Completeness Check

A large Dutch insurer wanted to substantially automate low to moderate-complexity claims of digitally submitted claims. The insurer asked omni:us to implement AI along the existing digital claims journey to automate the claims handling process of low to moderate complex claims for property and casualty.

Issue

Delayed communication on FNOL completeness and overall claims processing status impacted customer satisfaction negatively especially through digital channels
Limited claims triaging process capabilities did not allow a resource effective routing of low, mid vs. high-complexity claims to relevant personnel

IMPACT

Reduced manual claims incidence of low to moderate complexity by automating claims handling
Improved triaging and manual claims assignment increased case team effectiveness drastically
Decreased process time for remaining manual claims
Allowed a real-time claims settlement in significant amount of cases

Solution

Automated digital claims journey by applying FNOL-completeness check, coverage check, automated claims file creation
Enabled automated real-time customer interaction and feedback through digital channels (incl. real-time settlement)
Automated triaging and anomaly detection of claims based on complexity by routing to the relevant experts teams for manual processing or automated black box processing
Augmented manual claims adjustment process steps with AI generated insights and information

AI-Powered Claims Decisions

Reference Processes

Connectors

AI-Powered Recovery Detection

End-2-End Claim Automation

Automated Claim Indexation

Automated First Notice of Loss

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