Claims Navigator
Claims reimagined
We understand the importance of a seamless claims process. Broker partners, clients, and customers rely on us to ensure hassle-free, efficient claim resolutions without the frustration of confusing procedures and payment delays.
My son suffered a serious head injury a few months ago…Wellfleet really helped me and my husband cover his medical expenses. The entire process was simple and fast. I will forever sing Wellfleet’s praises!
Experience the difference
Simplified process & maxmized benefits
When certain claims are submitted, we will automatically pay benefits for commonly associated treatments. Leveraging predictive analytics, we proactively pay benefits for expected events, such as providing x-ray and appliance benefits for a broken leg.
Members submit one claim, and we handle claims for all other enrolled products, assuring coverage across all benefits with a single submission.
Wellfleet works with our client’s medical payor to identify medical procedures and services that may be eligible for benefits under their Wellfleet supplemental health coverage. Employer groups with 500 or more employees may choose to give members the option to receive alerts of potential claims. This process helps to ensure they get the most value out of their policy. Eligible groups have:
- Self-insured medical, Active enrollments (accept/waive)
- Minimum of two Wellfleet Workplace products (Accident, Critical Illness, Hospital Indemnity, Short Term Disability)
- Eligible supplemental medical products: Hospital Indemnity, Critical Illness, and Accident
Say goodbye to paperwork! Submitting health screening/wellness claims is now easier than ever, requiring no medical documentation, providing a faster and easier experience.
Best-in-class technology for enhanced service
Our cutting-edge technology is enabled by application programming interfaces (APIs) to offer more personalization and faster benefits administration.
- Members can view the products they are enrolled in.
- When filing a claim, only benefits available on the member’s plan will show, reducing submission error and processing claims faster.
- Forms available on the portal are personalized by the products enrolled, so only relevant forms will appear.
- Members can start a claim, save it, and finish it later. Members can conveniently track submitted claims without the need for a claim number.
- Members have the option for direct deposit, which can simply the claims payment process.
Enrollment data is loaded faster, without the need for a custom file, so members can view coverage and submit claims immediately following the effective date. Wellfleet’s single system means if your client calls us on day one of coverage, we will have access to their information and provide them with personalized service.
Faster turnaround
Members only need to provide information once per claim, ensuring a smoother and more efficient process for everyone involved.
We’re proud to deliver:
- One day average turnaround time1
- 3% denial rate1
1 Wellfleet Workplace, 2023. Unpublished internal company document.
At Wellfleet Workplace, we’re committed to elevating the claims experience, empowering brokers to offer clients a superior service that exceeds expectations. Experience Claims Navigator today, and witness the transformation in claims management that your clients deserve.
With Claims Navigator, we’re reimagining the claims experience for our partners, clients, and customers.
1500 Main Street, Suite 1000, Springfield, MA 01115-5369
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Wellfleet is the marketing name used to refer to the insurance and administrative operations of Wellfleet Insurance Company, Wellfleet New York Insurance Company, and Wellfleet Group, LLC. All insurance products are administered or managed by Wellfleet Group, LLC. Product availability is based upon business and/or regulatory approval and may differ among companies.