Claims Management

Solutions for the everyday

StoneWater helped our insurance customer co-ordinate 250+ monthly claims and reduced processing errors/service-level non-compliance by 25% by introducing workflow and tasking to create a queue of incoming home insurance claims. The company achieved increased accountability for claims management, an improved work experience for staff, and better visibility into statistics relating to the claims processing pipeline

Case Study: Claims Management


    Our customer is a provider of home, fire, car, and theft claims adjustments on behalf of a major insurance company. The workforce is primarily located in a central office with field staff conducting the claims reviews on-site. Standard claims forms and media were brought to head office staff who compiled and verified the final adjustment reports from initial claim through to charge backs to the insurance company. Claims workload was managed centrally through Microsoft Excel lists and shared folders on a network drive. As the business expanded, the operations were not addressed and the inefficiencies created had a multiplier effect on the business: as workload increased so did the administrative effort and the risk of human error compounded. The company realized these issues were both pervasive through their organization and an inhibitor to growth


    Having stand-alone electronic files reduced collaboration between claims adjusters, increased time spent administrating each claim as well as the error rate per claim. The lack of work integration, reminders, and automated forms production not only increased the per-claim cost but ultimately challenged company growth. Without an electronic case management and workflow solution, the company’s growth was restricted as the demand exceeded capacity


    Using a task-oriented case management system, you can expect greater visibility into the core workflow process of your claims management organization. This is accomplished through repeatable processes to achieve the mantra – “that which gets measured gets done”. While intangible to many, the improvement in work experience for staff can often be measured in the quality of work. In highly procedural organizations such as claims management, StoneWater continues to provide a best-in-class experience for your staff


    Without the need to spend $1,000’s of dollars on technical infrastructure, the company was able to configure StoneWater’s workflow and case management system to match their internal claims processing between their various groups (from intake, to quality control, to billing). The workflow process became repeatable and measurable steps removing ambiguity from the process. Work was integrated from origination (submission of a claim), through adjustment and finally, customer submission and chargeback. Through the case dashboard, all task timelines and claims statuses are tracked including who had responsibility of the process step and when the step was to be completed. Within the first month in the new operating model with StoneWater as the system of record, the company began to see improvement against the objectives of reduced human errors and reduced cost-per-claim. Ultimately, the company owner is realizing the transition towards company growth and away from managing the present challenges of daily administration


StoneWater's claims management capabilities were designed with the complex needs of today's claims in mind. Our incident-centric software enables you to track multiple claims through a single event, regardless of claim type. Quickly access complete claim histories to get snapshot views of your losses. Use StoneWater's full suite of workflow management and reporting tools to effortlessly handle files and identify high-risk areas

  • Registering notice of claim (by e-mail or online), which automatically opens the client file
  • Masses of paperwork, phone calls, letters, bills and deadlines organized online to reduce administrative time
  • Customizable "characteristics" allow capture of an unlimited set of data ranging from free-form entry to user-defined pick lists
  • Multiple claims per incident

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