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Improving Business Results Through Claims Integration

Author

Kimberly A. Landry
Associate Research Director, Workplace Benefits Research
LIMRA and LOMA
klandry@limra.com

May 2026

Supplemental health benefits provide tremendous value to employees by providing additional financial support after an accident, illness or other serious health event. Unfortunately, consumers tend to have a poor understanding of these products and, as a result, sometimes don’t realize when they have eligible claims to file.

To address this issue, many carriers are now offering claims integration services, in which companies monitor incoming workplace benefit claims to proactively identify relevant claims on other product lines. For example, an employee might go out on disability leave due to an accident that lands them in the hospital. Based on the disability claim, a company could identify that this person also has accident and hospital indemnity insurance and take steps to make sure the customer receives all their eligible benefits.

As carriers make strides in this area, they must overcome a number of challenges, such as securing permission to share the claims data, maintaining privacy and data security controls, developing ways to confidently map claims across product lines, and delivering an experience that is efficient and easy for the customer.

Meeting Customer Needs

Integration can improve the customer experience by making the claims process less onerous for insureds during a difficult time. Employees respond well to the concept when it is explained to them — roughly one-third believe carriers should automatically do this, while almost half are open to the idea but think companies should ask their permission before sharing the claims data (Figure 1).

Figure 1. How Do Employees Feel About Claims Integration?

Based on employees enrolled in insurance benefits through their workplace.

Source: LIMRA consumer data (unpublished), January 2026.

However, there is still uneasiness around this topic, with some employees uncomfortable with the idea of carriers sharing their claims information and a small number strongly opposed. To address these concerns, companies should communicate clearly about this service, making sure to explain privacy safeguards and how the data will and will not be used. Employers, too, express strong interest in having claims integration offered to their groups. In a recent survey, over 90% of employers without access to claims integration services said they wanted to have this available.

One Goal, Many Strategies

The industry has made significant advances toward claims integration in recent years, with more than 85% of workplace benefit carriers now offering some type of integration and most others planning to develop this capability in the near future. However, there is enormous variation in how carriers are choosing to approach this and how much they can do, making it difficult to compare offerings across the competitive landscape.

First, no one can agree on what to call this service. While “claims integration” is the most common term, a recent informal poll of LIMRA members revealed over 15 different phrases being used within the industry, including “cross product review,” “connected benefits,” “single claim intake,” and “intuitive claims processing.”

Companies also vary regarding which products they can integrate. Most carriers are making connections between some of their own nonmedical products, with the most common integrations occurring between the various supplemental health lines or linking disability to supplemental health. Integrations that target wellness or health screening benefits are also widespread.

In addition, just over half of carriers now offer medical claims integration, in which claims from major medical plans are leveraged to identify relevant claims on other products. This service presents a greater challenge to workplace benefit carriers, most of whom do not sell health insurance, meaning they need to obtain the medical claims data from other sources, such as third-party vendors, medical third-party administrators (TPAs) or other carriers.

Insurers also differ in which types of integration they offer. Approaches fall into three main categories, although again, the names for these vary from company to company. An auto-notify approach means the customer is informed that they might have a relevant claim on another product line, but the customer must file the claim on their own. In contrast, an auto-initiate method means the carrier starts the claim on behalf of the insured, but the customer must take some kind of action to move the claim forward, such as confirming or providing documentation. Finally, an auto-pay strategy allows the carrier to proactively create, process and pay the claim without the customer needing to do anything.

Most carriers have the ability to use more than one of these approaches, depending on the circumstances and the products involved. More than 6 in 10 carriers utilize an auto-notify strategy at least some of the time, while more than 8 in 10 offer some type of auto-initiation or auto-payment.

Carriers are most likely to auto-pay claims involving wellness benefits, which are fairly easy to adjudicate and involve low dollar amounts (Figure 2). Auto-initiation is common for integrations between carriers’ own nonmedical products, such as disability, absence management, and supplemental health. In contrast, integrations between major medical claims and supplemental health frequently use an auto-notify approach, which minimizes the risk of moving forward with claims that are not valid.

Figure 2. Most Frequent Approaches to Claims Integration

Data represents the number of carriers using each approach. Companies identified their one most frequent type of claims integration for each scenario. Based on companies that offer each specified product integration; number of respondents varies by row.

Source: Claims Integration in Workplace Benefits, LIMRA, 2026.


Moving the Needle

Although many carriers are still early in their claims integration journeys, they already report that the practice is having a meaningful impact on a variety of business metrics. Carriers say medical claims integration is enhancing their in-force persistency, success at winning new business, employee satisfaction, and volume of claims paid — among other factors. Integration between nonmedical benefits is also yielding positive results, particularly with regard to employee satisfaction and claims volumes. When comparing approaches, companies see the strongest impact across a variety of metrics when they use medical claims integration with auto-payment.

Of carriers that have seen an uptick in claims volume from claims integration, most are seeing a lift of at least 8 to 10 percent, depending on the approach and products involved. The most notable increases occur when companies employ medical claims integration with auto-initiation or auto-payment. Wellness claims are an outlier — carriers report an average 29% uptick in wellness claims when medical integration with auto-payment is offered.

As carriers enhance their capabilities, these results are likely to evolve. However, it is already clear that claims integration is delivering positive outcomes for both customers and insurers. By continuing to simplify the claims process and enable connections between products, carriers can ensure that employees receive the full value from their workplace benefits packages and get the support they need to recover when it matters most.


About the Research
In September and October 2025, LIMRA surveyed 37 workplace benefits carriers about their practices related to claims integration. Read the full report here.

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