Some risk management departments are less prepared to effectively manage casualty claims than others. Our team identified four of the most common obstacles that disrupt the casualty claims management process.

Issue: Lack of Specialized Claims Management Knowledge

Reason

Managing casualty claims, especially complex cases such as bodily injury, workers’ compensation, or large liability claims, requires specialized knowledge in medical management, legal procedures and negotiation tactics. Risk management teams often focus on broader risk assessment and mitigation strategies and may not have staff with deep claims experience.

Impact

Without specialized knowledge, the risk management department may struggle to evaluate claims, set reserves and negotiate settlements properly. This can result in increased claim costs, higher legal expenses and missed opportunities for early resolution.

Solution

Consider hiring dedicated claims management professionals or partnering with external specialists to provide targeted support.

Issue: Insufficient Data Analytics and Technology Infrastructure

Reason

Effective casualty claims management relies heavily on advanced data analytics, predictive modeling, and real-time reporting capabilities to identify trends, detect anomalies, and optimize settlement strategies. Many risk management departments still rely on manual processes or outdated software that lacks these capabilities.

Impact

Insufficient technology hampers the department’s ability to proactively manage claims, detect fraudulent activities and optimize reserving practices. This can lead to claim “leakage,” where costs escalate due to inefficiencies and misaligned strategies.

Solution

Invest in modern claims management systems, data analytics tools, and software solutions that provide enhanced tracking, reporting, and predictive analytics capabilities.

Issue: Fragmented Coordination with External Stakeholders

Reason

Casualty claims management often requires close coordination with third-party administrators (TPAs), legal counsel, insurers, and medical providers. Risk management departments may not have well-established communication channels or the capability to manage multiple stakeholders effectively.

Impact

Poor coordination can lead to miscommunication, delays in decision-making, and inconsistent claimshandling approaches, resulting in longer claim durations, increased costs, and reputational risks.

Solution

Establish clear communication protocols and collaborative platforms to facilitate better coordination among all stakeholders involved in the claims management process.

Issue: Resource Constraints and Competing Priorities

Reason

Risk management departments are often tasked with a wide array of responsibilities, including enterprise risk assessments, insurance procurement, safety programs and compliance. Managing casualty claims is just one component and often not a primary focus.

Impact

Limited time and resources dedicated to claims management can result in reactive rather than proactive claims handling, leading to prolonged claim closures, higher severity and increased litigation rates.

Solution

Allocate dedicated resources or create a specialized claims management unit within the risk management department to focus on complex claims and drive better outcomes.

Addressing these gaps requires a combination of specialized talent, advanced technology, better communication frameworks and dedicated resources to effectively manage casualty claims and achieve cost control and operational efficiency.

Property & Casualty Team