Claims Transformation: The Journey Beyond Modernization

An SMA Research Report

Karen Furtado, Partner
Denise Garth, Partner
Publication Date:
March 31, 2015
Number of Pages:
$995.00 USD

This report, the first in SMA’s thought leadership series on claims transformation, examines the need for changes in the end-to-end claims process, starting but not ending with claims system modernization. It introduces a new paradigm for claims in today’s fast-paced world and gives specific examples of how to apply this paradigm to the journey toward becoming a Next-Gen Insurer.

Claims transformation is bigger than modernization, encompassing changes to the entire claims business model and philosophy rather than simply the day-to-day processes of claims operations. Transformation touches all areas of an insurer’s business, establishing an organization with the right skills to support the new technology and vision of claims, the business capabilities that support the elevation in services, the redefinition of risk management, and the technology that supports and takes advantage of the continued advancements in the market.

Claims Transformation: The Journey Beyond Modernization also looks at claims transformation through the lens of SMA’s Business Value Maturity Model, which lays out the steps in the transformation journey from modernization through optimization and finally to innovation. It applies these levels of investment and the business value that they represent to the claims environment to give insurers a tool with which to interpret their own claims transformation.

Table of Contents

  • The Claims Transformation Imperative 3
  • Claims: Moving Beyond the Transaction 3
  • Claims Transformation 5
  • A New Claims Paradigm 7
  • SMA Call to Action 8
  • About Strategy Meets Action 9