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Claim Management

Expert.ai Team - 12 September 2017

Companies in many industries have started using cognitive automation to improve the automation of their business processes and the insurance industry is no exception. Like other industries, insurers have faced a number of changes and the so called “digital transformation” has given them the opportunity to innovate and improve a variety of processes, but especially back-office processes such as claims management.

Putting intelligence into claims management

The main objectives driving insurance companies’ claims management strategies are usually two: managing costs and customer demand. In this scenario, cognitive automation is the best solution for supporting insurance business process automation because it applies a human-like language understanding to the analysis of data.

A cognitive approach understands words, sentences anddialogue in context by leveraging Natural Language Processing and Artificial Intelligence algorithms based on semantic technology. This ensures high-quality language understanding combined with advanced data analytics capabilities when automatically reading, analyzing, identifying and extracting the most relevant data from claims and related documents.

The result is better and faster execution of the entire claims management process.

The advantage of cognitive automation

The claims management process involves several crucial procedures that start once the insurance claim has been filled out and a new customer file has been opened. The claims management process follows these steps:

  1. Review the claim, related documents, receipts and invoices.
  2. Check the insurance coverage to verify the request against policy benefits.
  3. Approve or reject the claim.

Claims, coverage documents and the variety of related documents (invoices, police reports for accidents, medical reports, receipts, etc.) should be quickly read and accurately analyzed to improve efficiency in the claims management process. As described in the video mentioned above, cognitive automation can reduce claims management from minutes to seconds, and allows for faster communication, both of which have a positive impact on the customer service experience.

From claim management to underwriting risk and fraud prevention

By minimizing human error and capturing relevant data trapped in the claim and related documents, cognitive automation optimizes not only the claims process itself by helping underwriters in their day to day back-office and customer relation activities, it also supports the insurance company as a whole by improving compliance, increasing operational scalability and avoiding future costs.

The benefits range from reduced fraudulent claims to protection from reputational damage, from a larger market share of bids to a streamlined underwriting risk evaluation, accelerated production of new quotes and comprehensive fraud prevention.

Contact us to learn more about our cognitive automation solutions.