5 Compelling Reasons to Automate the Insurance Workflow

Insurance Workflow

Table of Contents

Insurance companies have been at the forefront of technology adoption for decades. There are several reasons why they adopt technological innovations, better risk management, effective new customer acquisition, and enhanced customer experience are the top reasons for tech adoption. The COVID pandemic has forced the global economic engine to transform by enabling and building digital transformation and resilience. Consumer internet has fuelled the growth of new customer discovery and acquisition channels and evolved customer experiences and requirements. The top priority for insurance companies is to automate insurance workflows. Automating insurance claims workflow makes process inefficiencies and redundancies a thing of the past and provides consumers with a digitized and personalized experience.

Insurance Workflow Software At a Glance

Insurance business process flow diagrams lay out each work step in a specific process to identify improvements in employee productivity, customer experience, and risk management. Insurance processes can be simple, like auto insurance claim processing, or complex like health insurance. The complexity of the claims processing is dependent on the insurance product. Correspondingly auto insurance claims process flow diagrams are simpler compared to health insurance workflow diagrams. Processing a life insurance claim is different from auto insurance claim processing and the corresponding tasks in the workflow vary. Other variations in insurance process workflows are distribution channels and customer groups. In order to understand claims workflow one has to map the main tasks/steps in the workflow. Detailed insurance claims process flow charts help in understanding the customer journey and help insurers identify specific areas for improvement. To understand the insurance workflow better, let us first understand the steps in the process.
  • First-Notice-of-Loss (FNOL) – post the loss event, complete details on the claim are collected and the claim is assigned to the appropriate claims adjuster. Simple claims like auto glass repairs are settled by this process.
  • Appraisal – based on the details collected the initial assessment of the damage is conducted. Damage to non-living subjects is conducted as part of the initial assessment. Claims that involve bodily injury or total loss of property are handled/assessed differently.
  • Adjustment – the assessed loss is then compared to the level of coverage to set a loss reserve and negotiate a settlement with the policyholder. Once the final settlement amount is decided, it is communicated to the policyholder.
  • Settlement – after negotiation with the policyholder, the final settlement amount is agreed upon and the amount is transferred to the appropriate parties.
  • Subrogation and salvage – specific types of insurance claims may require subrogation (payment collection from other parties), or salvage ( sale of scrapped auto parts and totaled vehicles). Such claims are handled separately and have an additional step in the claims processing.
Some examples of claims workflows are online insurance sales, premium accounting, bill collection, prospect-to-issue, insurance licensing and contracting, auto and home insurance sales, medical claims processing, and property and casualty claims. Another area in the insurance domain prime for automation is insurance sales. Instead of adopting individual tools, insurance companies must look at automating the entire insurance sales cycle. For example, Mobile-optimized insurance product presentations enable teams to digitally co-review the insurance products the customer is interested in. Digital terms and conditions for the desired product can be shared with the stakeholders for instant approval. Collection of e-signatures and automated billing are other advantages of automating the insurance sales process. Manual insurance workflows take way too much time to complete and are prone to errors and inaccuracies. Another disadvantage of manual insurance workflows is the high incidence of claims that are mistakenly not submitted. Lack of clear communication is another drawback of manual insurance company processes. Most of these issues can be taken care of by insurance workflow automation. By automating the insurance agency workflow procedures, the communication path is clear and claims processing is transparent.

Why Should You Automate the Insurance Workflow?

Insurance companies require solid reasons to automate insurance workflows. Workflow automation is no doubt a big step in the right direction for insurance agencies/companies, here are 5 reasons validating the move to insurance claim automation.

1. Better coordination between systems

Insurance companies have disparate systems for each stage of claim processing. Manual claim processing lacks proper coordination between these systems. Although insurance companies might have digitized their content, they need an automation platform to integrate disparate claim processing systems. Workflow automation integrates data and systems at the business process level. Claim process automation breaks the segmentation between the insurance systems and improves coordination between disparate systems. Information sharing and governance are much easier and more accurate with workflow automation.

2. Updates Enterprise Content Management

An insurance agency that works with outdated systems is already lagging in the competitive market. Archaic methods hamper the working speed of employees and access to information. Mobile access to systems and information must be available to all employees. Using mobile apps for insurance processes could be a game changer for the insurance agency. Optimizing these apps as per the user functionality ensures that employees are up to date with data. Insurance claims can be conveniently submitted to clients through the web or the app. These models can be applied to obtaining information in real-time. Having a process management system enables insurers to manage queries in real time.

3. Efficient Record Management

Optimization of record management is an important part of the overall business strategy. Automating the insurance claim process enables efficient form, file, and data management, relieving staff from burnout and improving their productivity levels. Strategically planned workflow automation reinforces efficient claim management and effective processing and management of insurance claims so that they move from one step to another without any delay or loss of information.

