Building the Ideal Modern Claims Professional

Tomorrow’s skills are increasingly necessary, but traditional qualities are as important as ever

September 07, 2023 Photo

What makes a successful claims professional in today’s world? The industry’s needs are certainly changing with regard to the role of the claims professional, and the job looks quite different today compared to years past. But the fundamental traits that make a good claims professional remain unchanged, even if the role has evolved.

There are common traits that companies have consistently looked for when hiring claims staff—elements that every claims professional must have. They were needed 20 years ago, and they are necessary today. This list includes a combination of soft skills like empathy, communication, compassion, flexibility, and an ability to work under pressure; and hard skills like subject matter expertise and technical proficiency.  

Not that long ago, this list would surely have also included a willingness to travel—perhaps staying onsite for months if the situation demanded. Today, technology has made it possible to meet via smartphone, complete inspections remotely, and conduct investigations and collect data to produce estimates all through automation. The need to travel and the requirements for claims professionals to be able to complete their job have become increasingly flexible—although there is still value with in-person interaction that is difficult to replace through technology. 

Technology’s Impact on Skill Demands

There is also a new demand for tech-savviness. Now that almost everything we do involves some form of technology, proficiency with this technology has become almost as important as the ability to communicate.

Digital natives come to this profession with a different set of strengths and weaknesses than the claims professionals of years past. While younger hires certainly possess more skills and comfort with technology than their predecessors, as this first generation of digital natives enters the workforce we’re seeing that the ability to communicate, and the comfort level with doing so both written and verbally, has really changed.

Today’s generation of new employees grew up communicating through social apps and texting, and, as a result, often present as being hesitant to engage in direct verbal communication. Social apps tend to remove the element of interpersonal skills, neutralizing the interpersonal sensory skills. It is as though the newer generation views a direct message to someone as acceptable for the same type of communication that used to be accomplished through face-to-face interaction. 

Recognizing these differences as an opportunity rather than a detriment is critical to supporting the next generation of claims professionals and learning how we leverage their way of transacting business. Learning from the digital-native generation will propel our industry forward toward innovative ways to deliver next-level customer experiences. Companies are deploying complete texting strategies along with customized mobile apps to improve the end-to-end claim cycle. 

Tomorrow’s Claims Professional

Looking ahead, the claims professional of the future is a data scientist, or a version thereof—someone who is comfortable and skilled with reading, interpreting, and executing on data. Claims departments of today are filled with claims professionals who have Juris Doctorates, and we will always need skilled claims professionals who understand insurance products and can navigate the litigation landscape. However, digital transformations are putting many carriers on a fast trajectory toward usage of artificial intelligence (AI) to deliver on efficiencies, predictive analytics, and speed-to-delivery mechanisms to create a superior customer experience and impact results. This changing landscape means our recruiting strategies need to change. In addition to pursuing the various risk management programs around the country, we should be exploring those schools with strong data science programs. 

Claim modeling as a concept has become more prevalent in the claims space, especially with the increased utilization of AI tools. No longer is it just a methodology for managing natural weather catastrophes. A variety of insurtech companies continue to introduce tools that use AI for predictive modeling around everything from adjuster behaviors, to severity triggers, to litigation outcomes, and quality assurance. Effective integration of these tools into the claim adjudication process will drive improved results in ways that are still being explored and understood. 

There are a lot of exciting trends happening in the predictive analytics space, and the industry will need claims professionals with the skill set to navigate and consume the outputs of these emerging technologies.

Ultimately, a good claims professional is, and always will be, one who embraces the role and enjoys its challenges and opportunities. Above all, in today’s hybrid environment, successful claims professionals absolutely need to be self-starters. They are not always going to be surrounded by people. As an employer or colleague, you need to trust and have confidence that you can provide autonomy, knowing that, even if a manager is not there, the job will still be done. Ironically, this ability to operate autonomously was probably equally important when travel was a primary function of the claims role and people were on the road by themselves for long periods of time.

 Claims has always been a great field for curious people, and it remains so to this day. As the direction of the industry continues to evolve, the day-to-day requirements of the role may change, but the kind of person that is successful in the role will ultimately not be all that different. The more things change, the more they stay the same. 


About The Authors
Shawn Crawley

Shawn Crawley is chief operating officer, North American insurance claims at Sompo International.

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