automated claims

Mar 01, 2024


Why Insurance Claims Automation, Powered by Generative AI & Conversational AI is the Key to Stay Competitive

Early adopters of claims processing automation are benefiting significantly. More and more insurance companies are following this path, breaking free from inefficient processing methods. This is good for everyone – TPAs, the insurance providers, and the customers. Automation can make the insurance claims process better in many ways, and it will keep getting even better as technology (GenAI-powered conversational AI) advances. In other words, AI for insurance is the new normal.


Using automation can speed up the insurance claims process, making it error-free and self-sufficient without human intervention. This can be applied to new customer applications, handling claims, or reviewing a first notice of loss (FNOL) reporting. With the right solution provider, you can automate 80% to 90% of claims processing and FNOL filing.


Gen AI-powered Claims FNOL Voicebot

AN OVERVIEW OF A GEN AI-POWERED CLAIMS PROCESS AUTOMATION

1. Customers Start the Filing

Customers initiate the filing of FNOL through various channels such as call, text, or online submission.

2. Information is Gathered

AI Agents gather relevant information from customers, for a smooth submission process.

3. Document is Uploaded via AI Agents

GenAI-powered agents simplify the document upload process, making sure all the essential files are submitted for a thorough claims review.

4. Real-Time Validation is Performed

With the help of advanced algorithms, AI Agents conduct real-time validation of FNOL details, promptly recognizing and addressing errors or gaps in information.

5. Transfer to Live Agent (when needed)

In cases of complex inquiries or situations requiring human touch, the call can be transferred to a live agent. The live agent is provided with a detailed briefing on the particulars, ensuring seamless assistance.

HOW WILL YOU BENEFIT FROM AI CLAIMS AUTOMATION IN INSURANCE?

AI-powered automation for claims processing covers everything – from submitting a claim to reviewing, deciding, and paying out. If your business is just beginning, you might start by automating small, inefficient tasks and gradually move towards completely transforming the entire process digitally.

automated claims

Now, let’s see how you will benefit from claims process automation.

Efficient, Accurate, Faster FNOL Filing

Save lots of time and effort by using automation in filing First Notice of Loss (FNOL) for your customers. Streamline the submission process by enabling claims FNOL reporting on all their favorite channels – WhatsApp, MS Teams, Telegram, FB Messenger, and more. This not only benefits the claimants but also you, the insurance carrier.

AI Agents take care of data collection, guided reporting, claim type identification, documentation submission, instant confirmation, and follow-up communication. For complex scenarios, a live agent can get involved to ensure the concerns are addressed.

Reduce the cost of Claims FNOL  filing from $12 - $15 to <$2 per claim filed

No Human Dependency

Traditional FNOL filing relies on human agents during business hours, causing inconvenience for customers with incidents outside this timeframe, leading to delays in claim initiation.

The goal is to build a process that doesn't rely on human agents for customers to file FNOL. This can be done effortlessly through FNOL automation. Enabling customers to initiate claims at any time provides convenience and flexibility. Customers can report incidents immediately after they occur, rather than waiting for regular business hours.

Round-the-clock FNOL Filing

Improved Adjustments

Adjusters often face a heavy workload, especially when there is a surge in insurance claims, like during busy seasons or after natural disasters. Dealing with so many claims can be stressful, making it challenging for them to meet tight deadlines.

Some claims require in-depth investigations due to their complexity. Adjusters may need to gather extensive information, interview multiple parties, and assess various documents to make accurate decisions. This can be time-consuming and demanding.

AI in insurance, through automation, takes care of routine and time-consuming tasks, allowing adjusters to allocate their expertise to more intricate and value-driven aspects of claims handling.

An 80% increase in adjuster productivity

Enhanced Customer Satisfaction

Making things faster and more accurate when dealing with patients or customers makes them happier. Using AI in insurance, we can understand and customize their experience better by looking at their journey. With intelligent automation (IA), people can check the status of their claims in real-time and get quick responses from chatbots without needing to talk to a person. A GenAI-powered automation can provide real-time insights on interactions. This can be leveraged to improve the claims processing.

These speedy and accurate services make customers more likely to stick around and keep choosing you over others in a competitive market.

CSAT score increases by 80% or 2x

Cost Saving Operations

Inefficient use of resources in the claims support process can lead to higher labor costs and delays in claims fulfilment. Save money by reducing your operational costs related to claims support. Automation helps you use your resources more wisely and minimizes or eliminates mistakes, leading to significant savings over time.

Claims automation establishes a foundation for continuous cost savings. As processes become more efficient, organizations benefit from ongoing operational cost reductions over time.

Claims support operational costs reduce by 40%

CHOOSING THE RIGHT CLAIMS PROCESS AUTOMATION PARTNER: KEY CONSIDERATIONS

No-Code/Low-Code

No-code or low-code platforms enable those with limited or no coding expertise to build and deploy AI Agents effortlessly. This accelerates the development & deployment lifecycle, allowing you to respond swiftly to changing requirements without relying heavily on dedicated development teams.

Flexibility

Look for a solution that is versatile and adaptable to various types of claims and processes within your organization. It should be able to handle a range of tasks from initial submission to final payout.

Integration Capabilities

Ensure that the automation solution can seamlessly integrate with your existing systems and technologies. Compatibility with other software used in your business enhances efficiency and avoids disruptions.

User-Friendly Interface

Opt for a solution with a user-friendly interface to simplify the adoption and usage by your team. A straightforward interface can contribute to a smoother transition and faster implementation.

Scalability

Choose an automation solution that can grow with your business. It should be scalable to accommodate increased claim volumes and additional functionalities as your organization expands.

Data Security

Prioritize solutions with robust security measures. Since claims involve sensitive information, ensuring data protection and compliance with industry regulations is crucial.

Analytics and Reporting

A good automation solution should provide analytics and reporting features. This enables you to gain insights into the efficiency of the claims process, identify areas for improvement, and make data-driven decisions

Customization Options

Look for a solution that allows customization to align with your specific business processes. The ability to tailor the automation to your unique requirements ensures a more personalized and effective solution.

Audit Trails and Compliance

Ensure the solution offers robust audit trail features to track changes and actions within the system. Compliance with industry regulations is vital, so verify that the automation solution aligns with relevant standards.

Cost-Effectiveness

Consider the overall cost of implementation, including initial setup, licensing fees, and any potential ongoing costs. A solution that provides a good balance between features and cost-effectiveness is essential for a successful investment.

CLOSING WORDS

Insurance claims automation can be applied across various stages of the process. This includes tasks like data validation, claim status tracking, pre-authorization, real-time eligibility verification, document digitization, data extraction, claims validation, fraud detection, as well as the routing and tracking of claims.

Claims automation can be both voice-based and text-based through AI Agents (chatbots, voicebots, textbots). Additionally, you can leverage AI Agent Assists to guide your live agents in real-time to optimize the claims processing when manual intervention is needed.

Transform your insurance claims process with the cutting-edge automation offered by Floatbot.AI. Leverage AI Agents (powered by GenAI and driven by LLMs) to optimize First Notice of Loss (FNOL) filing, reducing costs from $12-$15 to less than $2 per claim. Seamlessly initiate and process claims with up to 90% automation, ensuring error-free FNOL submissions and instant claims initiation. Elevate claims customer support with real-time assistance, efficient status updates, and 24/7 query resolution. We are a recognized Guidewire Insurtech Vanguard.

We Serve: Life insurance, health insurance, personal auto insurance, homeowners, commercial auto insurance, small business insurance, workers compensation insurance, and renters.

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