A major player in the insurance industry for over 30 years and with annual revenue running into millions of dollars, our client is a complete insurance claim adjusting company in the U.S. Among its major services, the company handles claim management in residential, commercial, and catastrophes across the country.
Our client uses a suite of proprietary technologies to maximize the customer experience, thus enabling claims handling in the fastest time in the insurance industry.

With their existing claims management system, our client found it challenging to effectively collaborate with its adjusters and process their data. This, in turn, delayed the claims processing process, leading to dissatisfied customers.

After an in-depth discussion, Experion identified the following challenges in their existing system:

•  The system was incapable of processing unstructured data gathered in the field
• The claims management process was time-consuming and manual, including form filling, underwriting errors, and omissions
• It was not scalable nor adequate to meet the growing demands
• Had only 30% reusable code

A team comprising business analysts, software engineers, and UI/UX experts from Experion completed a review of the existing system for claims management and identified features that would enhance claims management and would be critical for their insurance business.
Based on their findings, the team proposed an AI and ML-enabled learning model for detecting damages. They also suggested digitalizing the entire claims management process, avoiding all manual effort and errors. Additionally, the team figured out how they could streamline the payment processing for saving maximum time.
The proposed Artificial Intelligence solution in claims management, focusing on insurance claims automation, brought disruptive changes in the client’s business operations in claims management and adjustment, underwriting, fraud detection, and customer experience. Further, the new solution helped generate insightful reports by leveraging advanced data analytics, facilitating better decision-making by senior management executives. It also offered team management and performance assessment modules for adjusters that enabled better team collaboration, performance reviews, competency reviews, and productivity analysis.

The standout features of the solution include:

• Mobile-friendly (for both Android and iOS users) for field inspectors to inspect and assess the overall damage
• Dedicated customer portal for the insured people to communicate with the insurance company
• An AI-enabled damage detection feature that could identify and assess the damage and predict the action that would be needed along with the estimated costs. Additionally, it could prevent fraud by checking the quoted costs of repair with the actual damage and ensuring efficient collection of vendor quotes
• A digital claims management module that would digitalize the claims settlement process and reduce business dependencies on manual processes
• Integrated payments system that could streamline the entire payment processing and eliminate manual errors

• The client was able to accelerate their claims management and settlement process, thus benefiting from an improved customer experience
• The new solution delivered better process transparency and visibility for all stakeholders
• Additional benefits included reduced operational costs thanks to the advanced reporting
• Data insights improved the client’s overall decision-making process