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Many insurance carriers have confusing multi-tiered claims processes that the average customer struggles to navigate and overlook the emotional journey the claimant is likely going through.
29% of customers changed insurers in 2025, and the time it takes to process and settle claims might have something to do with it. For many carriers, the claims experience is often the underlying driver behind customer churn. When you consider that improving retention by just 5% can raise profits by 25% to 95%, the value of optimizing the claims journey becomes clear.
More importantly, a better claims management process can help you deliver a compassionate and prompt response when customers are in need. Think about it — customers rarely file claims because of something positive happening in their lives. It’s more than likely they’re dealing with injury, accident, natural disaster, death of a loved one, or other challenges that mean they’re not at their best.
Why the claims management process is broken — and how to fix it
These multi-tiered claims processes are often burdened by back-office operations that remain tied to a legacy claims administration system. Changes to this environment can be costly, time-consuming, involve many IT teams and departments, and provide limited ability to adapt to changing market conditions. These are the main challenges we see across these complex and inefficient claims processes:
- Data fragmentation: Claims specialists struggle to manage multiple cases with information scattered across disparate system, with claims, participants, documents, and payments all living in silos.
- Manual workflows: Time-consuming manual processes create bottlenecks, increase error rates, and lead to delayed resolutions that frustrate both policyholders and adjusters.
- Limited self-service: The absence of automation and digital portals forces routine inquiries back into the call center, driving up costs and degrading policyholder experience due to low transparency and accessibility.
- Limited intelligence and automation: Rules-based workflows with minimal AI-driven triage, routing, or next-best-action continue to increase costs to serve.
So, how can you improve your claims process to increase customer satisfaction and retention while reducing operating costs?
A better claims management process starts with connected, trusted data
Delivering a seamless, efficient policyholder experience requires every insurance system to work from the same set of accurate, connected data. When underwriting, policy administration, and claims all operate on shared, consistent information, carriers reduce cost, eliminate complexity, and significantly minimize the risk of errors and rework.
Data 360 can act as the integration layer that unifies your ecosystem. It can bring together claims data with information from policy systems, customer interactions, and external sources — giving every team a single, reliable source of truth. When intake, underwriting, servicing, and claims all draw from the same data model, carriers gain meaningful advantages: lower operating costs, faster resolution times, improved accuracy, and higher policyholder satisfaction.
Creating a complete, 360-degree view of each policyholder can also drive significant operational efficiency. When life happens, having unified data can make it easier to capture information, assess loss, and manage claims. For example, by enabling policyholders to upload photos of damage immediately after an accident or break-in. This not only accelerates processing, it creates an opportunity to deliver support at a moment when your policyholder needs it most.
Replacing fragmented, manual processes with Salesforce
Salesforce’s Digital Insurance Platform now delivers full end-to-end Claims Management, supporting the complete lifecycle from First Notice of Loss through final payment. By improving your tech stack experience, you can reduce loss-adjustment expenses by more than 20%, and improve customer satisfaction by up to 30%.
Salesforce’s Claims Management replaces fragmented, manual processes with a streamlined digital approach — all with little-to-no code. Salesforce seamlessly integrates the customer’s claims journey into their broader relationship:
- Give your policyholders dynamic, user-friendly FNOL experiences with minimal typing required, guiding policyholders through loss reporting quickly and intuitively.
- Get real-time coverage verification with automated product- and peril‑specific questions to ensure accurate intake from the start.
- Allow policyholders to upload documents and photos from any device and easily search for repair shops and other third-party providers.
- Receive instant, rules-based auto-adjudication or monitor in-process claims and payment status through clear, real-time status updates.
- Set up fast, flexible payments, including checks or electric transfers, to one or multiple payees.
- Support policyholders through their emotional journey with empathetic, digital communication touchpoints throughout the claims process.
Using automation to add empathy while reducing costs
We often think of technology as a tool to facilitate transactions, data, or other emotionless activities. But what Salesforce can do for your insurance company is add a layer of empathy so agents can understand exactly what coverage looks like, how to help, and where customers can go next so they can take care of whatever life has thrown their way.
Automation may sound cold and technical, but it enables your team to act with more compassion. Oftentimes, insurance firms are supporting claimants through the emotional journey associated with situations requiring claims. Faster, friendlier follow-ups, next best action guidance for call center teams, and tailored responses based on the specifics of each claim help show policyholders they’re more than just a premium and policy number.
Automation like this can reduce the cost of a claims journey by as much as 30%, and Agentforce’s AI Agents take this automation to the next level by handling routine claims tasks, validations, and communications. Check out these agentic AI uses cases to see how you can accelerate each stage of the claims management process.
Agentic Use Case | Description |
|---|---|
FNOL Intake | Silverline Accelerator Agent that guides customer and human agents with intelligent prompts and automated data capture |
Servicing Assistance | Out-of-the-box FSC Agent that summarizes policy coverages, claims details, and recommended next actions |
Document Intelligence | Custom Agent that recognizes facts from photos and documents |
Intelligent Automation | Custom Agent that triages, segments, and routes complex cases |
Conversation Summary and Post-Call Wrap-Ups | Custom Agent that transcribes calls, generates escalations and wrap-up summaries, and initiates workflows |
Forecasting | Custom Agent that forecasts claims complexity, payouts, and creates reserves |
Claims Leakage | Custom Agent that recognizes patterns in settlements to avoid double payments |
Fraud and Subrogation Detection | Custom Agent that identifies suspicious patterns and missed opportunities to flag claims for review |
Knowledge Search | Custom Agent that surfaces answers grounded in your Knowledge base |
Proactive Communication | Custom Agent that sends personalized updates to stakeholders and tracks inquiries and complaints for sentiment analysis to prevent churn |
Ready to make your claims process easier for your team and more supportive for your policyholders? We can help. Salesforce can play a powerful role in improving your claims management process, and with deep insurance experience and proven Salesforce expertise, Mphasis Silverline is uniquely positioned to help you modernize and optimize your end–to–end claims operations. Reach out to learn more about how to improve your claims management process with Salesforce.
