By: Amit Kapoor, Deputy Head, Insurance - Intelligent Automation Practice, LTI

Insurance companies play a crucial role during the current Covid-19 pandemic. They decrease economic stress and help organizations and individuals to manage risks, and act as a cushion against losses. That said, they are equally vulnerable to uncertainty and volatility. For Insurers, daily processing activities like quote creation issuance, cancellation, policy administration, claim verification and claim processing are getting hampered due to lack of online customer data and partial/ no digitization of documents and processing activities. Regulators are constantly pressuring insurance companies to provide moratorium/ accept late premium amounts without any penalty by putting a strain on the cashflow. Life & disability insurance claims are in higher numbers than ever.

An efficient Claims Management is vital to any insurance company’s success. Intelligent Automation can help tackle these challenges by minimizing operational costs, while increasing customer satisfaction.

Here are some of the areas where IA can be a gamechanger:

• FNOL – Automating the first notice and subsequent notices of loss can prove to be a good starting point in the claims area. This can be achieved by introducing a chatbot interface backed by RPA + ML + Integrations, thereby enabling the Insured to get their claims estimated in minutes, savings costs with minimal cases going to litigation.
• Intelligent Case Management – During the FNOL stage, claim handlers evaluate claims manually to decide on the appropriate next steps. This includes things like scheduling a loss adjuster appointment or providing information about direct repair programs with local repair shops, initiating inspections and many more such tasks as a part of Triaging. Intelligent Automation can automate this entire process and perform the triaging without any manual intervention, thus ensuring error free outcomes.
• Frontline & Back-office Process Digitization – Loss adjusters manually carry out complex tasks, leading to significantly opposing results. Blending RPA with OCR and ML can make this entire process hassle-free and highly efficient at the same time. This results in higher customer satisfaction and a leaner process with reduced follow-ups and recalculations.
• Prediction Claims Analytics – Artificial Intelligence can help infer as-yet-unknown physiognomies of a claim, such as instance of fraud, potential of total loss or possible litigation, to accelerate the cycle time. IA can help drive down the number of fraudulent claims and improve the payments leakage by ~ 20%.
• Claims Segmentation – AI Algorithms can help categorize claims cases by complexity, using factual and predicted claims attributes. With the help of segmentation of claims, these cases can be allocated to the specific downstream processes such routing into a garage for repairs, Towing company for towing of vehicle, etc. and can considerably speed up the claims cycle.
• Claim Indexing & Routing – An AI-based intelligent Indexing and Routing of the claim to the claim handler based on the severity of the claim, type of claim, priority of broker, etc. enables improved customer experience and reduction in the overall processing time.
• Digital Integration of Claims Systems – Leveraging IA for an enhanced customer experience across various areas can help organizations maintain their competitive edge over others. Furthermore, it can also vastly improve efficiency in communication between the parties involved in the claims lifecycle and speed up the claims processing for the customer significantly. This is a very rare scenario; however, a carrier can become the ecology integrator, connecting the best of the network for its customers.

The effect on insurance industry of current pandemic is evidently quite huge and would remain so in the coming years. Therefore, it is implied and crucial for any insurance organization to conceive long term strategies that leverage these new-age digital technologies to sustain their business and continue delivering enhanced customer experience in the world of claims.