4. Improves business reach

Automated claims processing improves performance and communication between insurance agents, carriers, and underwriters. Clients expect speed and accuracy from claim processing, which means that agents demand faster responses from carriers and underwriters. Streamlined claims processing systems help insurance companies develop a strong word-of-mouth reputation among clients. From the standpoint of the customer, speedy delivery of information improves loyalty and delights those you do business with. Carriers that provided high levels of automation eliminated the guesswork from day-to-day activities.

5. Reduces business expenses

Carriers often try to maximize cost savings with large-scale process re-engineering but fail to achieve potential due to overburdened staff and multiple changes at the same time. As per a Harvard Review, optimization and digitization of insurance workflows can result in as much as 65% cost savings and up to 90% reduction in turnaround time. The key to successful workflow automation is integrating all the data gathering and storage systems.

Insurance Process Automation Use Cases

A cloud-based, process-driven integrated workflow automation solution like Cflow helps insurance companies automate claim processing workflows. Let us consider the following use cases to understand workflow automation in insurance:

Online Insurance Applications

Submitting insurance claims is one of the most cumbersome processes when done manually. Customers struggle to move from inquiry to quote to the proposal as quickly as possible due to the manual processes followed by the insurance team. Teams spend long hours on manual printing, scanning, and emailing paper documents to and fro between departments and customers. Moreover, manual documentation is prone to errors and inconsistencies. All these issues can be overcome by digitizing and automating the insurance application process. Using tools like optical character recognition and electronic signatures and automating the application process allows customers to start and resume paperless applications from any device at any time. The automated insurance claims application process enables users to gather signatures, track progress, and extract customer data directly into backend systems without the element of human error or displaced or missing applications. From proposal creation to approval all the steps are executed without any delay or overlap.

Property and Casualty Claims

The most common challenge faced by insurance companies while processing property and casualty claims is the friction within internal and external claim touch points. The source of this friction stems from manual paperwork and back-and-forth attempts to resolve data inconsistencies and errors. For example, an incomplete field in the claim form leads to resubmission and starts an email trail of information requests and nearly identical duplicate paperwork. Digitizing the claim submission eliminates the guesswork and inconsistencies from claim processing. Paper-free automation provides the necessary transparency and consistency at every step of claim processing. All the stakeholders are aware of the status of the claim. An automated client portal guides the policyholder at every stage and opens the door to quicker claims processing and superior customer experience.
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Medical benefits administration compliance

Compliance in medical benefits administration requires coordination between many gears and parties involved. All the claim requests need to be documented in a timely fashion and medical records need to be easily retrievable during audits. Digitizing and automating each medical benefits insurance workflow enables patients and healthcare providers to get their requests routed to the right person for speedy approvals. The audit trail for digitized reimbursements and other claims is clear, searchable, and easily storable (paperless).

Medical claims processing

Lack of collaboration among medical insurance staff is the main reason for slowing down medical claims processing. Centralized access and control of medical claims data are essential for the smooth processing of claims. Centralized claim data improves visibility across the various stages of claims processing. Manual gathering of information in silos leaves teams dense with redundant information that already exists in other departments. Automating the communication between policyholders, healthcare providers, and internal staff helps them stay updated and frees them from mundane data updation activities. Teams can focus more on the more involved parts of claim processing. Automation of data processing keeps the day tidy and reduces the time spent on communicating compliance tasks.

Home and Auto Insurance Underwriting

The insurance staff is overwhelmed with the underwriting work for home and auto policies. From quotes to renewals – human efforts must be focused on tasks that require a more analytical treatment. AI-based automation makes it easy to offload the routine onto bots. AI rules can guide the routine decision-making activities that are a part of the typical underwriting workflow. Machine learning can be used to absorb the nuances and pivot the human team towards more time and energy savings. Insurance staff can always pitch in whenever needed while bots pull off most of the work.

Customer onboarding

Onboarding new customers is a data- and labor-intensive process that takes up a major portion of the work hours of insurance companies. Communication roadblocks in the insurance application process across departments render each team’s workflow redundant and siloed. In addition to this, manual follow-ups and data re-entry are subject to oversights and human error. Digitizing and centralizing communication via the workflow automation platform creates a more visible and manageable customer journey. Automation using bots ensures that any delays or omissions are addressed with prompt email follow-ups. Insurance staff need not waste their time on these follow-ups, and the time thus saved can be utilized for addressing deeper concerns and cementing customer relationships.

Group Quote Marketing

Creating a custom group quote marketing is much more effective in personalized insurance workflow software. Tracking and measuring trends of past customer requests when done manually lacks the visibility needed by teams to reshape marketing campaigns. Adopting automated digital analytics enables teams to draw real-time insights into customer trends and creates a mechanism to measure data as well. Marketing teams are equipped with data insights into various customer segments and can easily adapt their strategies to current market trends. Teams can sculpt solutions that effectively balance risk with policy aspects desired by various groups.


Adopting a cloud-based, process-driven integrated workflow automation software like Cflow enables insurers to automate insurance workflows. Automated claims workflows provide data insights into customer trends and expectations, and also free the team to focus on strategic initiatives that improve their business bottom line. To explore insane workflow automation capabilities provided by Cflow, sign up for the free trial today.
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