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Claims Process Management

Claims are a core part of the insurance business. The Chartered Insurance Institute (CII) states that insurance exists in order to pay claims, and Claim Process Handling is “a key role in presenting your insurer to the world and also to its continued success.”


Any insured individual or business making a claim expects a fast and fair process so normal life can resume as quickly as possible, and to achieve this, insurance companies often promise to:

  • Be fast and pro-active

  • Respond rapidly

  • Personalise their claims support

  • Use pre-defined procedures


It can be difficult to keep these promises


Since quick and accurate claims are so important for all parties, the right process is deeply important for successful claims handling. Alas it’s not that simple - claims can include information from a variety of sources which can be fragmented, complicated and nuanced.


Add to this the insurance firm’s regulatory, compliance and adjudication commitments, and on top of this consider that lots of insurers still run legacy systems and lengthy complicated forms, it’s no surprise that much of the work is done manually. 


In fact, Accenture found that 75% of all insurance firms rely on multiple systems and archaic manual processes involving different systems and channels like email, phone and attachments. Information needs to be interpreted, re-keyed and shared. It’s difficult to have a scalable process with so many moving parts.


Problems that can lead to serious business issues

  • Even with training, manual work means speed and accuracy is inconsistent across the organisation and prone to error and worse, a risk of regulatory non-compliance.

  • The lack of fidelity of information can mean delays at busy times and errors - 3-5% of claims payments are inaccurate. [source?]

  • Poor policyholder experience can lead to non renewal when the policy expires

  • Broker and underwriter relationships may suffer

  • Any change in regulatory requirement means changing or amending processes and ways of working for staff. This can result in service degradation.

Approaches to improving claims process handling

Option 1: Intelligent Intervention

You can start by assessing what elements of your Claims Handling Process Handling are under-performing, working out the cost of this is to the business, and then start with the highest priority issue.


In essence the steps to take are ​

  • map formats

  • map variables

  • map error checking

  • map communication flow

  • incentivise staff to carry out onerous tasks quickly and efficiently


Option 2: Digitalisation

The alternative is to use Digital Workers to perform the manual and repetitive tasks on behalf of your real employees. These Digital Workers are software robots (AKA softbots or robotic process automation) that work alongside your real employees. Using them will improve Claims Handling performance by identifying what is best to automate and freeing up the team to use creativity and problem solving on valuable areas of the business.


Digital Workers operate using smart rules. This ensures the right information is used at the right time - for instance updating the client. There’s no code and no laborious process mapping. They can scan, index, manage and pull data from various communication channels, then communicate and update customers in real time


A digital workforce, as opposed to other improvement approaches, can be deployed in days, not weeks, and achieve an ROI in months. Any tweaks and fixes are done in hours, not days or weeks.


The benefits of using Digital Workers are striking​

  • increased speed 

  • reduced processing costs

  • reduced on-boarding and training

  • improved quality and consistency

  • adherence to business policies

  • 24/7 processing

  • And most importantly, human resources are freed up to deal with complex nuanced problems and other value added activities that drive supplier satisfaction and retention.

Decide Your Best Approach

The SoftBot No-Code RPA Platform

SoftBot's no-code Robotic Process Automation (RPA) platform lowers economic barriers to entry, enabling small and medium-sized businesses (SMB) to access a low-cost Digital Workforce that scales with your business needs; ensuring that you achieve an ROI within months, not years. Available as standard for deployment on-premise or in the cloud.

The SoftBot platform enables quick, agile implementations through rapid iteration of a production system. That means it will be deployed in days, not weeks. There is no need to write code to tell the Digital Worker what to do; and if an omission needs to be fixed or an improvement made, it only takes hours not days.

SoftBot's no-code Robotic Process Automation (RPA) platform will orchestrate the tasks to be executed within the business across the available workforce. This orchestration also manages escalations and exceptions. The typical benefits of this are:

  • Speeding up of individual task performance

  • Greater transaction throughput

  • Improved quality of results

  • Real-time monitoring of performance

  • Measured and controlled business processes (CMMI Level 4)

  • Data collection for business process improvement, providing the foundation for CMMI Level 5 - Optimising.

The combination of orchestration and automation has the possibility of delivering a whole that truly is greater than the sum of the parts.

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