Improving Data Quality and Availability in Claims
The Untapped Potential of Claims Data
Every claim tells a story—but too often, that story is incomplete. For insurers, the promise of data-driven decision-making is huge: better reserving, faster reporting, and smarter use of resources. Yet when systems are outdated or fields go unused, the data behind those decisions becomes fractured. Instead of clarity, insurers face roadblocks that keep them from realizing the full potential of their data.
This blog explores the biggest barriers to data quality and availability—and how carriers can overcome them.
Legacy Systems Create Blockages
Insurers tend to struggle with data quality and data availability. Legacy or homegrown claim systems make data gathering difficult and inconsistent. Typically, these systems were designed for basic data capture and did not consider the reporting needs required in today’s claim handling.
Many also rely on numerous outside systems (policy systems, homegrown add-ons, etc.), which creates data blockages and makes it harder to centralize information for valuable reporting or analytics.
Unstructured Notes Undermine Reporting
Another major obstacle is the over-reliance on claim notes. Because notes are unstructured, they create several challenges:
- Information may conflict throughout the life of a claim.
- Downstream reporting systems usually can’t ingest unstructured text.
- Structured fields—designed in newer systems for analytics and reporting—are left blank or updated inconsistently.
The problem isn’t with structured fields themselves—they’re built to support analytics and reporting. The issue is that they often go unused or inconsistently updated because adjusters default to claim notes. When that happens, data availability shrinks and downstream reporting and analytics suffer.
When Structured Fields Go Unused
Building on the challenge of unstructured notes, let’s look at a real-world pain point. The attorney representation or litigation fields in a claim system are often left unchecked once an attorney is retained or litigation begins. Instead, adjusters capture those details only in claim notes. Many insurers have moved away from requiring adjusters to update structured fields for the sake of efficiency. While this may feel faster in the moment, it creates downstream problems, leaving leadership without the accurate, centralized data needed for informed decisions.
From my experience as a consultant, insurers often struggle with gaps in readily available information or in sending it downstream, whether within their own systems or to external ones. This uncertainty makes them reluctant to adopt new technology, fearing inadequate reporting outcomes. Many worry they can’t provide the level of data required to achieve ROI. In some integrations, additional work is required to understand how updates would affect existing systems and downstream reporting.
Closing the Gap With CLARA
While data is critical, CLARA focuses on capturing not just more data, but the right data. That’s why we pair software and data experts with experienced claim professionals. Together, these teams deliver:
- Augmented claim handling insights for adjusters.
- Comprehensive reporting and analytics for claim leaders.
- Deeper intelligence from both structured fields and unstructured sources like claim notes.
By blending human expertise with advanced AI, CLARA helps carriers turn fragmented information into reliable insights—supporting smarter decisions and stronger outcomes across the claims process.
