Breaking Free from Inefficiency: The Case for Claims Modernization

One of the most common complaints I hear when I am speaking to prospects about their claims process is:

“We just have so many ‘manual processes’, ‘access databases’ or ‘excel spreadsheets’ ”. And every time I hear that, I can’t help but chuckle, not because it’s funny, but I had the same problems when I processed claims, over 10 years ago at a carrier. It’s something that has me sitting back in my chair wondering, “It’s almost 2025, WHY are we still seeing so much inefficiency!?”

Well…most often, the answer to that question is money… but let’s talk about why it’s important to start thinking about modernizing your claims process, regardless of price tag.

Challenges in Traditional Claims Management

• Inefficiencies

• Customer Frustration

• Operational Pain Points

As stated earlier, typically, the most common complaints we see with carriers are following the same three key points. So, let’s take this one by one:

Inefficiencies

Unfortunately, the claims industry is very often subject to the curse of being handcuffed to “legacy systems”. We’re talking old school, mainframe systems with F-Key navigation. Sure! These systems have their nostalgia-factor and some folks even prefer them, however, they don’t often allow a lot of freedom when it comes to integration, which then means, not leveraging new technologies to their fullest. A lot of IT teams don’t want to touch these processes because “if it ain’t broke, don’t fix it.” But keep in mind, we have a substantial workforce of Millennials and Gen-Z coming into this industry…how do you think it’s going to go trying to tell them they need to memorize f-key functions? Similarly, as beneficiary and claimant generations are shifting as well, carriers and solution providers need to start providing digital options for communicating with their customers. Yes, there will always be those clients who want paper, but we’re seeing more and more as times change, the desire to move to digital methods for claims intake, or requirement submission. We need to keep up with the times!

Customer Frustration

Let’s imagine a scenario…You’re a new college graduate, getting your first real job with real benefits and a life insurance plan. When you select your coverage, and pay your portion of premiums, what is the goal for that insurance? Ideally, if anything happens to you, that it would provide support to your family for bills, funeral costs etc…right? Now, imagine years later you pass, and your child is submitting the claim on you, they submit all the documentation that is needed and they wait and wait and wait.

Periodically, they call in to customer service on the phone, sit on hold for 40 minutes each time, just to be told it’s “In line to be processed, but they have high volumes at the moment.” It’s now been over a month; they call again and are told they had to double check the values because they weren’t accurate. All your child needs is for the policy it be paid out, so they can pay for the funeral bill, and work to get your house on the market. The bills keep coming, but they are having to wait through no fault of their own, because of operational inefficiencies and sub-standard systems. Not to mention the hours they wasted listening to elevator music on hold with the customer service rep.

This is not the purpose of your policy. The purpose you intended is so your family wouldn’t have to worry, when it came time. One of my mentors, always says, “The purpose of claims, is the fulfillment of the promise of the policy.” I couldn’t agree more. And it’s OUR job, as carriers and solution providers, to deliver that promise with speed, efficiency, and as little stress as possible for the families. We owe them that.

Operational Pain Points

Alright, down to the stuff no one wants to talk about…but we NEED to.

When we are dealing with manual keying of values, excel spreadsheets, word templates to generate correspondence, etc…guess what’s going to happen…you’re going to have errors, rework, overpayments…all those ugly things no one likes. Alternatively, you might catch the error, but that just bogs down your leads and quality analysts in documenting errors, and submitting for re-work. A thing that often shocks me when speaking with carriers is how many claims they send through for quality review before the claim can be paid. In some cases, 85-100% of their claims receive quality review of some kind. Now, when I was a claims lead, I did quality review, and the amount of times I sent something back for an error, then when resubmitting, the examiner made another error…were too frequent to count. I ended up spending 90% of my day doing quality review, not leaving any time to support the team in other ways that were desperately needed. This is a vicious cycle that continues to set the team back.

How Benekiva Enables Digital Transformation

When I walk into a client or prospect’s office, the first thing I want to know is simple: “What are you doing now, and why?” Most importantly, “What’s stopping you from doing it better?”

Here’s the thing: every carrier has inefficiencies, but not every carrier knows why they exist. A lot of it boils down to being locked into systems or workflows that don’t allow for flexibility or innovation. That’s where Benekiva comes in.

Our approach is straightforward:

1. Start where you are

   We don’t rip and replace everything. Instead, we work with your existing architecture to identify where we can integrate, automate, and simplify. If your team is manually keying data or managing claims through spreadsheets, let’s dig into why. Is it because your system doesn’t allow automation? Is it because the process has been handed down for years without being questioned? We aim to identify those bottlenecks and break them wide open.

2. Design for your ideal state

   At Benekiva, we believe in designing processes that actually work for you—not the other way around. That means fewer manual steps, seamless data integrations, and streamlined workflows that allow your team to focus on delivering value rather than fixing errors.

3. Deliver on the promise of the policy

   This is what it all comes down to: fulfilling the promise of the policy. It’s not just about processing claims faster; it’s about delivering for your claimants. By automating the mundane and giving your team tools to work smarter, we help you provide a customer experience that builds trust and loyalty.

It’s Time to Rethink Claims Management

Here’s the reality… your customers are demanding better, and your team deserves better. Legacy systems and outdated processes might have gotten you this far, but they aren’t going to help you thrive in a digital-first world. What we do at Benekiva isn’t just fixing inefficiencies—it’s about enabling transformation. We help you move from claims processing that’s reactive, slow, and manual to claims management that’s proactive, seamless, and customer-focused.

Let’s work together to deliver on the promise of every policy and ensure that your claims process isn’t just another step in the lifecycle—it’s a differentiator.