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Eastbridge Study Highlights Claims Integration Trends

A recent report published by Eastbridge Consulting Group has shed light on a notable trend among voluntary carriers in the insurance sector: the integration of claims with medical plans and other related products. According to the findings of the report titled "Claims Integration and Automation Practices of Voluntary Carriers," there has been a significant uptick in the number of carriers implementing these practices over the past two years. Approximately 75% of surveyed carriers now offer integrated claims services, an increase from around 66% in 2022.

Danielle Lehman, a senior consultant at Eastbridge, emphasized that today's employers, employees, and brokers expect a streamlined claims process that minimizes complexity and maximizes efficiency. This shift towards integration is aimed at reducing the time and effort required for clients to file claims, while also expediting payment for services rendered. The integration practices detailed in the report indicate a growing recognition of the need for a seamless experience in handling claims, providing a competitive edge in the voluntary benefits market.

The study, drawing data from a survey conducted in August and September 2024 with responses from 26 voluntary carriers, explores various topics including claims automation, submission methods, and the impacts of these integrations on overall business practices. Findings suggest that carriers are more prone to automatically initiate claims for voluntary products when integrated with their supplemental health and disability offerings.

One of the report's notable conclusions is the prevalence of auto-adjudication among carriers, which is often applied to at least one voluntary product—commonly, wellness claims. Carriers are also increasingly offering intuitive claim payments, which involve proactively disbursing payments for services associated with common injuries or illnesses. Accident claims stand out as the most likely category to receive these proactive payments, showcasing the carriers' commitment to improving the customer experience throughout the claims process.

The research emphasizes the importance of measuring the effectiveness of current integration practices. As carriers adopt these advanced methods, they gain the ability to compare their strategies against competitors', thereby identifying areas for improvement that could enhance their operational success.

Despite the positive feedback on claims integration, the report also mentions that the majority of surveyed carriers have not noted any substantial alterations in overall claims volume or loss ratios attributed to this integration. This indicates that while integration might facilitate a smoother claims process, it does not fundamentally alter the financial dynamics of the insurance policies themselves.

For organizations interested in adopting these trends, the report provides insightful data and analysis that could serve as a roadmap for navigating the integration landscape. Eastbridge invites interested parties to contact them for further insights and to inquire about purchasing access to the complete report.

This trend towards claims integration not only reflects changing expectations from clients, but also highlights the broader industry shift toward digitization and automation—efforts essential for meeting today's client requirements in the insurance market. As the landscape evolves, the focus on integrated claims practices will likely grow, paving the way for innovations that can redefine how voluntary benefits are administered.