How today’s environment is accelerating innovation in life & health claims management

Working closely with our partners, we have learned first-hand about the multitude of challenges they face. The pressures are unprecedented and multidimensional. The recent wave of insurance worker retirements means a shortage of skilled workers, with the US alone losing around 400,000 insurance professionals by 2026¹. Meanwhile, claim volumes are rising, and legacy systems have become increasingly out of step with today's digital world. Outdated systems prove to be sub-par at handling the increased number of claims, integrating with new technology, and effectively detecting fraud. With the 2020 estimate of US life insurance fraud totaling over $74.7 billion (and the global industry-wide estimate exceeding $100 billion annually²), stakeholders recognize a cause for concern.

These challenges are magnified by a backdrop of economic uncertainty – from inflationand supply chain disruptions to volatile energy prices and evolving regulatory demands. The result? Claims organizations find themselves under pressure to lower costs and boost efficiency while still delivering superior customer experience.

At Swiss Re, we have listened closely to our partners and taken action to develop a solution that addresses these concerns. Our investment in developing claims
automation technologies means that our partners can benefit from a fully integrated platform to transform their entire claims journey – from first notification to final settlement.

What sets this solution apart is the careful integration of award-winning technology and deep industry expertise. We’ve connected our acclaimed digital claims portal and advanced assessment and triage engine with a purpose-built claims administration system. The result is a unified, modular solution that brings together workflow, analytics, and AI-powered document processing – all under one roof. 

Claims move faster, errors are reduced, and claimants, agents, and examiners benefit from a more intuitive, supportive journey. In fact, our PromiseXP platform reduces claim cycle times and improves efficiency by as much as 80% within just months of implementation for some carriers. What once took weeks can now be handled in days or minutes. 

Implementing new technology can trigger resistance, especially when it might replace a “human touch.” Our teams, however, have witnessed how technology, when thoughtfully applied, allows partners to embed empathy and expertise into their processes and customer touchpoints. By automating repetitive, low-value tasks and leveraging AI to extract and structure details from claim documents, claims assessors regain precious time. They can focus on the cases that truly matter to identify risk and fraud while offering the support, compassion, and insights that claimants need at their most vulnerable moments. 

Moreover, our Claims Assessment Engine leverages Swiss Re’s 160+ years of risk management experience, guiding assessors with both product and region-specific rules and best next action recommendations. This means junior staff can confidently handle increasingly complex claims, while experienced professionals can focus their energy where it’s needed most.  

We know that navigating the implementation of new technology is in itself a challenge. We partner with clients not just before and during implementation, but long after go-live – offering business support, training, and ongoing optimization. Our global network of regional claims experts ensures that every solution is tailored to local needs and market dynamics. Carriers who choose Swiss Re gain more than a platform–they gain an ally, invested in their long-term success. 

Looking ahead, the priorities for claims professionals are clear: 

• Short-term: Address talent gaps and upskill the workforce to prepare for the use of modern technologies. Maintain investments in functional training and industry associations to ensure expertise in claims management remains strong so modern claim examiners can identify emerging fraud schemes, understand when AI-driven summaries or model-based recommendations should be followed or questioned.  

• Medium-term: Lay the foundation for technology transformation. Clean up data structures, build robust reporting, and strengthen executive buy-in for digital investments. 

• Long-term: Master change management. As the next industrial revolution unfolds, technology will only reach its potential when paired with human understanding and adaptability. Advanced computing and artificial intelligence will continue to disrupt how we conduct our work. Leading your teams through rapid and persistent change will be a key capability in all industries. 

Raising premiums to cover the cost of legacy systems and manual processes is not a sustainable solution. Instead, insurers must deal with technical debt and rising retirement risk head-on through adopting technology that drive efficiency, automation, and a focus on delivering value – both for the business and for policyholders. 

Even as we automate, we never forget that insurance is a business built on trust. Our research confirms that empathy, fairness, and positive social influence are the strongest drivers of customer satisfaction and repeat business.

Our behavioral science approach guides claimants through the process, reducing stress and minimizing the risk of error or fraud. Our solutions remain human-centered by design. And we recognize that sometimes, the best experience is a blend of digital and human touchpoints. 

As the industry moves beyond viewing insurance as a necessary evil, we see opportunities to deliver more personalized, meaningful service. By integrating digital bereavement support, proactive communication, and intelligent risk management, we help carriers support customers not just at the point of claim, but throughout their journey. 

The path to better service also runs through data. Most carriers already possess a wealth of valuable information – yet it is often trapped in unstructured documents and siloed systems. Our AI-driven solutions help carriers unlock and leverage this data, driving smarter decisions, increasing efficiency, and improved profitability. 

While investing in and implementing new technology may seem daunting, the financial and reputational risk of not doing so will likely prove even more costly. Point-of-claim is where the insurance promise is fulfilled. It’s where trust is tested, and loyalty is earned. Our new, globally award winning, end-to-end solution is designed to help carriers deliver on that promise - efficiently, empathetically, and at scale. 

We are proud to help clients navigate the complex and emerging challenges they face – and to offer our partnership and expertise during the journey. 

By bringing our innovations to market, we embark on a transformation journey with our partners to shape the future of claims management together. 

¹ Insurance News, Nov 14, 2023
² The Impact of Insurance Fraud on the Economy 2022, Coalition Against Insurance Fraud