Peter Venetis, Principal Claims Consultant at ValueMomentum

Over the last few years, we have done a phenomenal job of modernizing their claim platforms of modern capabilities. Where they’ve fallen behind, however, is in terms of modernizing their processes. Do they have mature claim handling processes? Do they have mature claim capabilities? Are they performing well relative to leading claims handling practices? Those are some of the gaps you see emerge today and it really is frustrating performance the ability to maximize the investments they made today in those modernizations.

Some of the places where modernization can really take place today is in terms of your claims performance. Are your metrics in line with leading claim handling practices in your peers and competitors? Do you know which metrics you should be leveraging in order to evaluate performance? Are your processes mature? Do you know which process need to be mature? When you talk about looking to integrate AI and analytics into your function, how do you know where to start?

A modernized claims organization is one that’s able to effectively manage and evaluate claim performance in real time. One that has modernized capabilities as well as modernized technology. It’s also one that’s able to leverage AI and automation in a manner that improves claim handling outcomes.