Rather than treating transformation as a technology-led initiative, Sedgwick has tied its efforts directly to business outcomes. The focus is on improving claimant experience while giving clients clearer visibility into trends that ultimately affect their financial and operational performance
Chief transformation officer at Sedgwick, Vishy Padmanabhan (pictured), has anchored the company’s digital agenda in a simple premise: claims administration must evolve alongside rising complexity in risk, severity, and volume. That shift is not theoretical. It is driven by changing claimant expectations, growing regulatory variation, and mounting pressure on clients to better understand cost drivers. “We want the claimant's experience to be great, and we want people back doing what they love to do,” Padmanabhan said.
At the core of this approach is a set of what he described as “uber metrics,” including claimant net promoter scores, total cost of risk, claims quality, and cycle times. These measures act as the organizing framework for transformation decisions, ensuring that new tools or processes are evaluated against tangible outcomes rather than novelty.
Sedgwick’s scale by handling millions of claims globally has become a central advantage in its transformation strategy. The company is investing in predictive models that assess the likely trajectory of a claim at intake, enabling more precise allocation of resources and expertise. “Because we have greater data scale than any other TPA, we believe we can predict the trajectory of a claim reasonably well,” Padmanabhan said.
This predictive capability is increasingly important as clients expect more than operational efficiency. Conversations are shifting toward insight and collaboration, particularly in areas where trends are difficult to interpret. “You should be able to predict the trajectory of a claim better than we can,” Padmanabhan said, reflecting a common client expectation.
The implications extend beyond individual claims. Clients are seeking guidance on systemic issues, such as rising litigation in specific jurisdictions or emerging risk patterns. Sedgwick’s role, therefore, is expanding from administrator to advisor, using aggregated data to identify patterns and recommend responses.
At the same time, the company has deployed generative AI tools to address long-standing inefficiencies in claims handling. Document summarization has reduced the need for adjusters to manually review lengthy medical files, while call summarization tools capture key details from claimant interactions in real time. “This saves me time; it helps me stay focused on the conversation,” Padmanabhan said, describing feedback from frontline adjusters.
These tools are designed not to replace adjusters but to enhance their effectiveness. Claims handling remains a people-centric function, particularly given the emotional and financial stress claimants often face. “It is still going to be managed by our experts, but it will be informed by our data scale and insights,” Padmanabhan said.
Sedgwick’s transformation has also required a broader and more dynamic approach to external partnerships. In addition to established technology vendors, the company is working with a growing number of early-stage AI firms, many of which are developing specialized capabilities in areas such as natural language processing and computer vision.
However, Padmanabhan emphasized that innovation alone is not sufficient. Providers must also demonstrate an ability to integrate with existing systems and operate reliably at scale. “We want to work with providers who are stable — with strong innovation leadership, sound business models, and excellent support models,” he said.
This reflects the operational realities of a global claims environment. Sedgwick operates across 80 countries, serving clients with diverse regulatory and operational requirements. As a result, vendor selection involves filtering a large field of potential partners down to those capable of meeting stringent standards for security, service quality, and scalability.
The pace of innovation in the Insurtech sector adds another layer of complexity. With thousands of startups competing for attention, distinguishing between viable long-term partners and experimental solutions requires disciplined evaluation. “As you apply these filters… the list narrows considerably,” Padmanabhan said.
Internally, Sedgwick has adopted a structured approach to implementing change, built around what Padmanabhan described as a “three-legged stool.” Each transformation initiative is led by a triad consisting of a transformation lead, a technology leader, and an operations leader. This model is designed to ensure alignment between strategy, systems, and day-to-day execution.
“We begin with the transformation vision… and how the workflow should change from today to tomorrow,” Padmanabhan said. Technology is introduced only after that future-state design is clearly defined, reducing the risk of misaligned or underutilized solutions.
Change management has been a critical component of this approach. New tools are piloted with small groups of adjusters, refined based on feedback, and then scaled gradually. In one example, a call summarization tool improved from over 90% accuracy to near perfect accuracy within a month following frontline input. “Once a hundred people adopt something, then a thousand. It spreads rapidly,” Padmanabhan said.
