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Ruben is Executive Director of Large Loss at Allstate based in the DFW area. He’s led both Claims and Design/Process teams simplifying processes, and implementing technology while building strategies that mitigate risk. Ruben bridges Claims, Litigation, Underwriting, and Finance teams removing silos with a focus on profitable growth. Ruben has an extensive background in Personal, Commercial and Excess lines. Before Allstate, Ruben held various claims leadership roles at State Farm Insurance. Ruben obtained a Master of International Business from Florida International University and holds a CPCU, CLU, CHFC, AINS and AIC designations. Ruben is fluent in Portuguese and Spanish.
At present, the insurance industry faces what many describe as a crisis. Today’s challenges are formidable, including wildfires in California, hurricanes in Florida, social inflation, litigation financing, and increasingly higher jury verdicts. Yet, the history of insurance is defined by its resilience and adaptability. One notable trend is the alarming rise in the frequency and severity of nuclear and thermonuclear verdicts, driven in part by medical cost inflation, social inflation, and litigation financing. From 2013 to 2022, the median nuclear verdict reached $21 million, with product liability cases peaking at a staggering $36 million in 2022, according to the Institute for Legal Reform (ILR). In addition, California, Georgia, Florida, Illinois, New York, and Texas accounted for approximately 61 percent of nuclear verdicts nationwide, per ILR. A New Approach to Claims Handling To address these challenges, insurers must continuously rethink their approach to claims management. A more pragmatic strategy combines advanced technology with a human touch to streamline processes and improve outcomes. Key to this approach is the early identification and segmentation of claims based on their complexity. A precise definition of complexity, a clear path, and timeline guidelines are essential to effective, proactive resolution. Defining Complexity Complex claims may include: • Significant injuries (e.g., fatality, traumatic brain injury, spinal injuries, dismemberment, or loss of vision). • Financial exposure exceeding thresholds such as $100,000. • Exposure exceeding policy limits. Optimizing Claims Systems Every claim begins with an assessment of coverage, liability, and damages. However, optimizing this process requires addressing inefficiencies and removing redundancies. Leaders play a crucial role in eliminating obstacles, enabling claims adjusters to focus on customer interactions and expediting resolutions. As James Clear aptly noted, “Goals don’t determine success— systems do. You don’t rise to the level of your goals, you fall to the level of your systems.” By fixing ineffective systems, and allowing adjusters to focus on investigation, evaluation and negotiation, carriers can achieve better outcomes. Leveraging Technology without Losing the Human Touch Advancements in AI and other technologies have revolutionized claims handling, enhancing efficiency and oversight. However, the core strength of the insurance industry remains its people. Adjusters and first-line leaders are invaluable assets. To truly empower them, insurers must: • Equip them with intuitive, user-friendly tools that streamline processes and foster productivity. • Remove barriers such as cumbersome platforms and ambiguous performance expectations that hinder effective customer engagement. The key lies in balancing technology with empathy— leveraging innovation not to replace the human touch but to amplify it. By doing so, insurers can ensure customers feel supported and understood, even during challenging times. Looking Ahead As technology evolves, the insurance industry must balance efficiency with enhancing customer interactions, and providing support during the entire claims process. Smarter, faster, and better claims system/processes— driven by innovation and human insights—will empower insurers to navigate the current landscape and continue delivering on their promise to policyholders.