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Cognitive automation for claims validation process

Expert.ai Team - 24 October 2017

How many elements need to be considered, understood and extracted in a claims validation process? If we’re talking about an automobile accident, for example, this could include many variables like date of accident, location, time of day, vehicle type, claimant motion androle, prognosis, claimant‘s date of birth, agency name, etc. The analysis of the information that must be detected in claim forms, medical reports, accident descriptions, invoices, etc. is an especially time-consuming, repetitive and error-prone task that, until now, has been handled entirely by human operators.

From the manual to cognitive automation

Manual validation of all the elements in the claims validation process—data, information and practices—is both slow and costly. It also reduces the efficiency claims management and the overall quality of customer service.

By applying a human-like understanding of text to information, the cognitive technology Cogito brings intelligent automation to the claims validation process. It augments automation at each step of this process, from collecting claim information and other supporting documents, to mapping the relevant information against the policy coverage DB, delivering unprecedented productivity gains and insight.

Benefits for insurance companies

Among the top customer service trends in 2017, Forrester cited cognitive RPA (Robotic Process Automation): “Companies can automate entire end-to-end processes such as account onboarding or insurance claims awards, with humans typically only managing exceptions. In 2017: Expect to see continued focus on RPA for automating repetitive rules-based tasks. Companies will explore the nascent world of cognitive RPA to drive real business value by improving nonroutine tasks requiring judgment.”

In a nutshell, cognitive automation streamlines a greater number of the operational activities. In the insurance field, it accelerates and automates the claims validation process and, in this way, it helps insurance companies

  • Increase operational efficiency
  • Reduce time, costs and error rates
  • Provide faster response to customer demands
  • Integrate easily with other systems and applications
  • Simplify conflicting requirements
  • Detect possible fraudulent claims
  • Focus on the highest-value aspects of the job: decision making.

To learn more, watch the recording of our recent webinar Beyond the Hype: How to apply Cognitive Computing to Customer Support in Financial Services and Insurance.”