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After working with 20+ life and annuity carriers, a clear pattern emerges:
Claims transformation isn't failing because of technology. It's failing because of the decisions carriers make around their processes.
In our recent Claimversation, Jes Vargas (Director of Product & Solutions at Benekiva) broke down the most common pitfalls she sees across carriers and what actually works when trying to modernize claims. Want to watch the full discussion? Here's the link.
Here's what stood out.
One of the biggest misconceptions in the industry is that implementing a new system equals transformation. It doesn't.
"If you digitize a bad process, you just get a faster bad process."
Many carriers invest in modern platforms but simply recreate the same workflows, bottlenecks, and inefficiencies they had before, just in a new interface.
Real transformation requires something harder:
Because the real value comes from:
Installing a system is not the same as redesigning your operation. The most successful carriers treat implementation as a redesign moment, not a lift-and-shift exercise.
Resistance isn't the problem, lack of context is. When teams don't understand why change is happening, it feels like something being done to them, not with them.
The fix:
Claims examiners are trained to question everything, and for good reason. When teams double-check calculations, rebuild correspondence, or manually override automation, it's not a people problem.
"If your team doesn't trust the system, it's not a people problem; it's a design problem."
Trust has to be earned through:
Flexible systems can become traps. Carriers often over-configure rules, exceptions, and workflows until they've essentially rebuilt their legacy system, just without calling it custom code.
The result:
Many teams try to design for every edge case upfront.
The reality? Most "requirements" are just habits.
"If you build for the exceptions… the exceptions become the process."
The better approach:
Claims operations often rely on highly specialized knowledge:
That model doesn't scale, especially with a looming retirement wave.
"If your operation only works when the 'right person' is available… it doesn't really work."
The shift:
Not all problems are big. Some of the biggest operational drag comes from everyday workflows:
Individually small. Collectively massive.
"It's not one big broken thing—it's a hundred small ones everyone's learned to live with."
If there's one idea to walk away with, it's this: Transformation isn't about the system you install. It's about the decisions you make about your process. Or, as Jes put it:
"You don't get transformation by installing a system. You get it by changing how you operate."
If this conversation felt familiar, you're not alone. These patterns show up across carriers of all sizes, and the good news is, they're fixable.
If you'd like to deep dive into any of these topics and discuss how to navigate them within your own company, let us know. We'd love to help.
