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Automated Claims Processing for Insurance Providers

Claims Process Automation with Intelligent Document Processing

The ability to efficiently process claims is crucial for any insurance company, but one that’s also labor-intensive, involving numerous unstructured documents and images. A solution lies in intelligent document processing, which applies artificial intelligence to automate insurance claims processing.

For relatively simple claims, many insurers are achieving straight-through processing (STP), a degree of automated claims processing that requires no human intervention. But even in more complex instances, intelligent insurance claims automation can speed the process by 4x or more – enabling companies to process more claims far faster, which keeps clients happy. Insurance claims process automation also means it takes fewer employees to do the job, which frees up some staff for more strategic work and helps the company grow without adding headcount.

Key benefits of Claims Process Automation for Insurance Providers

Increased capacity

Grow insurance revenue without adding headcount

Remove drudgery

Free employees from repetitive tasks, increase satisfaction

Increase competitiveness

Take on insuretech startups as well as stalwarts

Get work done faster

Realize dramatic reductions in claims processing times

Capture institutional knowledge

Codify and streamline claims processes

Applying artificial intelligence to insurance claims

Advanced intelligent document processing platforms employ artificial intelligence technologies including natural language processing, machine learning and transfer learning. Together, they enable employees who process insurance claims day-to-day to build claims process automation models – without involving data scientists or even IT. That helps deliver a higher level of model accuracy and significant scalability in terms of an insurer’s ability to roll out automation models across the company.

Insurance claims automation: email processing

Chief among the areas that are ripe for automated claims processing is the corporate email in-box. It’s common for insurance companies to have a single email address to which clients send claims information. Some use the same address for general information requests, including quotes on new business. Or, customers mistakenly use a generic address to submit a claim.

Many of these emails contain not only potentially complex requests, but attachments, such as ACORD forms, photos showing home or vehicle damage and the like. An intelligent document processing platform can essentially read and triage each email, determining where each should be routed.

The platform can also extract and read attachments, often dealing with them on its own. The Indico Unstructured Data Platform, for example, includes a large library of ACORD forms, often resulting in straight-through processing of the forms. In general, the Indico Data platform can ensure each email is entered to the correct workflow for efficient, automated processing.

Automating first notice of loss (FNOL)

No matter how an insurance company receives word of a client claim, it’s sure to come with plenty of documentation. Much of it will be unstructured, making it beyond the scope of a robotic process automation solution.

An intelligent document processing tool, however, can process any type of document, structured or unstructured. In the insurance first notice of loss scenario, that may mean accepting the initial claim (the FNOL), then validating the claim is covered by the client’s policy. Much of that process can be automated with a tool that “reads” the claim form, extracts pertinent data and inputs it to a claims management tool. Here again, STP may apply to simple claims while others can be prepared with all pertinent information already assembled for an adjuster, greatly reducing time spent on the assessment process.

Meet compliance requirements with explainable AI

A key concern in a highly regulated industry like insurance is the ability to explain why an automated, AI-based solution makes the decisions it does. If a claim is rejected, the insurance company must be able to explain in simple terms the reason behind that decision. A sound intelligent automation tool will make that easy, with an audit trail that makes clear – in plain English – the rationale behind each claim decision. Additionally, given insurance claims process owners create the automated models, the models naturally reflect the way they think during the claims assessment process.

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Outsmart insurance fraud perpetrators

Automation is crucial for insurance companies if they are to keep up with insuretech startups, or simply compete effectively vs. traditional competitors. It’s also important to helping detect fraud.

More than 7,000 insurance companies collect over $1 trillion in premiums each year, the FBI estimates, making them a prime target for illegal activity. The total cost of insurance fraud exceeds $40 billion per year, the FBI says – and that doesn’t include health insurance. That costs the average U.S. family between $400 and $700 per year in increased premiums.

Automation can help insurance companies do better. To learn more, see our page, “Intelligent Document Processing for Property & Casualty Insurance" or click below for an interactive demo, a free trial or to get in touch with any questions.

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