New Eastbridge study shows continuing trend toward claims integration

AVON, CONNECTICUT, USA (December 5, 2024)

Carriers report integration has little impact on claims volume or loss ratios

A strong majority of voluntary carriers now integrate claims with medical plans or other voluntary products, according to new research from Eastbridge Consulting Group.

Eastbridge’s “Claims Integration and Automation Practices of Voluntary Carriers” Spotlight™ Report shows about three-quarters of carriers offer integrated claims services, up from about two-thirds just two years ago. Carriers offering medical claims integration services most often integrate with self-insured medical plans. About half of these carriers require employees to opt in for medical claims integration.

“Employers, employees and brokers expect the claims process to be easy and seamless,” said Danielle Lehman, Eastbridge senior consultant. “Integrating voluntary claims with other employee coverage can mean customers spend less time and effort filing claims and receive payments faster.”

The “Claims Integration and Automation Practices of Voluntary Carriers” Spotlight™ Report compiles survey data collected from 26 respondents in August and September 2024. Topics include claims automation and adjudication, submission methods, payment timeframes by product, integration practices and impacts, challenges and future trends. Voluntary carriers can use this information to compare their own practices to competitors and identify opportunities to become more successful.

Other key findings in the report include:

• Carriers are more likely to automatically open a claim for a voluntary product when integrating with their own supplemental health and disability products.
• Most carriers auto-adjudicate claims for at least one voluntary product, most often wellness claims.
• Some voluntary carriers offer intuitive claim payments, paying proactively for services typical for an injury or illness. Accident claims are the most likely to receive intuitive payments.