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Transform Insurance with Claims Management

Learning Objectives

After completing this unit, you’ll be able to:

  • Explain the need for digital transformation in claims management.
  • Describe how Claims Management for Insurance delivers the transformation.

The Digital Claims Imperative

The insurance industry is in the midst of a well-documented transformation from legacy systems and manual processes to streamlined, customer-centric digital solutions. Claims offer one of the most promising and pressing opportunities for transformation. 

According to an EY Claims Customer Survey in 2019, 87% of policyholders say the claims experience impacts whether they stay with their insurer. In 2020, Gartner deemed claims the number one investment area across all cloud-based insurance use cases. And yet, as of 2021, over 90% of claims are still unautomated!

Customers now demand a seamless claims experience and expect a fast, hassle-free claims service. They want claims handlers to serve as trusted advisors who can give personalized advice based on particular customer needs. 

Digital Transformation at Cumulus

Recognizing this pressing need for digital transformation, Cumulus Insurance successfully implements a full claims-management solution to go along with its quoting, policy-administration, and contract and enrollment solutions. Already, Cumulus sees great value in this transformation.

For one, Cumulus now meets the increasingly sophisticated expectations of its customers. Anna Murphy, a long-standing customer of Cumulus, is thrilled by the ease and speed of her auto claim. Thanks to clever guided flows, she completes her first notice of loss easily from her smartphone. After that, her job is mostly done. If the claims team needs any more information, they always reach out through her preferred channel with no need for hold lines, printouts, or other delays. 

And for the claims department as a whole, morale, efficiency, and innovation are all trending up, way up.

Cumulus Insurance employees are happy with their new tools.

For Phil the adjuster, Claims Management for Insurance makes almost every aspect of his job easier. His new tools streamline just about every repetitive action: opening coverages, creating loss and expense items, calculating payouts, updating policy terms, and many more. Prebuilt processes and services do all the heavy lifting, and Phil can now focus on adjudicating claims with higher quality and speed.

That’s not all. The claims supervisor can better manage and analyze her team at every step. Using skills-based routing tools, she ensures that each claim is assigned to the appropriate resource based on the specific characteristics of the claim. For simple claims, she configures auto-adjudication rules to enable straight-through processing with no need for an adjuster. She sets up Tasks and Action Plans to achieve operational consistency. And dashboards give the supervisor team-level views. This way, she can drill into individual adjuster dashboards for a single source of truth regarding current workload and status.  

Let’s Review!

Let’s recap how Claims Management for Insurance provides transformative digital solutions for four core parts of a claims system: the claimant experience, the claims adjuster experience, automation, and financials. Click each tab to learn the details.

Going digital for claims management helps your claims department work more efficiently, innovate faster, and delight customers. For a double bonus, you lower costs of servicing the business while increasing renewals and revenue.

Well done! You should now have a solid handle on the key features of Claims Management for Insurance, and the lasting, transformative benefits they bring.

Want to Learn More?

If you’re a Salesforce customer, check out the following learning journeys to find out how to skill up on our amazing suite of digital transformation tools and industry applications.

If you’re a Salesforce partner, you’ll find the same great learning plus additional partner resources on Partner Learning Camp (Sign-in required). #AlwaysBeLearning 

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