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Modernizing Claims Operations for a Multi-State Insurance Provider

Industry
Insurance (Commercial and Automotive)
Location
United States (15 States)
Tags
INSURANCE
CUSTOM APP DEVELOPMENT
WORKFLOW AUTOMATION
DIGITAL TRANSFORMATION
Key Impact
Replaced a manual, document-driven claims intake process with a custom digital portal unifying five policy systems.
~35%
Reduction in claims processing time
THE CHALLENGE
Modernizing a fragmented claims process

A leading insurance management organization operating five insurance companies across 15 states and managing 52 commercial and non-standard automotive insurance products needed a more scalable approach to handling thousands of claims each month.

Claims intake relied heavily on manual Word-based documentation, resulting in inconsistent data collection, limited visibility into claim status, and highly variable processes across teams. Without standardized workflows, claims frequently stalled, slowing resolution times and making it difficult to scale operations.

The complexity extended beyond intake. Policy information was distributed across five independent systems, each with its own data model and interface. Customer Service Representatives (CSRs) and adjusters were forced to navigate multiple applications and manually re-enter policy information throughout the claims lifecycle.

Incomplete claim submissions often required multiple follow-up calls with claimants, while critical operational knowledge remained dependent on experienced employees, increasing training costs and contributing to employee turnover.

PROJECT DETAILS
Building a unified claims management platform
TransPerfect led the design and implementation of a custom centralized claims platform that modernized claims intake, standardized operational workflows, and accelerated claim resolution. Key objectives included:

  • Creation of a unified claims platform to provide a single view of customer, policy, and claims information.

  • Standardization of claims intake to improve consistency while supporting state-specific regulations and policy requirements.

  • Automation of claims workflows to reduce manual effort, streamline task routing, and accelerate processing.

  • Strengthening of data governance through standardized data capture and improved information quality.

  • Delivery of a scalable digital foundation using an Agile implementation approach to support continuous enhancement and future growth.
Results
Faster claims processing with greater operational visibility
The new claims platform became the organization's central system for managing claims from initial intake through final resolution, replacing manual coordination with automated workflows and integrated policies. Operational improvements included:

  • Approximately 35% reduction in overall claims processing time.

  • Approximately 40% improvement in claims accuracy through standardized intake and validation.

  • Approximately 25% fewer claimant callbacks per claim due to more complete and accurate information captured during intake.

  • Unified access to data from five policy administration systems, eliminating the need to work across multiple legacy applications.

  • Enabled real-time reporting on claim volume, cycle time, workload, and CSR productivity.
OUR ROLE

Solution Strategy & Experience Design

Partnered with business stakeholders to define the future-state claims experience, map business processes, establish functional requirements, and design intuitive user workflows that supported CSRs, adjusters, and policyholders.

Application Development & Workflow Automation

Designed and developed a custom Claims Portal, including dynamic intake forms, configurable workflows, business rules, task automation, and end-to-end claims lifecycle management.

Quality Assurance and Regulatory Compliance

Led Agile delivery across iterative sprints, providing quality assurance and user acceptance testing while delivering automated workflows, SLA tracking, and state-specific coverage validation to support compliance across all 15 states.

Solution Architecture & Systems Integration

Designed the overall solution architecture and integration strategy, connecting five policy administration systems into a unified platform while establishing a scalable foundation for future business capabilities.

Ongoing Partnership & Platform Evolution

Continued to enhance the platform through iterative improvements, new workflow automation, and expanded capabilities, helping the organization extend its digital transformation beyond the initial implementation.
~35%
Faster claims processing
~40%
Improvement in claims accuracy
~25%
Fewer callbacks per claim
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