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Technology Client Story

Automating Claims Increases Accuracy up to 80%

A leading global financial services strengthened its auditing and tracking capabilities with an automated claims processing system.

Reporting accuracy <br class="hidden-xs hidden-sm" />

increased 70% to 80%

10 to 12 minutes saved <br class="hidden-xs hidden-sm" />

on manual tasks per case

The Challenge

A leading global financial services company with business lines in life, vehicle, travel, and health insurance, had a legacy claim storage system that was unable to show linking between multiple claims. The lack of linking between claims caused inaccurate reporting and created the need for an involved and cumbersome manual process to cross-reference related claims to create accurate reports.

The Solution

We built an application on Pega 7 that created linkages between related claims. With this solution in place, the reporting process was streamlined and improved by removing the need for manual human intervention. This application also monitored the existing claim storage system, and automatically created files and stored them in the system of record (SOR) whenever a configurable threshold limit for files was reached.

The Results

The solution helped in developing an efficient and accurate reporting system that gave a better view on payments and loss. Replacing existing Excel spreadsheets with an automated claims processing systems led to better auditing and tracking. Reporting accuracy increased by 70% to 80% and an average of 10 to 12 minutes was saved on manual tasks per case.

 
 

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