Improving claims performance is rarely about changing everything at once. Often, the greatest opportunity lies in understanding exactly where claims are losing momentum, why decisions are being delayed and which interventions can have the biggest impact on everything that follows. With more operational data, technology and performance measures available than ever, Claims Directors need to distinguish between the metrics that simply report what has already happened and those that reveal where action can genuinely improve outcomes. From portfolio visibility and early handler allocation to supply chain performance, balanced KPIs and targeted operational change, Julien Nicklin, Head of Claims Consultancy at Gallagher Bassett, explores how claims leaders can identify the pressure points within their operations, address the underlying causes and make improvements that deliver better outcomes for customers, teams and the wider business.

If you were reviewing a claims operation looking for the greatest opportunity to improve outcomes, where would you look first and what would you be looking for?

I would start with total portfolio position: where every open claim currently sits on its route to settlement and how this measures against set KPIs and SLAs. Claims Directors need a live view of where claims are pausing now, before cost compounds through indemnity, rework or complaint handling.

Look for points of accumulation, extended ageing within a lifecycle stage, repeated hand-offs and deferred decisions. Those are indicators that momentum is being lost. The next question is whether the cause is capability, process or capacity.

Inflow analysis turns claims volume into a forecast of how external or internal factors could be leveraged to improve outcomes.

Where in the claims journey can changing one decision or intervention have a disproportionate effect on everything that follows, and what does better look like in practice?

The greatest milestone when an intervention can have a positive effect is usually when a claim is first assigned to a handler. When a claim is placed with a handler who has the right skills, authority and expertise to accurately assess and manage the claim, as well as keep the claim moving by connecting relevant specialists, this can have a very positive effect on the ultimate outcome.

That decision differs by class and portfolio: coverage, liability or entitlement; complexity and routing; first reserve; scope of damage; repair or treatment pathway; or the point at which specialist expertise is introduced.

Get those decisions right and the claim moves forward. Get them wrong and much of what follows becomes remedial: repeated contact, rework, cost drift, complaints or more expensive settlements.

One other area in the claims journey that I would highlight as particularly impactful is supply chain selection. The supply chain needs the same scrutiny as the handling operation. While delays and cost can be viewed as outside of the team’s control, the claimant’s overall experience is still reflective of your brand. Implementing regular supply chain reviews and testing performance under surge can go a long way in improving claim outcomes.

What is an example of an improvement that can look successful against one claims KPI but create an unintended consequence elsewhere, and how do you avoid it?

Productivity KPIs, when focused solely on number of resolutions, can have unintended consequences for complex claims. When volume drives the measure, effort follows what is achievable rather than what is valuable. Straightforward claims are worked because they progress and close, while complex claims may age quietly and deliver poor customer experience and brand impact.

This is why it’s important to read claim closure and duration numbers together. Better decisions, resources and supports for claims handlers should make productivity improve as a consequence, not become the target itself.

The same discipline applies to automation. Straight-through processing can improve speed and reduce handling cost, but the design question is how to preserve the human moment in which fraud indicators, recovery opportunities or customer vulnerability are recognised. The leakage at risk may be much larger than the handling cost saved.

The way to avoid unintended consequences is to run no measure without its counterweight. Speed should sit with duration, complaint and customer-outcome measures; closure volume with average settlement value by claim type; cost per claim with leakage, recovery or another financial-outcome measure; and productivity with quality audit results.

Claims leaders have more operational data than ever. Which measures are most useful for identifying where intervention will actually improve the outcome, rather than simply showing where performance has already changed?

Use measures that locate the issue before they report the outcome., such as portfolio position, ageing within position, reserve accuracy over term, or missed recoveries identified through audit. The precise measures will vary by class, but each should do one of three jobs: locate the issue, help diagnose the cause, or confirm the outcome.

Once you’ve determined your measures, what becomes more important is frequently monitoring and assessing performance against these. Frequent, focused checks will often reveal more than heavier reviews done less often, especially when recurring findings are treated as opportunities to improve the operation rather than isolated individual failures.

Findings should be treated as a symptom, driving you to find the root cause and then identify a solution.

If you were sitting with a Claims Director who wanted to materially improve one part of their operation over the next 90 days, what would you tell them to tackle, what would you change and how would you know it had worked?

I would tackle the single lifecycle stage where claims are accumulating most significantly and direct the effort towards the cause behind it. Find where the open portfolio is genuinely congested, then sample enough real files to identify a pattern rather than an anecdote. Examine ageing within the stage, repeated hand-offs, diary activity and deferred decisions. Determine whether the underlying cause is capability, process, capacity or a combination. Sampling converts assumption into evidence and provides the basis for everything that follows.

If the cause is capability, train for the specific decision under pressure. If the cause is process, change the process rather than training people to work around it. If it is capacity, decide whether the answer is people, technology or better routing, rather than making headcount the standard response.

You will know it has worked when congestion stays controlled through pressure, rework and reallocation fall, audit findings evolve rather than repeat, and fewer avoidable touches are needed to conclude a claim.

Julian Nicklin, Head of Claims Consulting, Gallagher Bassett