Speed first contact and assignment
When it may fit: Claims wait at the start.
Evidence needed: Intake and assignment times.
Trade-off: Needs staffing or automation.
Insurance Intelligence Brief
How to Investigate Claims Processing Delays
A slow claim costs more than time. It can raise severity, frustrate customers and increase the chance of dispute. Finding where claims wait is the first step.
1. The business problem
Why do some claims take so long, and what does it cost us?
Claims processing delays have many sources: slow first contact, backlog at assignment, waiting for information, repair estimates, approvals and payments. Each calls for a different fix.
Delays also have a financial cost, because a longer claim often costs more to settle, and a customer who waits is more likely to complain or leave.
2. What the evidence can reveal
A delay investigation looks at where time goes:
- Calculated Time at each stage: intake, assignment, investigation, evaluation and payment.
- Calculated Claims open past a target age, and the reasons.
- Calculated Workload: claims per adjuster, and how it varies.
- Information gap Customer experience: complaints, reopened claims and satisfaction.
The longest stage is not always the one with the most avoidable delay. Waiting time, not work time, is usually where the opportunity lies.
3. Investigate the problem
The synthetic insurer has no workflow data, so we use its figures to size the stakes. Calculated Claims incurred were $56.4M, and at an average severity of $12,818 that implies roughly 4,400 claims for the year, up from about 3,900. Claims adjustment expense was $5.90M, about $1,340 a claim, almost unchanged from about $1,330 the year before.
Calculated Claims adjustment expense grew 13.5%, close to the growth in claim counts, so handling cost per claim has been steady. If processing is slow, the problem is not showing up as higher handling cost. Hypothesis Delays would show up elsewhere: in severity, which rose 6.8%, in customer complaints and in retention. Information gap The demo cannot say whether delays contributed to the severity increase.
Illustrative An invented illustration of the cost of delay: if 10% of claims took 15 days longer than needed, and each extra week added 1% to the cost of those claims through storage, rental and litigation risk, the added cost would be about 2% of those claims. On about 440 claims at $12,818, that is roughly $113,000. The figures are invented, but the calculation shows the kind of evidence to gather. A report of claims by age, with reasons, is the first step.
4. Explore the interactive experience
Investigate it yourself.
Insurance Portfolio Explorer: a portfolio dashboard with loss, expense and combined ratios, a scenario simulator for rate, volume, frequency and severity, evidence-linked answers from APIS, and a sample brief, all on synthetic data.
The experience below is built on a synthetic insurer, “Demo Mutual Insurance.” It uses no policyholder or claims-handling data of any kind, and it has no cycle-time or workflow records, so it is used to show the financial side of claims. Every figure is illustrative.
- In the cost table, select Claims adjustment and compare its growth with claims incurred.
- Select Claims incurred. Which grew faster?
- Ask APIS what additional information would help validate these conclusions.
5. Evaluate possible solutions
Delays are fixed where they arise.
6. What leadership should do next
Questions to answer
- Where do claims wait?
- How many are past target age, and why?
- What does delay cost?
- Which adjusters are overloaded?
Data to gather
- Stage timestamps
- Pending reasons
- Caseload by adjuster
- Complaints
Steps to take
- Report claims by age and stage.
- Rank causes.
- Fix the largest.
- Track monthly.
7. Engage Two Pillars
Investigate Performance Across Your Insurance Business
Two Pillars can help carriers, agencies and brokerages investigate portfolio, claims operations, agency economics and process improvement using your own data. This demo uses no policyholder data. A good first step is a claims aging and stage-time analysis that finds where claims wait.
Sources and data notes
- The organization, its figures, and every number in this article and its interactive experience are synthetic and illustrative. They are not real data, a benchmark, or a forecast.
- Reviewed October 2026. This article describes an approach to investigation. It does not replace review by qualified professionals.