In the fast-evolving world of insurance and legal case management, staying ahead of inefficiencies and rising costs is more critical than ever. Today, we’re thrilled to sit down with Simon Glairy, a renowned expert in insurance and Insurtech, with deep expertise in risk management and AI-driven risk assessment. With years of experience helping organizations navigate complex claims processes, Simon offers invaluable insights into how smarter workflows and cutting-edge tools are transforming the industry. In this interview, we’ll explore the challenges of outdated claims handling, the power of early insights, the shift to proactive strategies, and the role of technology in shaping the future of claims management.
How do inefficient handling processes create roadblocks for claims teams in today’s environment?
Inefficient processes are a major hurdle for claims teams, primarily because many still rely on manual or disconnected systems. This slows down every step, from retrieving records to analyzing data, often delaying resolutions by weeks or even months. Beyond speed, the bigger issue is the risk of incomplete information. When adjusters and attorneys don’t have a full picture early on, they’re making decisions in the dark, which can lead to missteps in strategy, higher costs, or even unfavorable settlements. I’ve seen cases where missing a single piece of medical history led to prolonged litigation, simply because it wasn’t flagged early enough.
What are the consequences of not having a complete view of case history from the outset?
Not having a full view of case history upfront is like playing a game of chess without seeing half the board. Adjusters and attorneys might miss critical details—like prior injuries or undisclosed treatments—that can completely change the direction of a case. This often results in wasted resources, as teams scramble to adjust strategies mid-process. Worse, it can expose them to risks like nuclear verdicts or inflated settlements. The financial and reputational damage from these oversights can be staggering, especially in high-stakes litigation.
How have rising litigation costs and client expectations reshaped the need for better claims management?
Litigation costs have skyrocketed in recent years, driven by longer discovery periods and more aggressive legal strategies. This puts immense pressure on claims teams to resolve cases faster and more accurately. At the same time, clients aren’t just asking for results—they expect precision, transparency, and speed from day one. A few years ago, responsiveness was enough; now, it’s about delivering actionable insights before issues escalate. Meeting these demands often requires rethinking outdated processes and partnering with companies that can provide comprehensive data and tools to stay ahead of risks.
Why do early insights into a case have such a significant impact on outcomes?
Early insights are game-changers because they allow teams to build a strategy based on facts rather than assumptions. Small details—like a pre-existing condition, gaps in treatment history, or even social media posts showing activity that contradicts a claim—can shift the entire trajectory of a case. When you catch these early, you can adjust reserves, plan settlements, or prepare for negotiations with confidence. Waiting until mid-discovery to uncover these signals often means higher costs and weaker positioning, whereas early clarity empowers better decision-making from the start.
What does proactive case management mean to you, and how does it differ from traditional approaches?
Proactive case management is about anticipating risks and acting before they become problems, rather than reacting step-by-step as issues arise—the way traditional methods often work. It means having full visibility across the claims lifecycle from the very beginning, so you’re not just responding to data as it trickles in. This approach lets teams spot red flags, like inconsistent medical records, and address them upfront. The difference is night and day: proactive management builds a stronger foundation for negotiations and settlements, while traditional methods often leave teams playing catch-up.
How are new tools and solutions transforming the way claims are handled?
Technology is revolutionizing claims management by closing data gaps and speeding up processes that used to take weeks. For example, services like Medical Canvass help uncover hidden information—think undisclosed ER visits or prior treatments—that can drastically alter case valuations. I recall a case where a carrier set a high reserve for an injury claim, only to discover through canvassing that the claimant had a history of similar issues. This allowed them to settle for far less, saving significant costs. Tools like DICOM Viewer also streamline medical reviews by making it easier to access and analyze radiology images, reducing disputes and accelerating decisions.
What role does full-lifecycle visibility play in strengthening a team’s strategy during claims handling?
Full-lifecycle visibility is like having a roadmap for the entire claims journey. It means every piece of data—from initial records to final negotiations—is connected and accessible. This allows teams to identify risks early, allocate resources efficiently, and make informed decisions at every stage. Without it, you’re piecing together a puzzle with missing parts, which can lead to costly delays or misjudgments. With it, you’re not just managing a claim; you’re strategically steering it toward the best possible outcome.
What is your forecast for the future of claims management, especially with the integration of technology?
I believe we’re heading toward a new era of interoperability and scale in claims management. Technology, especially AI and data analytics, will play a central role in creating seamless, connected systems that deliver insights faster and more securely. We’ll see more automation in routine tasks like record retrieval, freeing up teams to focus on strategy. The future will also prioritize early intelligence—tools that predict risks before they escalate will become standard. For organizations that embrace these advancements, the ability to adapt and lead in an increasingly complex industry will be a defining advantage.
