Integrated Solutions for the Insurance Digital Transformation Pathway

Insurance companies across the world are re-engineering their business models to ensure quick turnaround time while delivering quality services, operational efficiency and throughput. The key priorities for insurance companies include addressing challenges around regulations, expenses and creating customer-centric products and services. Towards this goal, they are taking all possible measures for deploying innovative technology to improve business processes and streamline legacy applications.

Datamatics understands the needs and challenges in handling insurance processes such as new business insurance, underwriting, claims management, policy servicing, onboarding, no claim bonus, risk score, claim adjudication, claim processing, verification & validation, disputed claims resolution, regulatory compliance, anti-money laundering curbs, etc. Datamatics has the expertise to integrate insurance back-office automation with modern technologies including robotic process automation (RPA), business intelligence & analytics, artificial intelligence / machine learning (AI/ML).

Datamatics enables its institutional customers to strategically integrate statutory compliance checks in their day-to-day processes and take corrective and preventive actions to curb fraud and money laundering activities in the wider ecosystem. The RPA, NLP, and AI / ML powered checks integrated throughout the insurance digital transformation pathway ensure that fraud and money laundering are eliminated from the insurance processing lifecycle.

TALK TO AN EXPERT

Insurance domain is a complex mesh of processes. Is it possible to automate and integrate these processes?

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.

Insurance domain is plagued with bogus claims. Is it possible to identify and weed out the fraudulent claims?

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.

Insurance domain involves processing of high amounts of data during the lifecycle of each case. Is real-time decision making possible with such humungous data?

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%.

With show stoppers surging in different geographies from time to time, insurance operations are hard hit. Do we have a solution for remote operations?

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.

Customer Management is an important aspect in the Insurance domain. How does technology help Customer Management?

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.

What is the Provider Book of Records?

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.