Straight-through processing, or STP, uses rules, data validation, integrations, and workflow automation to process eligible low-risk claims with little or no manual intervention. These claims are also often called "fast-track claims." STP works best when carriers define clear eligibility criteria, exception rules, audit controls, and human review points for claims that require judgment.
Straight-through processing (STP) means a claim moves from first notice of loss through validation, adjudication, and payment without requiring manual examiner intervention at each step. The platform applies pre-configured rules to evaluate whether the claim meets defined criteria and, if it does, routes it automatically toward approval and payment.
Low-complexity, low-dollar claims with complete documentation and no coverage questions are the strongest STP candidates. Final expense and preneed life claims, small annuity death benefits, and straightforward life claims on uncomplicated policies are commonly automated. Claims involving contestability, litigation, missing documentation, or beneficiary disputes require examiner judgment and should remain in human review queues.
Effective STP requires clean policy data from the policy administration system, a complete claim submission with required documentation, and clearly defined business rules that specify eligible claim types, coverage thresholds, documentation requirements, and exception conditions. The stronger and more complete the data, the higher the percentage of claims that can move through without manual intervention.
When a claim does not meet STP eligibility criteria — whether due to missing documents, a coverage question, a data mismatch, or a business rule trigger — it is automatically routed to an examiner queue for review. Well-designed platforms make this routing configurable so that different exception types are directed to the appropriate team or skill group.
Compliance requires that all automated decisions are driven by auditable, documented business rules and that the platform maintains a complete event log of every action taken on a claim. Carriers should also define human oversight checkpoints such as review thresholds, exception queues, and reporting that flags automated claim volumes, approval rates, and outliers. Oversight checkpoints ensure compliance with state regulations and internal standards.
Benekiva supports straight-through processing through configurable business rules and event-based workflow triggers that automatically evaluate claim eligibility, generate requirements, route claims, and advance workflow steps when conditions are met. Benekiva clients have automated over 70% of final expense claims through auto-adjudication in production environments. The platform maintains a complete audit trail of every automated action, and exception routing ensures that claims requiring examiner judgment are directed to the right queue.
Benekiva helps life, annuity, preneed, disability, and long-term care carriers modernize claims operations with configurable workflows, digital claim submission, automation, integrations, claimant portals, reporting, and tools built specifically for claims teams. Our platform is designed to help carriers reduce manual work, improve visibility, and support better experiences for claims professionals and claimants.
