This is the era of digital work and transactions. In this kind of age, the value of automated transactions and processes has increased manifold. Insurance is one of the most widely availed industries. While many people avail of insurance from various policyholders, accurate processing of documents is a major requirement of the industry. Manual processing of insurance claims via traditional methods incurs a lot of human errors, is very slow and cost-recurring. Thus, with the help of modern technology and smart automated tools, claims processing systems have become fully digitized. Online claims processing platforms use intelligent software to correctly and quickly identify frauds and other malicious activities. Moreover, they provide the scope to track documents remotely. Most importantly, they help in much faster delivery of service with fully automated processes.

Features of efficient next-generation claims processing platforms

Modern, automated claims processing systems have various features powered by smart technology and software. These help insurance providers build a comprehensive network with customers deploy services much faster and eliminate errors. So, what are some features that help modern insurance claims processing platforms to streamline greater efficiency?

• Smart processing of documents: End-to-end automation of claims journey, flexibility in addressing various kinds of claims differently, and meeting regulatory compliance. Also, faster, more accurate, and more effective processing through capturing and tracking various data. These are done through:

1. Customer self-service portal- This is available via mobile and non-mobile, web-enabled applications. This portal lets customers register their claims and track the status of submitted claims.
2. Retrieval and verification of policy information- This will let customers enter key indexing fields to automatically retrieve policy information. This also prevents duplicity of claims and the flagging of duplicate entries, to avoid errors.
3. Smart case routing and allocation- Automated routing of cases based on the adjudicator’s workload and experience with handling complexity. Seamless tracking and management through a single interface.
4. Rule-based algorithms- These help to categorize claims and provides flexibility to ass or modify various stakeholders.
5. Thorough assessment of claim- Detailed assessment is done by providing the accessor with an all-inclusive dashboard.
6. Monitoring and insights Escalation matrix and monitoring reports are generated for the timely processing of claims.

• Insurance sale: Transformation of the experience of agents and customers with intuitive web portals and mobile applications. This is done through:

1. Quotation management- Management of quotation from capturing data for calculation of premium to generating the quotation.
2. Claim intimation- Intuitive portals or apps can intimate agents/claimants about the first intimation of loss. Mandatory checks are performed to detect loss.
3. E-application- Automatic submission of e-documents via online portal.
4. Service request initiation- Mobile app or portal to generate policy requests.
5. All-round process view- End-to-end monitoring and configurable user productivity and business reports.

• Policy administration and servicing: Improving service levels by tools such as:

1. Reduced turnaround time for processing and servicing of policies.
2. Automatic fetching of policy-related details.
3. Reduced human effort to find required details of policy endorsement.
4. Traceability of requests and related documents with automated reminders and escalations to assure compliance.
5. Quality checking, audit logs, and regulation of discrepancies across forms, processes, and transactions.
6. Template-based generation of documents through a customer communication management platform.
7. Faster, contextual, and effective communication with renewal notices, endorsement letters, etc.

• Insurance underwriting: Elimination of human intervention to achieve zero errors in underwriting with:

1. Automatic policy evaluation
2. Auto-classification of non-straight-through cases and routing based on underwriting limit
3. Smart dashboards for in-depth analysis and report generation
4. Dynamic rules to automate key underwriting tasks
5. Abstract underwriting rules and complex logic configured into the system.
6. Request capabilities for additional information and documents.
7. Access to comprehensive details for accurate decision-making

• Policy wording and clause management: Streamlining wording, binding, and generation processes to minimize losses and penalties by:

1. Updating wordings, clauses, and definitions with complete version control
2. Easy search access from central wordings and clause library
3. Review and approval of modifications to the library
4. Seamless integration with the core policy administration system
5. End-to-end monitoring, audibility, and control of changes

Conclusion

Insurance is one of the most important industries that need to streamline utmost efficiency by eliminating errors. Digital insurance claims processing platforms use smart technology to make the processing of claims much faster and more precise. They provide remote tracking, early fraud detection, and automated writing services to streamline efficient insurance operations.