Enhancing Claims Processing in Insurance Through Automation and Data Analytics - Primewise - Strategy & Consulting
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Case Details

Business Problem

Our client, a mid-sized insurance company, faced a big problem with processing insurance claims. It was taking too long to handle claims, there were too many mistakes being made, and as a result, customers were becoming increasingly unhappy. This is mainly because they were still relying heavily on manually entering data, the systems were not working well together, and ineffective use of advanced data analysis.

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Solutions

  1. With the implementation of Robotic Process Automation (RPA) technology, the repetitive and routine tasks such as data collection and entry was automated, manual errors were reduced and employees got more time to perform more complex claims investigations.

  2. By utilizing advanced analytics to analyze claims data in real-time, the patterns and anomalies that could indicate potential issues or fraudulent claims were identified, and accurate processing was determined.

  3. The development of an integrated platform that connects different data sources and systems used in claims processing ensured that data flows seamlessly across the claims handling process, reducing delays caused by manual transfer of information.

  4. The client-facing digital portals were enhanced to allow customers to upload documents, track claims status, and communicate with claim handlers directly. This improved transparency and customer satisfaction.

Results

Post-implementation of these solutions, the client observed a substantial transformation in its operations:

  • Reduced Processing Time: The average claims processing time was reduced by 37%, enabling quicker pay-outs.

  • Decreased Error Rate: Automation and data validation led to a 50% reduction in processing errors, significantly lowering the risk of claims rework and disputes.

  • Improved Customer Satisfaction: With faster processing times and increased transparency through client portals, customer satisfaction scores improved by 60%.

  • Cost Efficiency: The reduction in manual tasks and errors decreased operational costs by 19%, contributing directly to the bottom line.

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    Primewise – Business Consulting Solutions

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