Claims Integration and Automation Practices of Voluntary Carriers Spotlight™ Report
Cost: $3,500; published 2026
Voluntary claims practices continue to evolve as customers — brokers, employers and employees — place more value on the benefits provided by voluntary products.
These key stakeholders expect the claims process to be easy, especially for employees who own multiple voluntary products through the same carrier. This report updates our previous report on claims integration and automation practices for voluntary products and includes key information on:
- Use of artificial intelligence and/or machine learning in claims processing
- Claim payment timeframes by product
- Claims practices
- Impacts of integration
- Claims utilization reporting
- Concerns, obstacles and future trends
View Table of Contents
1. Executive Summary
A. Report Objectives
B. Methodology
C. Key Findings
2. Findings by Carrier
A. Claims Automation
1. Artificial Intelligence/Machine Learning Practices
2. Source of AI/ML Solution of System
3. Auto-Adjudication Activity and Percentage of Auto-Adjudicated Claims
4. Percent of Claims Auto-Adjudicated by Product
B. Claim Payment Timeframes by Product
1. Average Actual Claim Payment Times for Life Products
2. Average Actual Claim Payment Times for Disability Products
3. Average Actual Claim Payment Times for Accident, Cancer and Critical Illness
4. Average Actual Claim Payment Times for Hospital Indemnity and Wellness Riders
5. Average Actual Claim Payment Times for Dental and Vision Products
C. Claims Processes and Services
1. Intuitive Claims Payments
2. Prepayment of Disability Claims
3. Claims Investigation During Pre-Existing Exclusion Period
4. Wellness Claim Processing
5. Employer Verification of Claims
6. Self-Bill Eligibility Requirements
D. Claims Integration Practices
1. Carriers Offering Claims Integration
2. Types of Claims Integration with Medical Data
3. Accessing Medical Claims Data
4. Opt-In Requirement and Process for Medical Claims Integration
5. Types of Claims Integration with Life and Disability Data
6. Percentages of Claims Paid by Process for Life/Disability
7. Types of Claims Integration with Voluntary Supplemental Health Products
8. Percentages of Claims Paid by Process for Supplemental Health Integration
E. Claims Integration Communication and Costs
1. Methods Used to Notify Claimant
2. Claims Integration Charge
3. Use of Technology Platform, Outside System or Databases for Claims Integration
F. Claims Integration Impacts and Results
1. Volume of Integrated Claims
2. Loss Ration Impact Due to Claims Integration
3. Percentage of 2025 New Voluntary Cases and Sales with Claims Integration
4. Uptake Percentages
5. Obstacles to Employer Implementation
6. Actions to Overcome Obstacles
7. Requirements from Brokers/Employers for Claims Integration
G. Claims Tracking/Incidence Rates
H. Claims Utilization Reporting Capabilities
1. Reporting Provided
2. Claims Reporting by Product
3. Frequency of Providing Claims Utilization Reports
4. Information Typically Included
I. Claims Concerns/Obstacles/Future Trends
1. Key Concerns or Obstacles for Claims Integration and Automation and Utilization Reporting
2. Future Claims Concerns/Obstacles/Trends