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4 ways intelligent intake with AI improves the insurance claims process

By: Christopher M. Wells, Ph. D.
March 15, 2023 | Insurance Claims, Intelligent Intake

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When it comes to automating claims processing, commercial insurance companies have always faced a trade-off: speed vs. accuracy. When you focus on one, the other suffers. But intelligent intake solutions are changing the equation, making it possible to achieve both while also gaining at least two other key legal and analytics-related benefits.

Intelligent intake solutions take advantage of artificial intelligence technologies to automate many of the monotonous, manual tasks involved in insurance claims processing. With intelligent intake, as claims come in via email, AI-based models can “read” the email along with any attachments.

It’s a relatively easy task to train the models what to look for, by labeling maybe 200 actual documents involved in the process. Then, the models can find pertinent information, extract it and input it into your downstream claims processing system.

Automating claims processing in this fashion delivers at least four key benefits to commercial insurance companies.

 

Related content: How intelligent intake solutions deliver 20:1 ROI for insurance companies

 

Faster processing times

 

The first, of course, is speed. The best intelligent intake platforms can eliminate some 70% of manual document handling, which is what slows down the claims process. It takes time for even an experienced claims handler to pore over all the documentation that typically comes with a commercial insurance claim, be it ACORD forms, images depicting damage, and the like.

Claims handlers then have to locate important data such as policy numbers, names, dates, and descriptions of the issue. So begins the familiar swivel chair exercise, cutting and pasting this data from various documents into Guidewire Claims Center or another claims handling system.

It’s not hard to see how an automated tool – based on effective AI-based technologies – can dramatically increase claims handling speed. A properly trained AI model can review in seconds what would take a claims handler minutes if not hours.

 

Related content: Insurance claims automation for increased processing efficiency

 

Improved accuracy through claims automation

 

The next logical question is, “Yeah, but how accurate is this thing?” The answer is, extremely accurate – probably more so than your existing manual process. (That is, if you even know how accurate your existing claims handlers are at entering data; most customers we deal with don’t.)

Intelligent intake is highly accurate for a couple of reasons. For one, the models are trained on actual documents involved in your process. Your Chief Claims Officer, loss adjusters and others choose which documents are representative of the claims process at your firm. Working with the intelligent intake solution, they then label the pertinent pieces of information they want to extract from each document. This teaches the platform what to look for.

Out of the gate, you can expect a high degree of accuracy. Platforms that support staggered loop machine learning will become even more accurate over time because they learn from when your users accept or make corrections to the model’s work. And an intelligent intake platform will never make a mistake because it needs a break, gets distracted, or switched coffee brands.

 

Meet legal demands, save money

 

It comes down to the fact that computers are generally very good at doing what they’re told. That can pay off in spades when it comes to contested claims.

Commercial insurance companies can face an adverse impact from legal demands related to contested claims that may result in litigation. In such cases, lawyers are often obligated to offer settlement terms, usually with a time limit attached. When they don’t really want to settle, lawyers can also be good at obfuscating these terms, or burying them in the mountain of other documents associated with a claim.

In such cases, claims handlers can easily miss the terms entirely, or until it’s too late. But if you tell an intelligent intake model how to identify these terms, it will find them no matter how much your claimant’s lawyer may not want you to. That can save you a mountain of litigation costs and damages.

 

Fuel your data analytics capabilities

 

Our final benefit is one the data scientists in your firm will be happy about. Simply put, an intelligent intake solution can give them lots more data to analyze – and data scientists thrive on data.

It’s likely your Chief Claims Officer and claims handlers will be interested in a specific set of data from the various claims input documents. Let’s say it amounts to 25 fields.

Your data analytics team, on the other hand, may find value in far more data than that – maybe 100 fields or more. This is data they can use for predictive modeling applications, loss modeling, actuarial projects and the like – projects that can pay big dividends over time in terms of claims handling as well as underwriting.

Don’t settle for just speed or accuracy anymore; you can and should have both if you want to keep pace with the competition and keep clients happy. Click here to learn more about the Indico Data approach to intelligent intake.

 

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