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Enhancing the digital claim journeys for customers and prospects.

08/07/24, 09:00

Any industry where time, money, and efficiency are paramount is due for a change. The insurance industry is no exception and will need all the advancements technology offers. Currently, that is AI; without it, there is no competitive advantage. Hence, we are excited to tell you about our new AI modules, developed with the backing of an Innovate UK research grant. We provide a platform to remove constraints for insurers, streamline workflows, and enhance claims processing efficiency with our AI solutions.


An Invitation to be free of rules:

Imagine a platform where bulk claims processing is automated and even complex cases are already assessed to aid the claim handlers so they can focus on critical priorities. AI modules can go beyond structured-based processing and contextually analyse policy wordings, extract relevant information, and validate claims like human adjusters are trained to do. They can identify missing information and inconsistencies to detect fraud and intelligently ask questions to resolve issues. This is our vision for our AI-enabled platform.


Why should you care?

Because you are in the insurance sector, you might be dealing with inefficiencies and likely feel the brunt even as you read this article. Some traditional claims processing is lengthy and fraught with errors and delaysii. Claim handlers spend a significant chunk of their time sifting through policy documents, images, and claim data and validating claimsiii. We are here to provide a solution for that through our Policy Extraction and Policy Validation modules.


Real-world impact:

Automation in claims processing can save insurers up to 30% in operational costs while increasing overall revenueiv. By integrating Rightindem’s AI modules, you cut costs and enhance the quality of service provided to your clients. Reduced processing times, intelligently identifying errors and frauds, and providing accurate claim evaluations translate into higher customer satisfaction and trust.


Our modules are developed with state-of-the-art Natural Language Processing (NLP) and Deep Learning algorithms, guided by domain experts with decades of insurance experience. We’re creating a “virtual claims agent” by modeling the experience of a claims handler. From First Notice of Loss (FNOL) to claim outcome, we offer a solution that will automate bulk claims and save significant time for complicated cases by providing coverage recommendations through semantic analysis.


Automation and Efficiency:

Our Policy Extraction and Validation modules work with textual unstructured data. Identify relevant policy sections from the customer’s policy and validate the claim against it just as a claim handler would. We go even further by modeling the capability to handle complex scenarios, which will save a significant amount of your claim handler’s time by providing them with a coverage assessment so they don’t have to investigate from scratch. We provide you and your customers with the most efficient claims journey through this.


Handling Unstructured Text:

Insurance policies are notoriously difficult. Our models are trained to handle this by carefully considering the policy wordings, integrations such as weather reports, images, content valuation, etc., and the customer schedule to semantically evaluate if the claim is covered under the policy with reasoning. Additionally, the models identify general terms relevant to the claim, considering the overall context and using this information to assess coverage. This helped us to even identify flaws in the underwriting of a policy book. Hence, it ensures no stone is left unturned, providing a comprehensive evaluation that simplifies the claim handler's job.


Modularity:

We offer our modules as independent yet integrable components. We want to give you the flexibility of choosing what you want and make the tech dance to your beat. Whether it’s a comprehensive solution or specific functionalities to enhance your current systems, our modular approach ensures you can tailor the integration to meet your unique requirements. For instance, you can use our Policy Extraction module to pass on directly to claim adjusters, store it to use later for similar cases, or pass it to our validation module.


Contextual Fraud and Error Identification:

Traditional rule-based validation systems often fail to catch nuanced fraud cases or mistakenly reject genuine claims. With the ability of semantic claims valuation, our modules go beyond simple rule-checking as they can build the full context of a claim using policy wording, customer explanations, and unstructured data to determine coverage. Hence, it can intelligently identify potential fraud while ensuring genuine claims are not wrongfully denied.


It's time to step into the future of insurance with Rightindem’s AI Platform. We invite insurers to test our AI modules in their workflows and experience the transformative power of automation and contextual analysis firsthand. Contact us at contact@rightindem.com to know more. Here's what you can expect:


  1. Enhanced Efficiency: Free up your claim handlers to focus on more critical tasks, drastically reducing

    the time spent on routine claims processing and let us handle that stress.

  2. Contextual Decision Making: Get essentially a “virtual claims handler” built with the help and

    experience of our seasoned claim handlers. Our models will handle the elusive unstructured text and

    provide you with contextual decisions with reasoning.

  3. Empathy and Care: We are building our models with a duty of care, and they reflect that. Our models

    help remove biases and provide a balanced claims decision process.

  4. Leverage Modularity for Custom Solutions: Flexibility is at the heart of our platform. Use our Policy

    Extraction and Validation modules independently or together, tailoring the integration to meet your

    specific needs.

  5. Fraud Reduction: Don’t let rules hold you back. Intelligent, contextual fraud identification ensures

    that genuine claims are processed swiftly while fraudulent ones are flagged for further review.

  6. Seamless Integration: Our AI modules are designed to integrate existing workflows with minimal

    disruption, providing immediate benefits without extensive retraining or system overhauls.


Picasso said, “Learn the rules like a pro so you can break them like an artist.”. We take inspiration from this and are going beyond the limitations of rule-based claims processing. Our AI Platform is not just a technological advancement; it’s a shift in how insurance companies operate. The ability to handle unstructured text and provide contextual analysis opens up new avenues for innovation. The potential applications are limitless as we refine our models and gather real-world data. From personalized policy recommendations to advanced risk assessment, the future of insurance is brighter than ever.


We are committed to making claims processing faster and more efficient to better serve you with the ability to not be constrained by rules-based algorithms while ensuring an empathetic experience. With the support of Innovate UK and our team of proficient domain experts, we are in charge of leveraging AI for the insurance sector. We are just starting, and our roadmap is complete with modules to ease your workload and simplify speed. We invite you to see what we are doing to shape the market.


Contact us at contact@rightindem.com to book a demo and join our journey.

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