Claims Processing Business Process Transformation: Enabling a Digital Claims Experience

December, 2022

Amid the COVID-19 pandemic, the insurance industry, which has traditionally been slow to adopt digital technologies, saw an acceleration in the digital transformation of the claims processing function.  Insurers had to manage a large volume of claims, which pushed them to leverage new technologies through partnerships, acquisitions, and outsourcing. Outsourcing in particular, became an attractive option for insurers, with approximately 17% growth in the number of insurers turning to claims processing service providers. Claims management, payment integrity, and complaints and appeals segments continued to remain in focus.

These trends, and others, are covered in our Claims Processing Business Process Transformation 2022–2023 RadarView. The report is a comprehensive study of claims processing business process transformation service providers, including top trends, analysis, and recommendations. It also takes a close look at the market’s leaders, innovators, disruptors, and challengers.

We evaluated over 40 service providers across three dimensions: practice maturity, domain ecosystem, and investments and innovation. Of these, we recognized 20 that brought the most value to the market during the past 12 months.

The report recognizes service providers in four categories:

    • Leaders: Accenture, Cognizant, EXL, Genpact, and Wipro
    • Innovators: Conduent, Firstsource, HCLTech, Infosys, and WNS
    • Disruptors: CGI, Coforge, DXC, Exela Technologies, Hexaware, and Virtusa
    • Challengers: Datamatics, Mphasis, ReSource Pro, and Xceedance

Figure 1 from the full report illustrates these categories:

MoneyShot Claims Processing Business Process Transformation 2022 2023 RadarView 1030x687 - Claims Processing Business Process Transformation: Enabling a Digital Claims Experience

“Claims processing is a crucial moment in a customer’s insurance journey, and this experience needs to evolve with changing consumer behavior,” said Avasant Distinguished Fellow Ray Barnard. “Insurers must invest in simplifying claims processing and developing customer-centric and personalized offerings.”

The full report provides a number of findings and recommendations. Insurance carriers should:

    1. Optimize claims service delivery and operations by infusing digital technologies throughout the customer’s claims journey
    2. Focus on reducing manual intervention, improving agent experience, and aligning upstream and downstream insurance processes
    3. Reassess the customer experience strategy to build new engagement models and ensure a consistent claims experience
    4. Leverage next-generation claims capabilities through acquisitions, investments, and partnerships to address consumer demands

“To deliver differentiated value, insurers must solve the dual challenge of cutting costs and enhancing the customer experience for their claims function,” said Aditya Jain, principal analyst at Avasant. “Service providers can help insurers through platform-driven and digital technology-enabled claims services.”

The full report also features detailed RadarView profiles of the 20 service providers, along with their solutions, offerings, and experience in enabling claims process transformation.

This Research Byte is a brief overview of the Claims Processing Business Process Transformation 2022™ (click for pricing).