Claims transformation

In Insurance

We help organizations reimagine and transform their claims operations by designing the right customer experience, automating the right touchpoints and deploying the right mix of tools and technology to execute effectively.

Related topics Innovation in insurance Insurance Financial Services

The team

Jim Kremer

Jim Kremer

EY Americas Claims Transformation Co-Leader; Managing Director, Insurance Consulting, Ernst & Young LLP

Rising customer expectations, loss cost and efficiency pressures, and a changing landscape featuring new competitors are accelerating the need for the next wave of claims transformation.

  • Strategic questions

    To start, organizations must address strategic questions to help ensure their investments result in a more effective process and enhanced value to customers:

    • Have we mapped out and fully rationalized the end-to-end customer journey, considering emerging technology and rapidly changing customer expectations?
    • Is there risk in entirely removing the human interaction that some customers prefer?
    • Are emerging analytical models and technology being utilized to enable optimized efficiency, with flexibility to upgrade as improved solutions present themselves in the future?
    • Are we collecting the right information at loss notice to triage intelligently while avoiding payment accuracy issues?

  • Claims transformation benefits

    Optimizing claims performance requires a balance of outcome-focused, highly efficient, low-touch processing with personalized options that allow customers to choose the experience that they prefer during the life of the claim.

    Organizations that master their claims transformation will benefit from:

    • Enhanced customer experience through reduced claim durations, flexible engagement options and customer-centric communication
    • Increased process efficiency through reduced claim cycle times and loss adjustment expenses (LAE)
    • Improved payment accuracy by enhanced decision-making powered by real-time analytical models that drive optimal claims outcomes
    • Improved employee engagement and top talent retention through proactive skill development, removal of administrative tasks and creating a forward-thinking culture

  • How EY can help

    EY professionals can help organizations seeking a modernized and highly efficient claims experience by:

    • Establishing a performance baseline and projected benefits of transformation through a leakage study or diagnostic assessment
    • Collaboratively identifying and prioritizing critical capability gaps, while accelerating timelines to build or expand desired capabilities across all lines of business
    • Assisting in developing an analytics-driven claims operation to more effectively resolve losses and improve overall enterprise performance
    • Helping identify and seamlessly implement emerging digital capabilities across the value chain, while assisting with necessary operating and segmentation model adjustments
    • Supporting the development of internal capabilities or assist with the evaluation and selection of key claim process vendors, considering client-specific customer journeys
    • Assessing, prioritizing and implementing enabling technologies throughout the claims value chain based on value and complexity

Our team

EY has the knowledge, technology capabilities, tools, insights and alliances to power a claims transformation aligning with an organization’s strategic goals and ensures flexibility for the future.

Our diverse talent and experienced leadership include insurance industry leaders and visionaries, chief claims officers, product managers and operations professionals, technologists and data scientists.

EY utilizes a proven, research-based approach that is experience-led and customer-centric — with assets and accelerators that plug into an insurer’s transformation journey when and where they need it and bring change — across operations, strategy and technology — at speed.

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