Our client, a prominent insurance provider, manages a vast portfolio of policies and processes a high volume of claims daily. They sought to enhance their claims adjudication process to improve efficiency and customer satisfaction.
DOWNLOADBusiness Need
The client faced challenges with manual claims processing, leading to:
• Extended Processing Times: Manual adjudication was time-consuming, delaying claim resolutions.
• Inconsistencies: Human errors resulted in inconsistent claim outcomes.
• High Operational Costs: Labor-intensive processes increased administrative expenses.
Our Solution
Our AI-based claims adjudication solution was deployed to address these challenges. Key features deployed
included:
• Automated Adjudication: Automatic matching of claim provisions with claim information, dramatically
improving adjudication speed.
• AI-Powered Accuracy: Advanced text analytics and machine learning enhanced adjudication precision.
• Rapid Processing: Capability to process extensive claims and policy documents within minutes.
• Seamless Integration: Easy integration with existing IT systems, ensuring minimal disruption to
workflows.
Business Benefit
The deployment led to significant improvements:
• Increased Efficiency: Automated processes reduced claim adjudication times by 70%.
• Enhanced Accuracy: AI-driven analysis improved decision consistency, reducing errors by 60%.
• Cost Reduction: Operational costs decreased by 50% due to reduced manual labor.
• Improved Customer Satisfaction: Faster and more accurate claim resolutions led to higher customer
satisfaction scores.
By leveraging our solution, the client transformed their claims processing operations, achieving greater
efficiency, accuracy, and customer satisfaction.