Insurance has always promised certainty in uncertain moments.
Yet for many policyholders, the lived experience, particularly at claims stage, falls short of that promise.
For those working in insurance, this is a familiar tension.
Products are well designed, actuarial models are robust, and regulatory frameworks are respected, but when systems, processes and channels fail to work together seamlessly, the customer feels it immediately.
Claims delays, inconsistent communication, repeated information requests and opaque decision-making quickly erode trust.
As new entrants to the insurance industry raise the bar on speed, transparency and usability, this is no longer just a customer-experience issue but a strategic risk.
In increasingly competitive and technology-led markets, insurers must rethink how they operationalise care, accuracy and efficiency at scale.
Claims: the moment of truth
The insurance industry places particular focus on customer experience, financial protection, and risk management, as well as the competitive advantages these present.
Claims handling is the critical moment at which these priorities converge, as the primary point of engagement for customers when an incident occurs
As a client-facing function, claims handling remains the most emotionally charged and operationally complex interaction an insurer manages.
It is also where brand promises are tested most publicly.
In an era of social media, comparison platforms and real-time reviews, a single poor claims experience can have profound reputational consequences.
From an operational perspective, claims sit at the intersection of multiple functions, many of which share underlying data, workflow orchestration, and customer touchpoints.
Failures in upstream capabilities impact downstream claims and disbursement efficiencies.
Fragmentation across these functions, often reinforced by legacy systems, creates friction that customers experience as indifference or incompetence.
High-performing insurers increasingly recognise that claims excellence is not achieved through isolated process improvements, but through end-to-end orchestration supported by well-designed systems.
Technology as an enabler, not a silver bullet
Advanced analytics, artificial intelligence and automation are regular agenda items in insurance strategy discussions.
However, value is only realised when technology is deployed with clear business intent and embedded into operational workflows.
Across the insurance value chain, technology is enabling tangible improvements:
- Underwriting teams use advanced data models to refine risk assessment, improve pricing accuracy and reduce manual intervention.
- Claims functions leverage document intelligence, rules-based triage and anomaly detection to accelerate low-risk claims and focus human expertise where it adds the most value.
- Fraud and compliance teams use network analytics and pattern recognition to identify emerging risks earlier and with greater precision.
- Customer service is increasingly supported by intelligent self-service, enabling 24/7 engagement without sacrificing consistency or control.
Insurers treating AI and automation as part of a broader operating-model evolution, rather than point solutions layered onto broken processes, are the ones seeing sustained benefits.
Systems modernisation and data integrity
Many insurers remain constrained by fragmented policy administration systems (PAS), inconsistent data models and brittle system integrations.
The impact of these is most visible during system migrations or when handling complex claims, where missing or misaligned data can lead to incorrect outcomes and regulatory exposure.
For example, if a beneficiary’s date of birth is captured incorrectly at policy inception (when ID numbers are not mandatory), and the beneficiary later changes their surname, benefit verification becomes difficult and the two-out-of-three matching rule may fail.
Similarly, if policy records are not migrated correctly, a claims processor may erroneously reject a valid claim as the benefits do not appear under the policyholder or beneficiary.
Modernisation efforts must therefore focus not only on replacing technology but on strengthening data lineage, controls and governance across the enterprise.
Accurate, trusted data is foundational to everything from new business creation, claims decisions and customer communication, to solvency reporting and risk management.
Insurers that invest in robust business architecture and integration capabilities are better positioned to adapt to regulatory change, launch new products quickly and scale digital experiences without compromising control.
User experience as a competitive differentiator
In the past, user experience was often treated as a distribution or front-end concern.
Today, it is an enterprise-wide responsibility.
For customers, experience is defined by clarity, responsiveness and empathy.
For employees, it is shaped by system usability, workflow efficiency and decision support.
Poor internal user experience directly translates into slower turnaround times, higher error rates and disengaged teams.
Leading insurers are therefore redesigning the journey from both perspectives: simplifying interactions, reducing hand-offs and embedding guidance into systems so that employees can focus on judgment rather than administration.
This is achieved through automation across the claims journey: dynamically generating document requirements based on claim type, appending them to the correct case, embedded data validations and quality assurance, automatically creating claim references, and routing claims to the appropriate teams and assessors using rules-based logic.
Information is extracted automatically from documents to prepopulate cases, while low-risk claims are administered via straight-through processing, reducing errors and reworks, and enabling faster settlement.
Partnering for sustainable advantage
As the insurance landscape evolves, insurers need partners who understand both the technical complexity of transformation and the human reality of insurance operations.
Monocle works with insurers to strengthen claims, underwriting and policy administration capabilities by aligning strategy, systems and execution.
Our teams bring deep expertise across business analysis, process optimisation, delivery management, vendor oversight and change enablement, helping organisations translate ambition into measurable outcomes.
In a market where trust, speed and experience increasingly define success, getting the foundations right has never mattered more.
