Claims operations in L&H: Strategic investment in claims operations as a driver of long-term value creation

As claims costs begin to outpace premium growth in most markets, the Life & Health insurance industry is facing a decisive shift. Rising claims ratios, driven by higher healthcare utilization, increased diagnosis rates, and shifting morbidity / mortality trends, are challenging the sector’s historic new business focus and underscoring the strategic value of claims management. This article explores how digital infrastructure and advanced analytics, in collaboration with human-centered design, are transforming claims from a transactional function into a catalyst for trust, efficiency, and long-term value creation.

Digitally fluent insurance consumers, emerging technologies like generative AI, and under-utilized claims data, are reshaping industry priorities. Strategic investment in claims is no longer about if, but when. Automation and decision intelligence shorten claim durations, reduce leakage, and optimize manual effort; personalized digital interactions improve customer satisfaction and retention; and claims data strengthens underwriting, pricing accuracy, and fraud detection, thus contributing to improved profitability.

The benefits go beyond efficiency, from stronger long-term performance and greater regulatory agility to improved talent retention. Claims transformation also builds brand trust and transparency, turning moments of uncertainty into opportunities for clarity and support.

The claims function is now a lever for sustainable growth and competitive advantage. And the question is no longer whether to invest in claims, but what the cost will be for those who don’t. 

At SCOR, we are partnering with insurers worldwide to turn this opportunity into reality through modular, AI-enabled solutions that deliver measurable impacts.