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7 Features to Look for in a Modern Claims Management Solution

November 9, 2023

The complex world of traditional claims management often introduces significant obstacles, such as manual procedures, lengthy claim settlements, and limited transparency. These limitations underscore the need for an improved claims management approach. 

In fact, according to an article by Insurance Thought Leadership, the implementation of automated machine classification can enhance accuracy by 30% compared to human classification and potentially boost productivity by 80%. 

Thanks to digital transformation, claims managers can expect to utilize predictive and generative AI models to make intelligent decisions faster, and automate claims processes such as assignment, reporting and settlement, which means that claims managers are going to greatly simplify their claims processes and efficiency. 

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Benefits of a Modern Claims Management Solution 

Traditional claims management is plagued by inefficiencies such as time-consuming manual processes and disjointed workflows, often relying on paper-based tradition and leading to lengthier claim cycles with diminished customer satisfaction.  

A modern digital claims solution offers a remedy thanks to these three benefits: personalized customer experiences, improved efficiency through automated processes, and intelligent decision making with robust data management.  

7 Essential Features of an Efficient Claims Management Software 

When looking for an upgrade in your claims management software, several features are essential. Let’s delve into these seven crucial elements that comprise a comprehensive and effective claims management system. 

  1. First Notice of Loss (FNOL)

    An efficient claims management system must be equipped with robust FNOL capabilities. It should rapidly gather the necessary information through dynamic Q&A sessions, use predictive models to anticipate likely claim outcomes, provide omni-channel support to handle claims via phone, email, or other means, and promote low-touch processing to minimize manual intervention.
  1. Automated Assignment

    Claims can be complex and varied, requiring different adjuster skills and expertise. The software should use automated assignment to efficiently manage claims, considering factors such as adjuster skills, workload, and the unique aspects of each claim. For instance, it should be capable of assigning multiple roles like salvage, Special Investigation Unit (SIU), and subrogation, and accommodate special circumstances such as catastrophe or large accounts.
  1. Instant Policy and Coverage Data Access

    To streamline the claims process, the software should enable instant access of policy and coverage data. It should provide complete details of coverage plus limit and deductible information, determine the impacted coverage and reserve settings, and attach snapshots of the policy to claims for review.
  1. Efficient Adjuster Workflows

    The software should streamline adjuster workflows, sending task alerts and tracking claim statuses. It should drive claim workflows based on the claim type and cause, allow collaborative file notes for quick resolution, and support role-based assignment and fraud flagging.
  1. Effective Negotiation and Payment Management

    A modern claims management software should handle negotiation information and payments efficiently. When a user submits a payment, the system should be able to verify their role-based and entity-based authorization rules before escalating the payment to be authorized.
  1. Recovery Lifecycle Support

    The software should fully support the recovery lifecycle, identifying recovery opportunities early, and automating referral capabilities. It should support full file ownership and assignment of specialized performers, while enabling the management of the salvage process with proactive workflows.
  1. Robust Reporting & Analytics

    An effective claims management software should possess robust reporting capabilities. For instance, it should offer real-time data access and self-service dashboards to manage key performance indicators (KPIs). This would not only ensures regulatory compliance but also identify and tracks anomalies and trends in real-time, enabling ongoing claims process optimization

    See Also: Download the Duck Creek Claims brochure to learn more about how our claims management software delivers these features and more.

