AI Automates 75% of Claims Processing

A large insurance company, struggling with manual document verification, data entry, and disconnected systems, implemented an AI solution that automates 75% of processing tasks. This resulted in a 65% faster claim resolution, significant error reduction, and freed up staff for higher-value activities.

Client:

The client is a major insurance provider offering a diverse portfolio of insurance products.

Problem Statement:

● Manual Document Verification: Staff had to manually verify if all the necessary documents were submitted for each claim, a tedious and error-prone process.
● Data Entry Bottleneck: Extracted information from documents needed to be manually entered into various disconnected IT applications, leading to inefficiency and wasted time.
● Disconnected Systems: The lack of integration between different IT applications hindered smooth information flow and potentially caused delays.
● Inconsistent Claim Triggers: Different triggering scenarios for claims (incident vs. policy maturity) might require different document sets, further complicating the manual verification process.

Results:

☑️ Robotization Degree: 75% Effort Automated
☑️ ROI: 3 Months
☑️ Human Error Rate Reduced: Significant reduction in human errors
☑️ Manual Effort Reduction to 75%: Automation streamlines tasks, reducing manual effort by 75%
☑️ Faster Processing Time: 65% reduction in processing time, leading to faster claim resolution
☑️ More Standardization: Standardized processes ensure consistency and reduce errors
☑️ High-Quality Improvement: Automation and error reduction enhance overall claim processing quality

AI Solution:

Seeking to address the challenges of manual document verification, data entry, and disconnected systems, the insurance company implemented Gleematic, an AI-powered solution that automates and streamlines the claims processing workflow.
Gleematic’s capabilities revolutionized the way the insurance company handled claims:

1. Intelligent Document Processing:
Gleematic’s multilingual document processing capabilities extract data from various claim documents, including non-English ones, eliminating the need for manual data extraction.

2. Automated Data Entry:
Extracted data is automatically populated into the company’s various IT applications, eliminating the time-consuming and error-prone process of manual data entry.

3. Data Validation and Fraud Detection:
Gleematic’s data validation capabilities ensure the accuracy and completeness of the information, while its machine learning algorithms analyze data across multiple systems to identify potentially fraudulent claims, safeguarding the company from financial losses.

References:

1. Cognitive Automation for Claims Processing

Industry: Insurance

Vendor: Glematic
Client: A large insurance company