Claims Management - Not sexy?

Bringing Claims Management to the Next Level.

The core of insurance is claims. In Non-Life (P&C) on every € 100 insurance premium paid on average € 67 is to compensate for claims (including expenses), for which the premium ultimately was paid. One third (€ 33) of the insurance premium is used to do the job.

Getting this Claims Flow well under control is really making the difference. Not only financially but also for customer satisfaction and retention.

That’s not easy. Not from a process and/or technical perspective but claims management is simply not sexy and usually gets lower priority than Marketing & Sales and Product Development. I’ve seen this happening for decades in many companies. Claims relate to damage and/or injury or even death so there is always a negative side to deal with and they can always cause trouble. Anyhow money goes out and are we sure this is justified?

As an insurer however key responsibility is to protect customers when the worst happens and get them back on their feet as soon as possible. So let’s shine here, we can do better.


  • Automate as much as possible (but be there in person if necessary)
  • Reduce the number of claims (risk-management, predict and prevent)
  • Online claims notification and tracking with fully integrated mobile solutions (and guest domains (TPC))
  • Reduce handling costs
  • Outsource claims handling or go for a relevant mix
  • Speed-up the process and make it paper free
  • Control actual claims costs
  • Reduce fraud
  • Survey each claim to learn
  • Real-time monitoring and MI
  • And last but not least put the customer in the center and solve all “issues” as soon as possible. Increase customer satisfaction (CX)

Claims & UBI

With current ICT-solutions these objectives are already no real issue (had most of this in operation around 2002). But implementing UBI with back-end claims means coming full circle. Those insurers with continuous accurate pricing, good analytics, fresh risk approach, supportive mobile apps and in close touch with the customer will get ahead of competition. Especially if the claims process is organized with the same sophistication.


There is a clear shift to the smartphone (or: Personal Smart Device) being the gateway between the insured and relevant parties. Possibly after synchronization with the data produced by other sources. Having all those data and know how to use them offers competitive opportunities.


It starts with being proactive. Using environmental and infrastructural data in combination with data actually produced by the insured. Improving behavior (scoring) and create early warnings.


When it nevertheless comes to an accident a claims app is opening. The customer/user/driver is guided in a dynamic way through a relevant notification process and the information is automatically attached to the right policy. The result is sent as pre-FNOL (First Notification Of Loss) and integrated in the online FNOL to complete (if necessary) at a convenient time and place. If requested assistance is provided (e.g. in combination in eCall).

Get immediate FNOL with evidence (time, location, images (accident location, damages, objects involved, witnesses, video, car: speed, deceleration, dashcam etc.). If possible (partially) via smartphone on the spot. The FNOL basically goes in 5 steps:

And is immediately integrated and available in the Private Domain of the customer and for the claims handler(s). An overview with all the questions and (outstanding) answers for the claims handler and loss adjuster is online available. And on top of that: In case of a car accident a look alike of the Standard (European) Claims Form can be produced afterwards as well (for (international) recovery and litigation; as long as some parties are not there yet). Professionals involved, customer and third parties can follow every step in the process online (claims tracking with guest domains). Based on automated analyses the claim is categorized in low and high risk (80/20 and improving).

Where Low Risk means speed and customer satisfaction (STP). Low risk is handled along automated guidance. Random checks and audits. So far everything is automated and dealt with by partners in the field.

High risk claims need some more attention; however when indicators give green light they are pushed back to Low Risk. Otherwise the claim is further scrutinized carefully or ends up in litigation.

Highly automated

Based on the structured and dynamic FNOL (without any manual intervention) a Claims Binder is generated with one or more Claims Files, all the initial reserves are set including the relevant cost type. A notification lands at the Inbox of the Claims Department (internal- and/or external) where Claims Handler and Claims Owner are determined and when the claim is not settled in a fully automated way (STP), the Claims Handler takes off immediately. Responding asap but within 30 minutes.


The initial reserves are automatically set at FNOL and give accuracy in a bandwidth of +/- 1.5%. Triangulation is as good as flat. The real-time MI on the Dashboard shows the Claims- and Loss Ratio spot on.

Customer Experience (CX)

All communication preferably takes place via the Private Domain(s) and is integrated in the claims file, named and with a time stamp. The customer can follow progress in detail.

As soon as the claim is closed for the customer a button with “Your opinion” automatically appears in the Private Domain linked to that specific claim. At the same time the claim gets the status “Closed” an eMail and SMS are generated automatically to remind the customer to have a look in the Private Domain. The eMail also contains a direct link to the Private Domain. By clicking on the button a short survey pops up enquiring about:

  • Speed of the claims handling
  • Information provided
  • Result of the claims handling
  • A comment box allows the customer to enter free text.

Third Party Capture (TPC)

Normally the Third Party is not a customer. And here you have the perfect moment to shine and offer all your services and best practices to a prospect you have to deal with anyhow. So also create Guest Domains to include third parties in the process.


Claims Handling and Claims Management should be valued at its true importance. And yes, servicing and compensating your customers in case they experience material or personal damage should be attractive and exciting (maybe “sexy” is not the good word).

Customer Focus, Customer Experience, Customer Centric are not just words.
Recognizing the importance of claims, bringing priority a bit more in balance.
And take claims to the next level; it’s no rocket-science and it’s worth it!
Above all the customer is worth it.

About Sunfield Consultancy

“Smart Protection for Safer Living”
With a small international team we built the world's first international online fully licensed insurance company.
With a unique ICT-Platform and Smart Operations.
Successfully rolling-out to 8 countries and selling it to key players.
Now expanding to a holistic concept based on CX, IoT and Telematics.
Called InConnect

As Insurance Engineer I love to work on Safety First.

Company: E.J. Van Zonneveld
Commercial Register (NL-KvK): 73498351
Trade name: Sunfield Consultancy
VAT: NL073769708B01
General Conditions PDF (Dutch Law)
Director: Ewout van Zonneveld
Email: ewout@sunfieldconsultancy.com