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The P&C Claims Adjuster Role is Dead; Long Live the Claims Adjuster!

New SMA Blog by Mark Breading, Partner, Strategy Meets Action

Decades ago, a refrain began that predicted the death of the insurance agent. The Internet was going to cut out the middleman! Disintermediation would result in the demise of the traditional insurance agent! But here we are – years later – and distribution intermediaries such as agents, brokers, wholesalers, and others are not only surviving, they are thriving. I believe that claims adjusters and claims professionals in general are starting on a new and improved journey.

The pandemic has served as a catalyst for putting digital transformation across insurance on the fast track, and claims is one of the focus areas that is primed for implementing digital capabilities. As more claims information is captured and managed digitally, new opportunities to leverage AI technologies arise. This leads to a vision of full automation, high levels of straight-through processing, and (logically) a diminishing role for claims professionals. These themes are explored in a new SMA research report, “P&C Claims in the Post-Pandemic Era: Emerging Stronger, Accelerating Transformation.” There is tremendous momentum for leveraging technology to automate and enhance the claims process, but that does not mean that the role of the adjuster will become obsolete… and it brings to mind the old Monty Python gag, where an old man is flung onto a heap of bodies, only to announce that he is “not quite dead yet.”

So it may be with the claims adjuster. As a matter of fact, the stage is set for claims roles to be elevated as they focus on high value activities. And the phrase “not quite dead yet” doesn’t really do the situation justice, for these roles as they are very much alive and evolving. The key lies in exploring the complexity of the claims landscape.

There is no question that many simple claims are best handled in automated fashion, with digital workflows, connections to restoration partners, and AI-based decisioning. The ability to reduce cycle times and settle claims faster benefits everyone, especially the claimant.

But the reality is that there are many complex claims, especially those where serious injuries have occurred, where large commercial properties are affected, or where insured vehicles or property are related to industries with unique risks. Add to that the vital areas of fraud detection and investigation, litigation, medical management, and recoveries. And it becomes clear that human expertise and experience will still have important roles to play. It’s true that all of these areas will benefit from automation and claims experts will be aided by AI capabilities. However, the need for human-to-human connection, expressing empathy to claimants, and applying judgement in complex, multi-faceted situations will always be needed and will remain the hallmark of good claims organizations.

For more information on the evolution of P&C claims, see our recent research report, “P&C Claims in the Post-Pandemic Era: Emerging Stronger, Accelerating Transformation.” This report identifies how insurers have responded throughout the pandemic and how claims technology plans have changed over the past 18 months. Digital transformation and AI technologies are also address, based on SMA surveys of P&C executives. Finally, a vision of the future of claims is presented, including the role of the claims professional. Far into the future, we are still likely to be saying: Long live the claims adjuster!

About The Author

Mark is known for his insights on the future of the insurance industry and innovative uses of technology. Mark consults with insurers and technology companies on forward-thinking strategies for success in the digital age. His inventive methodologies, fresh ideas, creative conceptualizations, and ability to incorporate InsurTech and transformational tech in business strategies are unparalleled. He also leads SMA’s research program, publishing 25-30 research reports per year and conducting various custom research projects for insurer and vendor clients. His thought leadership in the areas of InsurTech, transformational technologies, customer experience, and digital strategies has earned him a ranking of one of the “Top Global Influencers in InsurTech” by InsurTech News and Onalytica and a place in the ten finalists for the “Top Global IoT in Insurance Influencer Award.”

Before joining SMA in 2009, Mark spent 25 years with IBM in roles including the Global Insurance Strategist and Director of Global Financial Services Executive Conferences in addition to leadership roles in consulting and marketing. Mark co-developed IBM’s Account Based Marketing program and led the global project office to implement ABM across all industry verticals worldwide. Mark has held both technical and business roles in sales, consulting, marketing, and business strategy and has advised insurers around the world for almost 30 years.

About SMA, a ReSource Pro company

Strategy Meets Action is an industry-leading strategic advisory firm delivering strategic insights, consulting services, and published research to carriers, solution providers, and InsurTech startups. The firm provides insights and guidance on business strategy, digital transformation, core systems and customer experience. Learn more about SMA at www.strategymeetsaction.com.

SOURCE: Strategy Meets Action (SMA)

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