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.

 

Warning-2

Issue

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

IMPACT

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

Solution

  1. Automated digital claims journey by applying FNOL-completeness check, coverage check, automated claims file creation
  2. Enabled automated real-time customer interaction and feedback through digital channels (incl. real-time settlement)
  3. 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
  4. Augmented manual claims adjustment process steps with AI generated insights and information