Smarter Claims Processing with Artificial Intelligence

Smarter Claims Processing with Artificial Intelligence
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Traditional claims processing could soon become a thing of the past thanks to artificial intelligence (AI). Various companies are integrating and developing new cognitive solutions making the claims process smarter, faster, and more efficient than ever.

Artificial intelligence is hugely impacting various applications across all business sectors. In regards to the insurance industry AI and cognitive computing techniques are allowing companies to process claims more efficient and more automated than ever before. As well as improving in claims and automating the claims process improvements have also been seen in regards to First Notification of Loss (FNOL) handling and adjudicating of the claim.

A claim is no fun time for anyone. It’s stressful for the consumer as they’re having to deal with a potentially significant loss and for the insurer it’s a time that could make or break their relationship with the client. An insurer’s adjudication needs to be accurate and quick. Through the use of AI and cognition the claim handler’s workload is much more manageable. There’s also less chance of claims leakage happening where they are is being used. Early fraud detection and prevention methods are also enhanced using AI.

One of the more recent companies to come into the limelight is Elafris, Inc. and it’s AI-powered insurance chatbot. This app makes it much easier for clients to view old claims, submit new claims, or view the status of current ones. Once the client has answered a few question about the claim and clicked on a few pictures to indicate what damage has been done, the chatbot then tells them that a claims adjuster will be in touch soon. It will also search a list of nearby repair shops that the customer can call to obtain an estimate.

Another way in which AI helps drive down insured costs is by determining what’s the most accurate claim settlement. Tractable is a UK-based company that uses an AI review program to check repair estimates and flags up any unnecessary repairs. Not only does this free up loss adjuster’s time but it also minimises claims leakage as well. Shift Technology has also come up with its own AI solution called SaaS that uses artificial intelligence to flag potentially fraudulent claims.

Japan-based Fukoku Mutual Life Insurance made the headlines last year when it announced the replacement of 34 claims staff with an AI system based on IBM’s Watson Explorer . The system has the ability to read medical records and other documents in which to determine what payment should be made. These innovations are all proof that AI can significantly benefit the insurance industry and will hopefully encourage more firms to integrate it into their business models.

Source Capgemini

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