The Hidden Cost of Claims Portals

By Garry Nelson

Pet insurers talk a lot about claims efficiency, data quality, and underwriting discipline. But there’s an uncomfortable contradiction sitting right at the start of that process – it’s claims portals.

That friction isn’t just an efficiency problem for the clinics; it undermines the very data insurers rely on to make better, faster decisions. As claims are submitted through different, highly variable portals with their own fields, validation rules, and workflows, consistency inevitably suffers. Even small variations in how data is captured create noise at scale.

Multiply that across thousands of claims, and what looks like “acceptable variation” becomes a major operational drag, with exceptions, manual handling, and reduced confidence in downstream data.

From an insurer’s perspective, claims data is one of the most valuable assets in the business. It feeds pricing, risk management, fraud detection, and long-term portfolio strategy. Yet we often design the front end of that data flow in a way that almost ensures inconsistency and is optimised for claims processing rather than business needs.

Why does this persist? Legacy systems, control or because the friction is felt first by clinics, not insurers. I believe it’s all of the above.

But here’s the real question worth debating:‍

Is controlling how claims are submitted more important than improving the quality of the data itself?

Now imagine a different standard – one where claims are submitted directly from the clinic’s practice management system (PMS), validated during submission and only accepted to the insurer if all information is correct. A workflow built around how clinics and insurers actually operate, resulting in more accurate data for insurers.

When claims are captured inside the clinic’s PMS it creates that new standard, and everything downstream changes. Automated workflows scan and interpret information far more reliably. Treatment dates, diagnosis codes, and costs can be identified with confidence.

The shift also changes the economics of claims handling. Less manual intervention, faster processing and much fewer avoidable errors. And over time, a cleaner, more trustworthy dataset that supports trend analysis, underwriting decisions, and pricing strategy.

Of course, integration isn’t trivial, 30+ PMSs and 5,000+ clinics must meet the requirements. Insurers already invest heavily in downstream cleansing, but if the source data is flawed, even the best systems produce poor results. The question is where effort matters most.

If claims data truly is a strategic asset, then improving how it’s captured at the source deserves more attention than it currently gets. Reducing friction at the clinic level isn’t just a service improvement – it’s a data strategy – creating better inputs for better decisions.

So, do you want to keep relying on manually input data or start leveraging a true competitive advantage?