RPA can process GI claim forms and documents, freeing up employees to focus on complex claims

Updated: Aug 5, 2019

Claims intake represents a significant portion of policy servicing costs, but cost shouldn’t be the only priority, it’s also a major customer experience touch point. A simple and fast claims process can also be efficient, meaning an insurer can achieve a high level of customer experience whilst maintaining a cost advantage. While claims system technology may lag behind expectations, forcing employees to perform manual tasks, RPA can be quickly deployed for simple claims to close the gaps.

In general insurance, the claims process continually proves to be a moment of truth during a customer’s journey. When isolating the process steps, claim submission is a large issue, as customers often receive untimely feedback of additional requirements, further delaying the process and causing frustration. RPA offers a two-part solution to insurance-document intake.


First, upon receiving documents, RPA can verify the document has been correctly completed, and if so, extract and input the relevant information to the claims system. In the event that the document has incorrect or incomplete information, RPA can provide immediate and targeted feedback to the customer, notifying them of the document to be resubmitted and specifying the incorrect/incomplete information.


Secondly, when documents are received and processed, RPA can reference a claim submission checklist and notify the customer of any outstanding documents. A significant customer pain point is submitting a claim and receiving feedback several business days later notifying them of additional required information. RPA can significantly reduce this feedback cycle from days to minutes, allowing the customer to quickly respond with the relevant information, without an unnecessary time-lag.


Once the insurer has all relevant information, completed and correct, the claims process is usually automated and straight-through-processed (STP). An additional value-add for RPA is that it can use business rules to escalate claims, if necessary.


In short, RPA allows an insurer to improve customer experience, claims payment times and improve process accuracy, all whilst reducing costs.


The Bot in a Nutshell:


As a customer submits claim documents (claim forms, supporting documents, receipts, etc.), the bot reviews the documents, and enters the relevant information into the claims system. If the document is incomplete, the bot will notify the customer and request a new version. As additional documents are received, the bot will also notify the customer which documents remain outstanding, to ensure the customer understands the additional information required to process the claim.


Main Functions:

  • Customers can be immediately notified if they fail to submit all required documentation, or if documentation is incorrect/incomplete

  • Using OCR, documentation is entered into core systems, reducing manual keying and data quality errors

  • Simple claims can be straight-through-processed and paid immediately

  • Employees can focus on value-added tasks, like complex claims and investigations


High-Level Plan


Main Benefits:

  • Customer satisfaction

  • Cost & scalability

  • Process reliability


Hands-On Considerations


Pain points targeted:

  • Processing time

  • Scalability during peak volume

  • Cost reduction

Challenges to expect:

  • Document variability

  • Complex products


What will the bot do?