MALVERN, PA — The insurance industry’s leading research organization is pushing back against interpretations of claims data that equate claims closed without payment with claim denials, arguing that such figures can misrepresent insurer performance and consumer outcomes.
The Insurance Information Institute, known as Triple-I, issued the statement amid ongoing scrutiny of claims handling practices as insurers face increasing losses from natural disasters, inflation-driven repair costs and rising regulatory attention.
According to the organization, claims may be closed without payment for a range of reasons unrelated to claim denials, including losses that fall below policy deductibles, duplicate filings, uncovered losses or claims in which investigations determine no payment is owed under policy terms.
The distinction has become increasingly important as policymakers, regulators and consumer advocates examine claims data to assess insurer conduct and market performance.
Triple-I said economic conditions, catastrophe-related claim surges, fraud detection efforts and increased claims solicitation following severe weather events can all contribute to higher numbers of claims being opened and subsequently closed without payment.
The organization also argued that deductibles play a significant role in the trend, particularly as insurance costs have risen alongside inflation and catastrophe losses.
“Claims falling below a deductible are functioning as intended under the terms of the policy, not evidence a valid claim was improperly denied,” the group said.
The statement also cautioned against direct comparisons of claims data across insurers, noting that companies may use different reporting methodologies, policy structures and exposure calculations. In some cases, a single loss may generate multiple claims exposures, some of which result in payment while others do not.
Large-scale disasters can further complicate claims statistics, according to the organization. Following floods and other catastrophes, private insurers may open claims that are ultimately determined to be covered by another source, such as the National Flood Insurance Program. Those claims may still require administrative review before being closed without payment.
The industry group’s response comes as insurers face mounting pressure from increasingly severe weather events. Triple-I cited estimates showing U.S. natural catastrophes generated approximately $112.8 billion in losses during 2024.
The organization said insurers paid billions of dollars in claims during the year and noted that the industry maintains nearly $1 trillion in policyholder surplus to support claim obligations.
Property and casualty insurers are also expanding the use of technologies such as drones, artificial intelligence and electronic payment systems to accelerate claims processing and catastrophe response, according to the statement.
The Insurance Information Institute concluded that claims closed without payment should not be viewed as a standalone measure of claims fairness or insurer willingness to pay covered losses, arguing that broader policy terms, deductibles and claim-specific circumstances must be considered when evaluating claims data.
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