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Automated Claims Processing – Reshaping the Insurance Landscape

Jun 28, 2022
Automated Claims Processing Insurance

Automated Claims Processing

Claims processing is a critical task for any P&C insurance firm. Conventional claims processing has become a challenge due to heavy reliance on manual work, outdated methods, and legacy systems, and an overflow of routine back-office operations that often results in errors.

Mismanaged resources, manual input errors, data crunch, and other operational roadblocks persist to pose a challenge to the accuracy and efficiency of claims processing.

With technological advancements in the insurance core system industry, a few challenges like reduction of expenses, faster turnaround times, and enhanced consumer experiences have cropped up for traditional insurers. Henceforth, adopting Robotic Process Automation for insurance industry is the solution to these challenges.

RPA leverages programmed bots to act as digital workers that streamline mundane and repetitive business processes. At KMG, our RPA-bots can deliver personalized quotes, manage claims quickly, and increase customer engagement by providing relevant coverage, calculating premiums, and serving your customers 24/7, thereby reducing costs. Please visit to know more.

Creating an innovative and hassle-free claims journey for clients requires a blend of RPA, AI, and integration of other digital technologies. Here is a workflow involved in automated insurance claims processing:

Automated Claims Processing


KMG employs RPA in claims processing, enabling insurers to automate the FNOL process and enhance the claims experience for consumers. When a claim is filed, RPA bots can easily extract pertinent details from unstructured documents coming from different sources and feed the data into appropriate systems.


These days, insurers depend heavily on AI algorithms that KMG uses to anticipate exact outcomes. With the help of AI-driven models, organizations are improving their efficiency by facilitating damage assessment, enhancing fraud detection, identifying billing abnormalities, and recognizing lapsed policies.


In this stage, data is cross-checked automatically with the existing terms & conditions which relates to state law, cause of loss, damage type, etc. Accurate fraud detection, rapid data processing, prediction of new fraud schemes, etc., are a few merits of leveraging automation in this stage.


With all the relevant data available through the above stages, automation-driven evaluation helps KMG establish an end-to-end digital client journey. The claims estimation journey involves considering and calculating all the processes like cost estimations, calculation of legal expenses, medical management, adjuster costs, etc. Thus, helping the insurers to make smart decisions that are free of errors.


Lastly, KMG’s AI-driven RPA in Insurance is used to perform claims triaging based on the result and sends the request to the task inbox for claims process automation. Thereafter, based on its complexity, the claims request is circulated for underwriting work. The decision is then communicated to the customer for final settlement.

KMG – Trusted Partner for all your RPA Needs

The real-life applications of modern technology cannot be overlooked anymore, as it carries the capability to deliver to the consumers of today & tomorrow.

Key Management Group Inc. is a top RPA solutions provider that assesses everything right from planning to adopting and ensuring the strategy is well implemented across your insurance core system organization. Our company delivers automated end-to-end claims processing, thereby enhancing service delivery, reducing expenditure, and improving customer satisfaction.

Get in touch with KMG at to begin your insurance process automation journey!

Let’s discuss your project. Connect with us.

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