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AI and claims management - what is really important?

28 September 2021 · By Irene Martínez

Artificial intelligence (AI) and machine learning (ML) are quickly transforming the insurance sector, a long stagnant industry that has been begging for change. Underwriting, evidence gathering and customer service is now easier and more effective than ever, thanks to the industry embracing this new technology. 

One of the most valuable areas that AI can improve is the claims management process. Claims processing is the entire process of managing policyholder claims, covering every stage of a claim, from initial contact to the closing of the case. 

This includes claims triage, review, fraud investigation, adjustment (if necessary) and finally either the acceptance or rejection of the claim itself. AI can speed up turnaround times, detect fraudulent claims and so much more, offering benefits to both the insurer and the insured. 

How does AI improve claims management?

Big data has the capability to completely overhaul the way we work in the insurance industry. Big data is the name given to the enormous amounts of information that is being collected from various sources, such as wearable technology. 

Previously, technology was too limited for companies to use this data to their advantage. These days, we have the capability to hold thousands of terabytes of data that can be used for many helpful purposes. 

AI is the key to unlocking the value this wealth of data holds. Sorting through the data with AI can streamline the claims management process. Claims can be handled faster and more accurately, leading to lower fraud rates and higher customer satisfaction. 

How do insurers and the insured benefit from AI in claims management?

The insurance industry is often at odds with its customers, with a deep rooted sense of distrust hampering the relationship. AI can help this, generating major benefits for both parties.

Fraud reduction

AI can break down the fraud triangle and build back trust between the insured and insurer. But how can AI reduce fraud during the claims process?

For starters, the AI and ML processes can sort through countless previous case files and compare them to the current claim. By comparing to previous cases, the AI can detect irregularities that could signal fraud. This can include obvious signs – such as differences in witness statements – or more nuanced clues that could not be caught without AI.

Fraud analysts have great intuition and like AI, they can recognize patterns and irregularities with claims. However, AI can provide real-time risk analysis and view historical data within the correct context for the individual claim. This offers accurate results in a much shorter time frame.

Faster turnaround times

As we have mentioned, AI can take processes normally done by humans and provide results within minutes. Yet it’s not just fraud that can be tackled with technology. It can also cut down wait times across every stage of the claims process.

Initial contact used to be a case of phoning up your insurance company post-incident and sitting on hold for a while. Because so much time had passed since the incident, it could be challenging to try to recall the details for the report. This lengthy delay between the incident and the report means that facts can get diluted, leading to inaccuracies that could change the outcome of the claim.

Thanks to the AI revolution and companies like Bdeo, initial contact can start almost immediately. When it is safe to do so, the insured parties can initiate the claims process with a single button. They can then gather their own evidence with the help of the app’s AI assistant, collecting and sharing valuable and accurate data. 

The AI takes the data provided and can assess damage, check for signs of fraud and even approve the claim if no issues are flagged. In fact, the whole claims process can be completed within minutes. This offers a cost-effective solution for the insurer and peace of mind to the insured, who have less to worry about. 

Improving payment processes

Of course, faster claims processing means faster pay-outs for those who need it. If a claim is successful, the AI can verify payment information and trigger the payment straight away. That saves time for the insurance agent and reduces stress for the claimant, who has a lot to deal with already!

Settlement and payment times are some of the most important factors for potential customers. In fact, a survey by Accenture reported a staggering majority of policyholders viewing settlement speed as the main consideration when choosing an insurer. 

How to integrate AI into your claims management workflow

The insurance industry is still taking its time when it comes to incorporating new technology. Insurers looking to upgrade their claims management process with AI still have to follow the same regulations as those who don’t, which can be confusing. This also makes it difficult to dive straight into AI-powered claims processing.

Rather than trying to make the switch to AI across the board, introducing it gradually into the process allows agents to understand the new system step-by-step. This also gives them time to identify if the process is still in line with current regulations before letting machine learning take over completely. 

A good way to start is by identifying problem areas that are the most in need of improvement. For example, if there is an issue with manual data extraction and organization for later use, that would be a perfect starting point for the company’s AI transformation. The AI can collect the most valuable data, then organize and sort the information so the agent can easily assess the claim with accuracy. 

Once the first stage of the claims process has been integrated, you can move on to other areas, eventually creating a highly efficient, highly accurate process. 

Bdeo makes AI and Visual Intelligence accessible to everyone

Bdeo is a revolutionary application that brings much-needed disruption to the insurance industry. Our VI technology allows even the most technologically inexperienced users to collect accurate evidence and assess the data with precision and speed.

Request a demo today to find out how Bdeo can revolutionize your business.

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