Claims Tech Evaluation

Claims technology evaluations have a systematic bias toward features, and that bias produces bad decisions.

When an evaluation team lists requirements, they tend to list what the current system does not do — the features they wish they had. Vendors respond with demonstrations of those features, which look compelling in controlled settings. The system that wins often wins because it has the most features on the checklist, not because it will actually improve claims outcomes.

The better evaluation process starts earlier: what outcomes are we trying to achieve, and how will we know we have achieved them? Faster cycle times. Lower reopened claim rates. Reduced litigation frequency. Better reserve accuracy. These are outcomes. When you know the outcomes, you can design an evaluation that tests whether a system will actually produce them — through reference checks with similar carriers, pilot data, and realistic scenario testing.

This outcome-first approach also produces better implementations, because the team has a clear success definition from the start and can design configuration, training, and workflow design to serve that definition rather than just replicating the current process in a new system.