Insurance Claims Management

How can technology assist and streamline the insurance claims management process?

Let’s look at Hollywood’s take on artificial intelligence (AI). The depictions include the intelligent robots produced to assist humans in I, Robot; C-3PO in Star Wars; and the sentient computer HAL 9000 in 2001: A Space Odyssey.

In reality, however, AI may not be as exciting. But the potential for the technology to impact all business sectors is indeed high.

Cognitive computing, along with AI, has started impacting areas across the insurance value chain and, in particular, claims management, from adjudicating claims to the First Notice of Loss (FNOL). This goes a long way in making claims processing more efficient and automated.

It is important to streamline the claims adjudication process with the help of AI to make the handler’s processes faster and more productive.

AI is expected to take over handlers’ administrative functions, letting them spend more time to evaluate, investigate, and negotiate.

Chatbot Solution

Elafris, a San Francisco-based company, boasts of an AI-enabled virtual chatbot that enables customers to see the history of claims that have been submitted, including the payment information and current claims.

Moreover, customers can also submit claims using the app by answering a set of questions, such as on the damaged areas in car drawings.

The chatbot — once the claim is submitted — will indicate that a claims adjuster will speak with the customer. It can also list local repair shops where the customer can get an estimate for fixing the damaged car. The FNOL is complete in minutes and without the help of a claims adjuster.

AI can also help reduce insurer costs by finding out the most precise claims settlements.

A company enabling this is Tractable, a UK-based company that has an AI-enabled review process which can make repair estimates and spot unnecessary repairs. The review process frees up adjusters’ time and prevents claims leakage.

Focus on InsurTechs

While InsurTechs have been in the limelight for their AI innovations, established insurers are not far behind. In 2016, Fukoku Mutual Life Insurance announced that 34 of their claims FTEs would be replaced by an AI system.

However, other industry players are not taking the same route as Fukoku. They are instead developing AI solutions that can complement the efforts of their employees. Companies like MetLife and Aviva have innovation labs to enable them to develop new AI-based solutions.

AI has transformed the insurance industry in a short span of time. The technology has reduced labor costs and increased the efficiency of claims processing. Insurers will be looking at AI-based solutions to retain and attract customers. This can be achieved by offering world-class services that delight the customers across channels.

HCL has been at the forefront of helping insurance companies improve their claims management. The company makes use of solutions like iSPARC, iSPOC, and iPAS and partnerships with claims transformation leaders to streamline claims management.