Insurance claims management is a precision business. Every open claim represents a financial obligation, a claimant with a legitimate need, and an opportunity to either build or destroy a policyholder's trust in their carrier or self-insured employer. Third-party administrators (TPAs) and claims management companies are under constant pressure to close claims faster, spend less on loss adjustment expenses, and deliver better outcomes—simultaneously. Virtual assistants are becoming a meaningful part of the solution.
The LAE Problem Driving Operational Change
Loss adjustment expense (LAE) is one of the most scrutinized cost categories in insurance. Gallagher Bassett's 2024 Claims Insights Report noted that LAE as a percentage of incurred losses has risen steadily over the past decade as claim complexity has increased, litigation has grown, and regulatory requirements have expanded. For workers' compensation TPAs and liability claims managers, controlling LAE without sacrificing claim quality is a central operational challenge.
At the same time, the claims workforce is under demographic pressure. The Insurance Information Institute estimates that nearly half of the current claims workforce will be eligible for retirement by 2030, and recruiting experienced adjusters into the field is increasingly competitive. Claims departments need to find ways to extend the capacity of experienced adjusters rather than simply hiring more of them.
Virtual assistants address both problems simultaneously—reducing the administrative cost per claim while freeing skilled adjusters to spend more time on investigation, evaluation, and resolution.
Virtual Assistant Applications Across the Claim Lifecycle
The claims workflow contains distinct segments that range from highly specialized judgment calls to routine administrative tasks. VAs take ownership of the administrative segments:
First notice of loss (FNOL) intake. When a loss is reported, the first step is collecting basic facts: date of loss, location, parties involved, description of incident, and contact information. For many standard claims, this intake can be handled by a trained VA following a structured script. VAs log the information in the claims management system, assign a claim number, and route to the appropriate adjuster—ensuring nothing is missed in the initial record.
Medical record and document retrieval. Workers' comp and bodily injury claims require collection of medical records, bills, employment records, and other supporting documentation. VAs send records requests to providers and employers, track outstanding requests, follow up on delays, and upload received documents to the claim file. This process is time-consuming and routine—ideal for VA delegation.
Status updates to claimants and insureds. Claimants want regular updates on their claims. VAs handle templated status communications at defined intervals—acknowledging receipt, confirming adjuster assignment, providing expected next steps—so adjusters aren't interrupted by routine inquiry calls.
Reserve and diary management support. VAs review upcoming claim diaries to ensure that required actions—medical record requests, independent medical examinations, recorded statement scheduling—are tracked and adjusters are reminded before deadlines pass.
Data entry and system maintenance. Claims management systems require consistent data entry to produce accurate reporting. VAs handle routine data updates, close out completed diary actions, and maintain claim notes so that file documentation meets audit standards.
The Productivity and Cost Case
According to the Bureau of Labor Statistics, claims adjusters and examiners in the United States earn median annual salaries of approximately $68,130. When adjusters spend 30–40% of their time on administrative tasks—document retrieval, data entry, routine communications—they're providing that work at an average cost of $20,000–$27,000 per year in labor that a VA could perform at substantially lower cost.
For a TPA with 50 adjusters, redirecting two hours of administrative work per adjuster per day to VA support recovers the equivalent of 15–20 full adjuster-days of capacity per week. At an average claim cycle time of 45–60 days, even modest improvements in adjuster productivity translate directly into faster closures and lower LAE ratios.
Claims management organizations looking to build VA-supported adjuster teams can find experienced remote professionals through providers like Stealth Agents, which places vetted candidates in insurance and business operations roles.
Claims Excellence Requires Both Judgment and Efficiency
The best claims outcomes—fair resolution, satisfied claimants, defensible files—require skilled adjusters making good decisions. But good decisions require time: time to review records, interview witnesses, consult with counsel, and evaluate liability and damages.
Virtual assistants create that time by handling the documentation, communication, and data management work that surrounds every claim. The investment in VA support is, at its core, an investment in claim quality—and the claims organizations that understand that connection are the ones building sustainable competitive advantage.
Sources
- Gallagher Bassett, Claims Insights Report, 2024
- Insurance Information Institute (III), Claims Workforce Demographics Study, 2023
- U.S. Bureau of Labor Statistics, Occupational Employment and Wage Statistics: Claims Adjusters, 2024