By: Dinesh Ghevade, Senior Consultant

Conventional claims processing in the Insurance industry involves a lot of error-prone and time consuming manual work, resulting in long processing and turnaround times, which then lead to unhappy customers. Insurance companies have been trying hard to automate the claims process by adding advanced technologies and functionalities to existing legacy applications. But these attempts resulted in higher cost of implementation due to lengthy implementation cycles and increased complexity in integration.

Robotic Process Automation, or as its more popularly called RPA, can transform the entire Claims Processing value chain by using automation to reduce the time and cost involved in investigating and processing a claim, and also improves data accuracy. That’s because RPA brings to the table intelligent automation, which means that bots (software robots) can mimic human action on transactional, rule-based, repetitive and cumbersome tasks, except those that require complex, cognitive decision making. RPA tools can interact with any thick client claim application, web application, user portal, CRM, service or cloud etc., making interaction easier and similar to human communication. RPA automates legacy Claims Processing systems making them more efficient and streamlined, thus reducing customer churn and taking care of repetitive tasks that impact operational efficiency.

Let’s look at the 5 top enhancements that RPA can deliver to Claims Processing:

Operational quality and accuracy
RPA will eliminate the margin of human error involved in manual data entry into a COTS system. Bots can be ‘trained’ to read a FNOL form and intelligently extract and capture claims data and integrate it smoothly with the core claims system. This makes it easier to register a claim with better quality and higher accuracy.

Higher overall efficiency
RPA bots, unlike humans, can tirelessly work 24/7 that too at an automated process speed, thus allowing Insurance companies to handle higher volume of claims. They also take away time-consuming repetitive manual tasks allowing employees to focus on more creative, cognitive and decision oriented tasks.

For instance, RPA facilitates frictionless triaging of a claim from a queue to the correct person (Adjuster) by considering various pre-defined factors thus speeding up the claims process. Bots can hand-off a claim to a human in real-time for further claim processing, while STP claims can be handled by bots without any human intervention.

Seamless integration
RPA can work, interact and link any kind of claim application, be it a legacy application, web application, user portal, service or cloud, with no modification in these applications. Processes like claim intake, claim assignment, claim adjudication, STP etc. can be executed within multiple applications easily.

Excellent processing speed
Bots can work tirelessly and are less likely to make mistakes. They can be easily programmed to comply with multiple claims regulations and standards, thus eliminating the possibility of human error and shortening the processing time by baselining the work.

Enhanced agility
RPA is flexible and easy to use so that users can make any modifications as required by an application. It is also easily scalable and can be expanded or scaled down by adding, removing, changing or expanding any automation process.

What the future holds…
Insurance firms have come a long way from age old technologies and have started moving their Claim Processing function to RPA, aiming for low-touch or touchless claims processes. They are leveraging RPA to increase operational accuracy, efficiency and effectiveness, thus benefitting the stakeholders involved in the value chain and realizing early ROI.

There is a novel RPA trend in the making, called ‘Unattended RPA’ which will deliver ‘Hyperautomation’ by developing AI capabilities within RPA, thus becoming a game changer for the Insurance industry. This will digitally transform the Claims process radically and will require minimal monitoring.