3 Ways Duck Creek Claims Meets Modern Claims Solution Needs  

Enter Duck Creek Claims, a Claims Management cloud service which is part of Duck Creek’s comprehensive Suite for insurers.  Duck Creek Claims is designed to streamline the entire claims process from start to finish. It offers automated workflows, robust data reporting capabilities, seamless integrations and more, effectively serving as an end-to-end solution for all your claims management needs. Here’s how Duck Creek Claims stands out: 

  1. Streamlining Claims Process for Efficiency

    With Duck Creek Claims, the intricacies of insurance claims management are greatly simplified. Our service doesn’t just automate the end-to-end claims process, it revolutionizes it for enhanced efficiency and speed with low-code configurability, rich ecosystem of integration partners and pre-integrated solutions, allowing insurers to focus more on strategic goals. Claims adjusters can also manage their caseloads more effectively, thanks to increased accuracy in a modern claims service.
  1. Empowering Decision Making with Real-Time Data

    The power of informed decision-making cannot be overstated. With real-time data and analysis, Duck Creek Claims not only provides you with valuable insights at your fingertips but also equips you to identify and address emerging trends swiftly, driving business growth. Duck Creek’s new Claims Intelligence UI also enables carriers to plug in Artificial Intelligence / Machine Learning models into the claims adjuster workflow, enabling insurers to make smarter, more accurate decisions faster than ever.

    See Also: See how Duck Creek Insights power insurers with real-time actionable data for informed decision making.
  1. Boosting Customer Satisfaction and Compliance

    In today’s customer-centric world, a satisfied customer brings long-term value and referenceability to the business. Duck Creek Claims excels at this by simplifying the claim submission process and enabling constant communication, thus fostering trust and satisfaction. Moreover, the software ensures your regulatory adherence, turning compliance from a tiresome obligation into a strategic advantage.

Claims Management: SaaS or On Premises? 

The short answer? SaaS, specifically cloud-based software as a service. Duck Creek Claims distinguishes itself in the insurance landscape through its superior functionality as SaaS for insurers. This shift from conventional on premises, self-hosted claims systems to scalable cloud-based SaaS provides several competitive advantages:  

  1. Enhanced Financial Efficiency

    SaaS options remove the need for significant hardware investment, resulting in substantial cost savings.
  1. Unparalleled Scalability

    Insurers benefit from unmatched scalability, allowing businesses to respond and adapt quickly to changing operational demands.
  1. Seamless Updates

    A SaaS claims system ensure continuous software improvements without any interruption to operations, keeping users always updated with the latest features.
  1. Robust Data Security

    SaaS claims management solutions also offer enhanced security measures, protecting sensitive information against potential threats.
  1. ESG Framework Support

    Leverage all the above benefits and more while reducing your carbon footprint with cloud-based services.

Duck Creek Claims: Revolutionizing Insurance Operations 

Duck Creek Claims is a trusted solution by insurers when it comes to streamlining their claims processes. Equipped with all the features above and more, Duck Creek Claims is the go-to modern claims solution in the insurance industry. For example, Mutual Benefit Group is one of the insurers who has used Duck Creek Claims to improve their customer experience and keep up with the evolving insurance marketplace in their region. 

See Also: See how Duck Creek partners are improving their claims operations with Duck Creek Claims. 

Final Thoughts: The Future of Claims Management 

To meet today’s requirements of customer experience, data security, and efficiency – modern claims management systems are no longer a luxury, but a necessity. Duck Creek focuses on empowering insurers to redefine insurance futures with a simplified, humanized approach to technology.  

This is where Duck Creek Claims stands out, enhancing operational efficiency, customer satisfaction, and compliance. Our platform is an ally that prioritizes the insured, provides comprehensive protection, and navigates change to ensure it’s not just manageable but advantageous and accessible to all. 

Discover how Duck Creek Claims can redefine your claims management experience into a humanized one. Reach out to our sales team today. 



KPMG International, 2021, Creating a modern claims workforce: Meeting a bold new era of challenges

Silke Genuit, 2018, Insurance Thought Leadership, How to Use AI in Claims Management.  

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Luis Amadeo
SVP of Product Strategy & Innovation
Seasoned Technology Leader, Executive, and Architect with a demonstrated history of working in the computer software industry. Strong leadership and engineering professional skilled in cloud-native application architecture, multi and hybrid cloud strategies, microservices architectures, open-source technologies, software engineering, agility, DevOps, infrastructure & operations, enterprise architecture, and technology transformation & evangelization.