Intelligent Automation – Improving Claims Process for P&C Insurance

Jan 31, 2023

For many Property & Casualty insurance carriers, providing coverage for clients has become intimidating. P&C claims Automation is a mission-critical task for any insurer. Conventional claims processing has become a challenge due to its tedious nature, high time consumption, inaccuracies, complexities, and fraudulent activities, thereby making claims management difficult to handle.

This often leads to increased payouts and a high client attrition rate as customers tend to switch providers based on an unsatisfactory or delayed claims experience.

Then what should insurers do to streamline claims processes and increase customer retention?

Henceforth, the insurance intelligent automation sector is heavily focusing on enhancing processes and incorporating technology into its workflows to improve customer experience and increase ROI.

Does that imply every insurance business would now have to invest in new technologies to meet the rising demands and retain existing customers?

The answer is “Yes.” Today, customers like you & I are adopting digital channels and have all the data available at our fingertips. From ordering a product to booking an airline ticket, technology is making life easy. Therefore, present-day customers want digitized and fast insurance core system services. Implementing RPA in claims processing is one of the most effective ways to directly impact productivity and customer satisfaction.

It’s great to see the increasing number of insurers investing in automation – it’s a crucial step towards digital transformation. It assists insurance businesses in overcoming traditional challenges and attaining new levels of efficiency and quality. Intelligent automation leads to reduced operational expenses, faster reaction times, and increased productivity.

The blog will discuss how straight-through processing (STP) and automation can streamline the entire claims workflow and how balancing claims processing using automation and human intervention can boost customer satisfaction and retention.

Leveraging STP Boosts Insurance Claims Processes

By implementing STP automation in the claims lifecycle, insurers can provide clients with a self-service ability, removing unnecessary manual touch points and enhancing customer experience, thereby creating a more efficient claims process.

STP can make certain claims a low-touch or no-touch end-to-end process. By leveraging STP for low-complexity claims, adjusters can concentrate on high-value, complex claims to ensure appropriate investigation and resolution.

When an insurer begins to use STP interventions in low-complexity claims, they also can start migrating some of the key aspects of this claims automation across other claim types. For instance, carriers may use STP for automatic triage and customer notifications for complex claims. This boosts efficiency, increases standardization, enhances customer experience, and reduces cost.

Let us now discuss how automation enhances the efficiency of the entire claims workflow.

How Does Intelligent Automation Work in the Claims Journey?

Creating an innovative and hassle-free claims journey requires a blend of intelligent automation and integration of other digital technologies. However, there are several steps involved in processing a claim.

• FNOL:

Harnessing automation in the first step of PC insurance claims processing enables insurers to significantly improve the FNOL experience for their clients.

By automating the FNOL process, the policyholder can use a mobile app or a chatbot to fill in the required information and upload media files & document scans instead of handing the documents in person or calling up an insurer. This allows the carrier to manage claims much faster and with an improved accuracy.

• Document Processing:

Once the FNOL is shared, the documents are processed, and significant data is extracted. Intelligent document processing uses computer vision, natural language processing, and deep learning to classify docs, enhance document quality, and extract unstructured data that can be transformed into usable, structured data analytics.

For instance, IDP used in claims processing will be able to analyze documents sent by the customer, extract relevant data from media and text, and send it for further processing, all with very less human intervention.

• Triaging:

After all the vital information is collected through document processing, claims triaging is done. Based on past data, predictive analytics uses machine learning techniques and statistics to identify the likelihood of future events. This helps insurers to distinguish low-complexity claims that can be automatically processed from complex claims that need to be appropriately adjusted.

Here’s how it works:

1. Claims data is collected using digital FNOL intake channels.
2. Based on parameters from similar historical claims, each new claim is assigned a complexity score.
3. Claims are then segmented and routed to assigned adjusters based on the score.
4. Low-complexity claims are sent straight to payments.

• Assessment:

Once claims triaging is made, automation-driven assessment is executed. With the help of AI or ML, insurers improve their efficiency by facilitating damage assessment, enhancing fraud detection, recognizing abnormalities, and identifying lapsed policies.

• Investigation:

After assessing the requested claim, an investigation is carried out. In this stage, automated matching of incident information or loss run data with the trained conditions, which relate to state law, cause of loss, damage type, etc., is done.

A few advantages of leveraging automation in claims processing for investigation are:

1. Claims with chances of any fraudulent activity are more accurately detected.
2. The system can detect connections that exist between various factors that may be unnoticeable to human eyes.
3. The application of variations in data analysis & the constant revision of the claims data allows insurers to anticipate the discovery of new fraud schemes.

• Evaluation:

With all the crucial information available through the above stages, automation-powered evaluation enables insurers to establish an end-to-end digital customer journey.

The claims evaluation journey includes the consideration & calculation of all the processes like cost estimations, legal expenses, adjuster costs, medical management, etc., thus, helping insurers to make smart error-free decisions. By evaluating the claim’s correctness and validity, insurers decide whether to pay or deny the insurance claim.

• Settlement:

Lastly, automation sends the claim request to the task inbox for processing. Thereafter, based on the complexity, the claims request is circulated for underwriting work. Finally, the decision is communicated to the client.

Significance of Automation & Human Touch in Claims Processing

Although automation holds numerous benefits in claims processing, it isn’t one-size-fits-all. What works for one firm might not work for another. This is the reason why human intervention is equally essential to complement automation. For instance, if you have an exceptional client service team, there is no requirement for chatbots.

Ensuring the use of existing strengths for retaining clients and using P&C Clams automation to make it easier for customers to reach out to the organization is the right choice to boost the overall efficiency of claims workflow and enhance customer satisfaction.

In a Nutshell

The real-life applications of intelligent automation cannot be overlooked anymore as it carries the capability to deliver to the customers of today & tomorrow.

Contact us to start your insurance process automation journey today!