Automation & Productivity

Unlock New Levels of Productivity and Efficiency with Five Sigma’s Automation-First Claims Management

Automation First – A Paradigm Shift in Claims Management

At Five Sigma, we designed our entire claims management platform with an “Automation First” mindset. What does this mean? It means that anything that can be done automatically by the platform without human intervention is done that way.

Our claims experts know from experience that adjusters spend a significant amount of time on data entry and repetitive manual tasks. By automating many of these tasks, the software handles them efficiently and accurately, without fatigue or human error, allowing adjusters to focus their time on tasks that require human expertise and smarts.

With Five Sigma’s automation, our customers can streamline their operations, cut costs, and accelerate the claims handling process. With an automated, AI-native platform, Five Sigma sets a new standard for efficiency and adaptability in the insurance industry.

Automation Means Business.

Automation plays a pivotal role in enhancing efficiency by streamlining repetitive and time-consuming tasks, allowing teams to focus on high-impact activities. By automating processes like data entry, communications, and workflow management, businesses can significantly reduce errors and accelerate operations.

This boost in efficiency directly translates into improved business KPIs, such as reduced costs and LAE, increased productivity, and faster turnaround times, enhancing overall business performance.

The automation capabilities also lower administrative overheads, directly reducing the expense ratio and enhancing the combined ratio. Additionally, Five Sigma platform expedites claims handling, enhances communication, and provides personalized customer interactions, leading to higher customer satisfaction, retention rates, and better Net Promoter Scores (NPS).

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improvement in time to first contact with automated FNOL

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improvement in claims cycle time

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improvement in time to settlement

Examples of Claims Automation

Our platform automates many critical steps in the claims process, drastically reducing the time that adjusters spend on routine tasks. This allows them to handle more claims, faster, and to concentrate on decision-making and customer interaction, where human intelligence triumphs.

Here are some examples of Five Sigma’s automated features along the claims lifecycle:

First Notice of Loss (FNOL) Data Population

  • Automatically populate claim forms with policyholder data upon receipt of FNOL.
  • Integrate data from external systems and documents to fill in details, reducing manual entry.

Automation First

Claims Triage and Assignment

  • Automatically categorize and route claims based on complexity, urgency, and adjuster expertise.
  • Assign claims to adjusters based on their workload and area of specialization.

Reserve Calculations

  • Use historical data and current claim details to automatically set or recommend reserve amounts.
  • Dynamically update reserves based on new information or changes in the claim status.

Vendor Recommendations and Selections

  • Suggests preferred vendors based on past performance, cost-effectiveness, and proximity to the loss location.
  • Automates the process of engaging with vendors, from selection through to invoicing and payment.

Communications Integration

  • Captures and logs all communications within the claims file, including emails, calls, and text messages.
  • Allows adjusters to send and receive communications directly through the platform.

Payment Processing

  • Automates the payment authorization process based on pre-set rules and limits.
  • Processes payments to policyholders and vendors directly through the platform.

Claims Status Updates

  • Provide real-time updates to policyholders about the status of their claims on their preferred communication channel.
  • Automatically notify adjusters about critical tasks or deadlines.

Compliance and Reporting

  • Ensure compliance with regulatory requirements by automatically applying relevant rules and protocols.
  • Automatically update policies according to the latest issued regulations.

Empowering Adjusters with Native AI and Data Insights

Five Sigma equips adjusters with practical AI tools and comprehensive data-driven insights, improving their confidence in making informed decisions on claims swiftly.

Five Sigma’s AI capabilities significantly enhance adjusters’ productivity. For example, the platform summarizes all communications, suggests the next steps in handling the claim, gives recommendations for settlement amounts based on past settlement data in similar cases, and more. As a result, claims handling time is much shorter. Adjusters are more productive and effective, allowing them to focus on value-add activities better handled by humans – such as decision making and customer interactions. They are also able to handle many more claims in less time, while maintaining high-quality service.

Strategic Management Tools to Maximize Team Productivity and Overall Operations

Dashbaord & Reporting

Five Sigma’s platform offers claims managers real-time dashboards and detailed reports on key performance indicators (KPIs), enhancing their ability to manage and guide their teams more effectively.

The dashboards display the entire claims lifecycle, status of claims, and operational trends, providing an overview of the claims operations. The dashboards offer critical insights into various aspects of the claims, such as frequency and causes of claims re-opening, cycle times for claims processing, analysis of claims settlement patterns, and more. As a customer, you’d also be able to customize the dashboards and reports that work for you.

In addition, the dashboards give you transparency over your team’s performance, on a team level and individual adjuster level. You’d be able to understand the workload of your team members, their throughput, and status of claims under their handling, so nothing falls between the cracks. In turn, this improves handling time and policyholder satisfaction.

Five Sigma also sends managers automated alerts to keep them informed of real-time developments.This allows for targeted improvements in operational workflows and empowers managers to make data-driven decisions that improve productivity and financials across the board.

See How Five Sigma’s Claims Automation Helped INSHUR in Reducing Cycle Time

Hear what INSHUR’s Head of Claims has to say about Five Sigma’s platform and how they started handling claims digitally in record time and reduced claims cycle time by 36%.

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