AI-driven Claims Management Solution for an Insurance Company
According to McKinsey, AI technology has a potential value of $1.1 trillion when fully applied to the insurance industry. Through process automation, artificial intelligence technology solutions can streamline insurance claims processing leading to improved customer experience.
The Client
A major player in the insurance industry for over 30 years and with annual revenues of over $6 million, our client is a complete insurance claim adjusting company in the U.S. Among its major services, the company handles claim management in residential, commercial, and catastrophes across the country.
Our client uses a suite of proprietary technologies to maximize the customer experience, thus enabling claims handling in the fastest time in the insurance industry.
The Challenge
With their existing claims management system, our client was finding it challenging to effectively collaborate with its adjusters and process their data. This, in turn, delayed the claims processing process, leading to unsatisfied customers.
After an in-depth discussion with this client, the Experion team identified the following challenges in their existing system:
- The system was incapable of processing unstructured data gathered on the field.
- The current claims management process was time-consuming and manual including form filling, underwriting errors, and omissions.
- The existing system was not scalable nor adequate to meet the growing demands.
- The existing claims management solution had only 30% reusable code.
The client was looking to partner with an experienced technology company that could effectively address these challenges with a customized solution.
Our Solution
The Experion team comprising of business analysts, software engineers, and UI/UX experts, completed a review of the existing system for claims management and identified features that would enhance claims management and would be critical for their insurance business. Based on their findings, the team proposed an AI and ML-enabled learning model for detecting damages. The new Experion solution would have the following features:
- Mobile-friendly (for both Android and iOS users) for field inspectors to inspect and assess the overall damage.
- Dedicated customer portal for the insured people to communicate with the insurance company.
- An AI-enabled damage detection feature that could identify and assess the damage and predict the action that would be needed along with the estimated costs. Additionally, it could prevent fraud by checking the quoted costs of repair with the actual damage and ensuring efficient collection of vendor quotes.
- A digital claims management module that would digitalize the claims settlement process and reduce business dependencies on manual processes.
- Integrated payments system that could streamline the entire payment processing and eliminate manual errors.
The proposed Experion artificial intelligence solution in claims management would bring disruptive changes in the client’s business operations in the areas of claims management and adjustment, underwriting, fraud detection, and customer experience. Further, the new solution would help in generating insightful reports by leveraging advanced data analytics, thus facilitating better decision-making by senior management executives. Additionally, it offers team management and performance assessment modules for adjusters that would enable better team collaboration, performance reviews, competency reviews, and productivity analysis.
Business Impact
With the new claims management solution from Experion, the client was able to accelerate their claims management and settlement process, thus benefiting from an improved customer experience. Along with improving the efficiency of claims handling, the new solution delivered better process transparency and visibility for all stakeholders.Additional benefits included reduced operational costs along with advanced reporting and data insights that improved the overall decision-making process.