Homeowners Claims Management

The profitability of the U.S. P/C insurance industry is under pressure. How you handle claims can make a difference.

The average combined ratio of the largest U.S. homeowners insurers was over 100% yet again in 2021, marking the fourth time in five years that the figure has been above the profitability benchmark, according to an S&P Global Market Intelligence analysis. For policyholders, this means premiums are continuing to rise.

Insurance claims comprise approximately 70% of insurance carriers’ total expenditures in the forms of payment, fraudulent losses, and processing costs. And even a fractional optimization in losses paid and their associated expenses can have a material impact on insurers’ profitability.

Therefore, your company’s claims handling and administration could well make the difference between an underwriting profit and an underwriting loss.

Key Challenges for Homeowner Insurers

Catastrophe Management

As we all feel, climate risk is continuing to put pressure on all things weather-related. And insured damage from tornadoes, hurricanes, sever storms, wildfires and other natural disasters has reached $82 billion in the U.S. this year. For insurers, this means that you need to be able to quickly and efficiently manage the aftermath of high volume, high severity events and have the ability to:

  • Recognize and forecast size and scope of the event in real time as claims information is captured
  • Rapidly understand additional resource needs (internal and external) on an exponential basis
  • Quickly transition from a claim ownership operating model to a resolution processing operating model (all hands on deck)

High Severity Losses

Understandably, high severity home losses (up to total rebuild or replacement of the home) are a uniquely negative experience for the homeowner and as result a difficult situation for your adjusters resolving these losses. A modern claims management system can help mitigate and enhance the experience for both parties by proactively:

  • Coordinating the resolution and communication process across all relevant coverages for both the adjuster and homeowner
  • Presenting and communicating the underlying policy parameters that become relevant in high severity losses
  • Streamlining and automating administrative components of inventorying, valuing, and applying depreciation to personal content and managing temporary living expenses

Vendor Management

Vendors interface with your policyholders on your behalf across the entire claims process and execute key tasks (FNOL, mitigation, damage scoping, damage assessment, content inventorying). To this extent, vendor management plays a large role in the success of your claims operations and is key for creating a smooth customer experience. 

Omnichannel Communications

Your policyholders expect real-time communication across multiple channels (text, email, chat, phone, video) – corresponding just by snail mail or even email is no longer an option.  Unfortunately, most claims insurance technology is outdated and does not support omnichannel communications,  leading to frustrated customers and unhappy adjusters.

Five Sigma Benefits for Homeowner Insurers

Our cloud-native data-driven claims management solution makes your claims processing simple and smart.

Automated Claims Submission

Our digital claims management solutions (CMS) provide:

  • All FNOL data received from the insurers/digital channels are embedded automatically into our workflows and ready for the next step in the process
  • Rapid system identification of claim types
  • Automated triage and adjuster assignment
Embedded Omnichannel Communications

Our CMS includes an API-level communication module that support all types of communications including: SMS, mail, voice video calls, and even WhatsApp. All claims-related communication is documented, stored and analyzed automatically.

Just-in-time Recommendations

Our systems flags coverage and liability issues and presents the adjuster with relevant information and investigative steps within the claims system.

Damage Assessment and Negotiation

The key to effectively negotiating a claim begins with accurate damage assessment. Our CMS includes a digital bodily injury evaluation module to itemize, assess and aggregate damages.

Monitoring and Management

Based on our advanced data modeling, we enable insurers to monitor your operations and receive actionable insights that will help you make strategic management decisions.

Is Your Claims Operation Ready When Catastrophe Strikes?

Many claims management systems are auto-centric claims systems that have been modified to accommodate homeowner claims. When a catastrophe strikes these systems’ deficiencies become glaring and can intensify handling delays and resolution inaccuracies.

Learn how our claims management solution has been built from the ground up to specifically resolve homeowner claims and help you better manage the exponential increase in claims volume when catastrophe strikes.

Go live in weeks with the state-of-the-art claims management platform.