How AI will make “simple” claims even simpler

Many insurers across Europe use the skills and experience of their claims handlers to settle simpler claims themselves (often cases where the disability is assessed to be less than 5%), without the involvement of medical experts. This is what we call “desktop assessments”. And in many markets, this kind of evaluations are on the rise. Why?

As expectations from customers for quick responses are increasing, a speedy and accurate claims journey is going to be a key factor in achieving customer satisfaction moving forward. By unleashing the power of AI in claims, you could both increase the share of claims handled this way AND reduce the current average time spent on each desktop assessment case, thus keeping on top of increasing caseloads. How?

Using advanced AI algorithms, you can semantically extract claims data, creating structure to information earlier hidden in an unstructured format in medical documents. Say goodbye to reading through hundreds of pages of medical documents, trying to pinpoint key events and dates. With the help of AI, you can get all events presented visually in a timeline of all events in the documentation, allowing claims adjusters to read up a case three times faster and reduce the number of errors.

Key benefits of AI in claims management:

Increase the share of assessments managed directly by your claims team, ensuring shorter handling times and reduced costs.
Decrease the handling time for “desktop assessment” cases with 30%.
Empower your team by ensuring that they are claims adjusters in the true sense of the word, instead of “just” claims handlers. You will find that it will be easier to attract and keep skilled staff when you empower them to make decisions supported by the right technology.
Get more time for the human touch where it adds value to the process: in the ever so important interaction with the customer. Stop wasting time on endless administration and looking for the right information.
Shorten learning time for new staff and their mentors, as reading up on each case will be easier and quicker.
Increase team performance as less time is spent on each case.
Increase accuracy: An experienced medical advisor might have handled 5000 cases, with the help of AI you can get aggregated advice from the system based on ALL similar previous cases.

The outcome? A shorter, more accurate and straighter line between your claims team and the customer, meeting the customers’ ever-increasing demand for shorter handling times. And no, neither the claims adjusters nor the medical advisors are redundant. But with the help of AI, they can use their professional skills where they are most useful. For the claims adjusters, that means spending more time interacting with the customers, and for the medical advisors it means they can assess more complex cases and spend less time sorting through documents, without looking for that needle in a haystack.

Emma Hansson