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Insurance companies around the world, come across new challenges every year that interrupt the process and make it hard to maintain the company’s core competencies along with favoring high standards of customer satisfaction.

Insurers were traditionally dependent on the data collected by private investigators and given by the claimants, therefore the insurance industry has a reputation of turtle-paced procedures and even slow payment processes. However, customers still often deal with depositing physical checks.

But, modern insurance companies know the potential of digital technologies that are gradually transforming the industry. With ever-increasing customer expectations and their distance from the paper-based system and the waiting time accompanied by them, it has become crucial for companies to leverage these technologies to offer more personalized services to meet customer demands and get a competitive edge.

According to a recent study, 87 percent of insurance companies are planning to invest over $5 million in Artificial Intelligence before 2021 and more than 50 percent are considering leveraging these technologies to innovate their processes to enhance customer services.

Modern customers have a practical and cost-effective mindset. They assume to get more returns for their money with cheaper insurance policies and wider coverage. While the customers have started thinking like retailers, insurers don’t only need to redefine their IT, data collection, and process, but also reinvents the overall business operation to showcase a customer-friendly reality.

And today, with low digital maturity, only a few leading companies are using digital technologies to streamline their claiming process. It has become crucial for companies to recognize the possibilities and partner with digital Artificial Intelligence and Machine Learning to survive and remain a long-term player in this digital world.

Before leading to (behind the scenes) how these technologies can transform the insurance industry, let’s talk about the top challenges and then we will detail a few transformations in claim cases for the property, healthcare, and pet, etc.

Consideration for Claim Management

Insurers need to focus on resolving these issues to update the claim playbook and improve the operations;

Data & Analytics: Insurance providers solely relied on the data provided by clients and investigators, but today insurers must learn to use the advanced technologies to improve the accuracy of data.

Claim Efficiency: A recent research revealed that insurers spend almost half their day in processing that doesn’t even fluctuate the business outcomes.

The talent: Claims were on the targets of cost-cutting measures and today, there are a few claim professionals that is undoubtedly a rising concern.

While successful claim process transformation relies on your technological capabilities, we will show some techniques to easily transform your claim process through automation, Artificial Intelligence, and Machine Learning. Let’s go!

The AI and ML Imperative in Claim Processing

Very soon the global insurance industry will be highly sensitive, and specifically vulnerable, to the ingenious changes that AI combined with ML will bring. While we are expecting back-office operations to be replaced by AI-powered robotic process automation, the processing time may shrink from days to hours. Every customer jumps through expectations to get their claim filed and processed timely. However, it was tough, but with the advent of Al and ML, insurers can experience improved process by:

  • Triaging Claims
  • Recognizing Outlier Claims
  • Automating If Possible

A report published by Mckinsey “Insurance in 2030” — machine learning & AI insurance industry will allow the insurers to minimize overheads accompanied by claim management by 70-90% in 2030, even if it will continue as a primary function for carriers.

Triaging claim processing will allow the customers to file a claim, schedule inspection, upload images, audit the system, and communicate with customer support, all with just an application powered by AI and ML.

Expanding its arms, AI and ML have the unique capabilities of tracking and recognizing the patterns in claims to better-predict the outlier claims and frauds. Also, the internal dashboard to inform the brokers to run an investigation if the fraud is detected.

“Insurance fraud is a big game that generates nearly $40 billion annually. Therefore, it’s a crucial concern for insurers.”

Robotic Process Automation

Other than information management, the robotic process automation (RPA) can improve claim processing in multiple ways.

It enables efficient execution of transactional, administrative, checking a claim input to ensure competence, and requesting back for missing information. This perfectly meets the needs of most insurers striving to gain operational efficiencies with improved back-office operations, including claim processing, policy application, and a few data-related functions. Companies can adopt RPA to streamline the overall business operation to show customer-centric reality. RPA can increase claim processing efficiency in the following ways;

  • Automated Claim Adjuster Assignment
  • Bulk payment processing, for instance, in catastrophes
  • Improved fraud detection and management

While we are expecting the future insurance industry to be all about humans with machines, adapting robotic process automation can eliminate the need for human resources for claim adjustment.

On the other hand, Digital Transformation has increased the involvement of large players such as Tesla, Google, and Amazon, etc. These have set up insurance programs to provide homeowners with the primary that includes bodily injury and property damage. While they can invest more in advanced technologies, insurers must deep dive and adopt AI to improve business efficiencies.

However, the claim process within the property, casualty, and pet insurance is benefiting more from this digital transformation. Now, these technologies can help insurers in claim prevention, credit goes to the Internet of Things. Shortly, the sensors will be able to learn your water consumption pattern and interrupt the overflow to prevent big damage that results in costly claims. The same goes for the healthcare and pet industry as well. For instance, people often have through finding insurance for particular breeds of pets. Now, with the combination of search engines and social media, individuals can reach the right provider and make a better deal.

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