INSURANCE

Insurance businesses have complex workflows and processes. They include new business insurance, claims processing, policy servicing, etc. More tedious processes, such as, onboarding, underwriting, no claim bonus, risk score, claim adjudication, claim processing, verification & validation, disputed claims resolution, regulatory compliance, anti-money laundering curbs, etc., require multi-team involvement.

Automation can handle simple to complex processes. The simpler ones can be automated by using Robotic Process Automation (RPA) and the rather complex ones require Artificial Intelligence / Machine Learning (AI / ML) infusion in strategic layers, that is, by using Intelligent Automation. The bottom line is that all repetitive and rule-based processes can be automated in any domain including Insurance.

Wherever financial transactions are involved, there is scope for fraud, unless and until specific verifications and validations are performed at crucial points in the workflow. AI / ML and Data Science techniques allow to perform auto-validations at key points as a part of the workflow. A separate stream of Data Sciences, that is, Fraud Analytics is instituted to check the rampant proliferation of frauds and money laundering activities. It uses a variety of techniques such as anomaly detection, machine learning, distance functions, k-prototypes, parallel computing, etc. to nip the frauds at inception.

Yes. Business Intelligence, Analytics, and Data Visualization tools can be directly appended to the databases. It improves the capability of decision making by manifolds. Datamatics TruBI offers intelligent real-time data-processing and analytics with data that is stored in enterprise-grade databases, cloud data bases, data lakes, and other DMSes.

Datamatics TruBI has DIY features that supports 360 view of a single version of truth. Data Visualization techniques allow an interactive experience over a highly scalable platform. The features allow the insurance personnel to take real-time decisions even while working with humungous data thus improving productivity by 60%.

eOffice paradigms are getting accepted over the globe due to recurrent occurrence of global show stoppers. As a result, businesses are increasingly making Digital Workplace or eOffice a part of business operations.

This paperless office model is powered by a cloud-based ECM platform at the backend and a device agnostic user interface, which can be integrated with all enterprise systems. This model can be customized for different business requirements towards a collaborative remote workspace.

This remote operations solution or eOffice reduces instances of misplaced files and papers and lack of traceability. It introduces agility and scalability in business operations and offers a future-proof business model that can be accessed anytime anywhere.

A high volume of data is generated in the Insurance domain during the lifecycle of a case. An insurance company manages millions of cases at any given time. Artificial Intelligence enables pattern analysis, which plays an important role in the case management. It not only improves customer interactions but also allows the placement of new products within different customer demographic groups. The pattern analysis also allows to estimate the risk exposure of the company.

The Provider Book of Records or PBoR is a cloud-based platform for end-to-end contract management and claim processing across the lifecycle.

PBoR reduces the risk of payment leaks, reduces the contract validation time, reduces claim processing time, enables faster audits, improves credentialing time, etc.