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Claims Management

Overview

The “Claim Moment” is the most important moment of truth in the insurance customer lifecycle. The customer may have had a superior quoting and contracting experience, a superior customer service during the contract lifecycle, but when a claim occurs, either big or small, how the insurer and specifically the claims manager handle it can ultimately lead to a customer loss. Since a claim can be a difficult and emotive experience for the customer, the ideal claim should be quickly settled and at the same time generate no additional hassle or resentment. Keeping the customer informed about the claim’s status, presenting fact-based arguments for policy coverage and exclusions and related indemnities/reimbursements (that optimally should already have been clear during the contracting stage), and facilitate all the interactions that are required to be conducted by the customer are key factors for a successful claim’s process outcome.

Solutions

Claims Workflow

Claims workflows are core to the claims management process. As orchestrators, they guarantee process consistency and transparency, by integrating all the relevant claims-related data with other systems, sharing it with the appropriate stakeholders, manage decisions and delegate actions according to roles and responsibilities.

  • Workflow
  • Mobile
  • Low-code
  • Automation
  • API
Cognitive Claims Document Extraction | Data Capture

Automate the handling of the essential documents used in quoting, underwriting, and contracting by automatically classify, extract relevant data, and integrate that data with workflows and core systems.

  • Artificial Intelligence
  • Automation
  • Low-code
Service Provider Engagement in Claims

Insurance service providers are critical to claims processes and many times impact, positively or negatively, customer satisfaction. Engagement with service providers through Portals, Apps, Chatbots and API that are tightly integrated with claims workflows lead to higher claims handling efficiency and effectiveness. Service provider rule-based routing, service scheduling automation, service contract-based validations and auto-invoicing/auto-payment are some of important features that need to be incorporated in Service Provider Portals, Apps, Chatbots and APIs.

  • Portal
  • Mobile
  • Chatbot
  • Low-code
  • API
  • Web services
Claims Chatbots

Deliver a frictionless customer service experience with a chatbot that guides the customer through his needs and concerns regarding claims.

  • Chatbot
  • Automation
  • Natural Language
  • Artificial Intelligence
Simplified Payouts/Claims reimbursement

Improve Customer experience by offering multiple payout/reimbursement options based on customized rules related to insurance products, reimbursement amounts and distribution channels.

  • Payments
  • Automation
  • Compliance
Claims Litigation management

Control, in a centralized, shared environment, supported by Portals and Apps, claims-related litigation processes, bringing together customers, litigation process managers and lawyers.

  • Portal
  • Mobile
  • Low-code
Simplified Customer Communications

Digital, omnichannel communications help insurers connect with their customers at the right time, with the right message and content and through the right channel.

  • Omnichannel communication
  • Automation

Partners

Docdigitizer Foreteller Theros Uniksystem