Claims Intelligence

What is Claims Intelligence?

Claims intelligence uses advanced claims technology and artificial intelligence to create personalized and contextual recommendations based on all the historical data on a customer and the data collected during the claim process, to facilitate a more efficient claims journey and help the claims adjuster achieve a better outcome. It provides the adjuster with smart recommendations; automatically calculates the reserve; recommends vendors; and overall, takes a lot of guesswork out of the claims process, using smart, automated AI-based insurance claims technology.

This improves insurers’ decision making by allowing businesses to create process models based on data analysis, and solves critical business challenges. Claims intelligence can assist insurers in automating processes that do not require human intervention, for example, assessing the damage to vehicles or properties using visual intelligence gathered via the Internet of Things (drone feeds, smart devices, etc.). Assessors can quickly make smarter decisions, shortening the claims process, reducing the cost of the process and increasing customer satisfaction.

Benefits of Claims Intelligence for Insurers

Claims intelligence offers insurers a range of benefits including:

  • More accurate customization of plans, so customers pay only for what they actually need, and insurers have the right reserves to pay claims.
  • Reduced human error as a result of increased automation in the application process, ensures that customers have the right plans for their needs, and saves the insurer time and resources.
  • Significantly reduces fraud by detecting patterns based on massive amounts of data, preventing major revenue losses, with savings passed onto the customer.
  • Helps insurers significantly reduce claims leakage by using AI and machine learning to automatically calculate claims payouts.
  • Automated decision-making capabilities results in quick claims resolution and reduces client churn.

How does Five Sigma make claims intelligence an asset for your organization?

Five Sigma knows how to turn the vast stores of your organization’s data into claims intelligence that enhances operational efficiency, improves the customer experience, and boosts future growth. At Five Sigma, we believe that all relevant data should be stored in one database. With this in mind, we developed our Claims Management Solution (CMS), a cloud-native, agile, and scalable SaaS solution that enables insurers to use claims intelligence to automate their entire claims management process.

Our CMS imports, collects, stores, and updates all data, including the claims-related communication in one database. It uses historical and online data to generate personalized and contextual recommendations that help adjusters perform better and facilitate a better claims journey. Complete visibility of data empower management with strategic insights that help insurers make smarter decisions to perfect their operations, sales processes, and more. Advanced API-based architecture enables integration with other applications and databases resulting in easy integration with policy administration, communication systems, and more.

Claims automation takes over tasks previously handled manually, such as filing or emailing reports, reducing the potential for human error. It also streamlines communication by sending alerts, tasks, or messages to adjusters, improving communication and creating greater organizational competency.

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