatory compliance. Also since it is protected, only authorized personnel can access sensitive data. Online document storage also improves collaboration. It ensures that processes are more standard across the whole organization.

3 - Highly Complex Claims

Claims are becoming increasingly complex, especially in workers' compensation, health, and business insurance. The graph below, published by Marsh JLT Specialty, illustrates how complex, and therefore more disputed claims are rising.

Solution: Insurance adjusters need training to help them with this increasing difficulty. Technology can also help insurers, as data analytics can help you to identify patterns and trends. Claims management systems can help insurers manage complex claims with risk scores to flag claims that need to be reviewed in more detail. Having a complete system that integrates with other software solutions, and helps you to analyze cases will provide you with an edge.

4 - High Customer Expectations

According to McKinsey, customers now expect personalized advice. They also want an omnichannel experience and seamless end-to-end journeys. Insurance companies often don’t meet their expectations, leading to frustration on both sides.

Solution: Listening to customer feedback, and creating a smooth customer experience that mixes digital with human interaction will improve customer satisfaction. Have you ever tried to speak to customer service and been stuck with a bot that loops endlessly and leaves you fuming with frustration? It’s not the type of experience that you want your customers to have.

You should have a meeting with different teams on how you can meet customer expectations considering your operational capabilities.

5 - Proliferation of Emerging Technologies

With so many new technologies appearing, getting distracted by them all can be easy. They all represent a solution and could help your business, but constantly bringing in new solutions can become a problem!

Solution: When assessing what technologies, both software and hardware, could help your team you need to consider what issue needs to be addressed. You also need to think about how it will link up with your technologies. Finally, analyzing the security of your possible solution is important in claims management, where you deal with highly sensitive data

6 - Poor Integrations

Managing different systems with bits of information spread between them is inefficient and frustrating. The data that insurers handle could be outdated and incorrect due to integrations that don’t work correctly, and need a lot of maintenance. This situation becomes frustrating and strains your IT department and claims analysts.

Solution: Find software that integrates well with others you use. You can search for options with an open API. Or, you can seek ones that provide secure, easy integrations. These things will improve your efficiency and employee productivity.

7 - Dependence on Outdated Claims Management Systems

Using older, outdated technologies present specific challenges to insurance companies. They use a lot of resources, including electricity and time, and often specialist support. It can be hard to switch systems, it requires a team of people to search for and test new claim adjuster software options. However, using an outdated system and not modernizing is riskier. Customers will become unsatisfied with your service and employees will struggle.

Solution: Moving to modern software, such as Guidewire Claims Center, is worth the investment. It makes you more efficient, productive, and accurate.

8 - Inaccurate Data

Analyzing your claims data can help you to identify fraud better. It can shorten the claims cycle, calculate loss reserve and litigation propensity score.

But, in a West Monroe study, they found that 66% of respondents said data quality and accuracy were the top challenge for advanced analytics. You can use predictive models to predict the future from past data. But, if they're not accurate, your model won't be trained well and it won't be useful. By automating your claims technology you boost efficiency and data accuracy. When insurers input data manually, mistakes naturally increase, so using automation these errors decrease. 

Solution: A concrete example would be to avoid taking recorded statements by hand and copying out your notes manually. Instead, use a recorded statement management software that enables you to record statements using an app and upload them to the cloud automatically.

The Solution to Claims Issues

An easy-to-use, modern solution can help your whole organization. It will let you view accurate data, streamline processes, and share data securely. It is the best solution to all 8 issues that we have detailed.

n2uitive's Role in Elevating Claims Management

An integral part of managing and resolving claims is the recorded statement. At n2uitive we are a unique solution, the most secure and innovative Recorded Statement Lifecycle Management solution on the market. Over 10,000 adjusters trust us monthly with over 1 million statements recorded, stored, shared, and analyzed on our platform.

To increase productivity and efficiency, we also integrate with Guidewire Claims Center. All recorded statements are shared securely and smoothly with Guidewire to help you settle claims accurately and faster.

To find out more about our solution, get a free demo here.