Cognitive computing for claims processing
Based on artificial intelligence algorithms, Expert System’s Cogito cognitive technology enables an automatic, human-like understanding of the content of text documents. Using the claim management solution from Cogito, companies can expect up to 53% savings on activities such as FTEs and warranty management, and cost reductions of 30 to 60% for email management and quote processing, etc.
The claims management process revolves around the production and retrieval of information from documents that capture the specifics of the insured’s case. What cognitive technology brings to this picture is its ability to read documents much in the same way humans do, in a fraction of the time. It automatically recognizes and aggregates the key pieces of information that characterize each case and reasons on them, reducing the time spent on such tasks from hours to seconds.
Manage risks, improve processing efficiency
When dealing with Automotive Claims, for example, it can review claim packages automatically to evaluate their complexity and route them accordingly, recover essential aspects of accident descriptions to support liability determination, and suggest an appropriate settlement value based on the facts of the case, such as the injuries incurred, the medical tests or treatments applied and taking into consideration current prognosis as well as past medical history.
An essential part of underwriters’ jobs is to evaluate the risk profile of the customer they will be insuring. In Commercial Property Insurance for example, this involves analyzing third-party risk reports that describe the facilities to be insured, their particular risk factors (such as building combustibility, presence of flammable materials) and mitigators (smoke detectors, sprinklers, fire extinguishers, site surveillance). Cognitive technology quickly and consistently extracts each of these indicators and reports an overall, evidence-based, risk grade to the facilities. This means risk engineers can allocate more of their time to direct verification of the most complex cases and underwriters can turn around quotes on new policies faster.
When applied to the review of existing policies, cognitive can analyze clauses and compare them to reference policies to flag misalignments and excessive exposure. This means underwriters can more easily prioritize which clauses of a policy they may need to renegotiate in the future.