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Success Story

A leading insurance company in South Asia: Streamlining the process architecture for extracting unstructured data from medical reports with Datamatics TruCap+

Insurance

The client is a leading joint venture insurance company in South Asia. It is engaged in life insurance and asset management. It is also into wealth creation business and manages assets worth billions of USD. The client is a major player in the insurance sector in South Asia, having an employee base of 20,000. They have an annual revenue of $53 Million.

The Challenge: The leading Insurance company wants to expedite insurance claim processing

The client, though a major player in the insurance industry in South Asia, had challenges in processing the claim documents and delivering the claim payouts. The volume of the medical reports accompanying each claim was huge and took much time for data updation, and automation was the only recourse.

The client faced multiple challenges in the unstructured data extraction. The medical reports contained data in different formats that were difficult to ingest and automate using contemporary automation solutions. Besides, extracting data from multiple medical reports from various labs in different formats was time-consuming.

Keying in data repeatedly, in both structured and unstructured formats, took a lot of time. Similarly, case details in free-flowing text were challenging to understand and key in, resulting in typing inconsistencies and errors. Further, the error-prone data entry affected the due diligence and analysis of the claims, resulting in rework, customer dissatisfaction, and delayed payout.

The Solution: AI/ML & GenAI-led unstructured data auto-ingestion with Datamatics TruCap+

The insurance company urgently needed to automate the entire process of ingesting huge volumes of the insurance claim supporting documents, including medical reports. Being more of a process architecture transformation, the insurance company partnered with Datamatics, which had significant experience in setting up process architectures for ingesting unstructured data from documents, PDFs, images, and hand-written forms.

Datamatics understood the business requirements through proper due diligence. They quickly brought in their AI/ML & GenAI-led TruCap+ IDP solution to establish a systematic process for unstructured data auto-ingestion. With pre-configured document ontologies and human-in-the-loop functionality, Datamatics TruCap+ enabled the client to automate the data ingestion and data validation for claim processing.

TruCap+ is a holistic data ingestion solution from the Datamatics Intelligent Automation suite of solutions. The versatile cloud-based solution works with an AI/ML-driven template-free approach that allows businesses to scale up their document automation process, both vertically and horizontally.

Impact: Setting up a scalable & flexible process architecture underpinned by high-volume & high-accuracy processing

98% Billing Accuracy

High Accuracy
The solution offered 99% field-level accuracy

99% Reduction in Wait Times

Reduction in TAT
The automated process reduced TAT by 70%

80% accuracy

Centralized Access
The claim processing executives had faster access to data for analysis.

Enhanced Revenue Assurance

Cost Savings
By eliminating manual processes, the client achieved a 45% reduction in operational costs.

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