This case study is based on data from a large global insurance company which is engaged in providing Auto insurance. With offices in multiple countries, the claims department handles various activities such as processing and approving claims etc. Each of these processes comprise of several activities that are repetitive and time consuming but critical for employee satisfaction. To overcome this, we developed and implemented RPA (Robotic Process Automation) for monitoring the incoming customer claims received via emails in the form of PDF. Our solution captures the required data from each claim which is then populated in the Master excel sheet and emailed to the company’s head of claims. In addition, the solution leverages our Minsky™ AI engine to categorize each claim as High Risk or Low Risk based on the customers historical data. Minsky™ then creates a high risk/low risk prediction for each claim that are emailed out to the appropriate claims adjuster based on the rating for further processing. This real time monitoring/actions helped us automate the claims processing across various geo locations offices while also reducing fraudulent claims. Solution was integrated with an existing system
Our goal was to explore how RPA and AI can lead to automate Claims processing and reduce fraud. After thoroughly evaluating the client’s challenges, we used UI Path to automate the various steps in claims processing. Our AI Engine then processes the claims and rates them as High Fraud Risk or Low Fraud Risk for appropriate processing.
The typical RPA and AI process for this project involves: