Process Mining | Intelligent RPA | Cognitive AI
Insurance Industry

Insurance Use Cases

Insurance use cases are mostly focused on Customer life cycle management, Agent and compensation management and  New Business and Insurance Claims processing:

    • Customer Life cycle Management
    • New Business Processing
    • Licensing and Compensation
    • Insurance Claims Processing

Let’s now see some industry-specific examples of automation

1. Communication with brokers

The insurance industry business model involves brokers. Working with many brokers generate a lot of paperwork (as the contracts are signed between 3 parties), validation (given that the conditions for each broker are unique) and processing work

UiPath attended robot that took over almost the entire communication with the brokers, from the moment when the email is received, by verifying the attachments, confirming the contractual conditions available for that particular broker, making the fraud verifications and approving the requirements.

Human intervention is needed only for business exception handling.

2. Claim processing

Insurance is a large volume business, with lots of clients, policies, and papers to verify and validate. Consequently, the amount of manual work and the fraud risk are both high, especially at the claim processing time.

UiPath unattended robot that is able to process claim emails, categorize and check the attachments, make fraud verifications and authorize payments if there are no flags. All the claims with fraud suspicions and business exceptions are forwarded to claim inspectors, which receive them via email in the morning.

3. Claim Closing

To close a claim on the SaaS based web application called Conversense, following that close the claim on Legacy system where all the subfiles under the claim needed to be closed before closing the claim. All subfile could only be closed if the amount under them was 0.

This had another real issue in that because of the distraction of phone calls, emails and faxes sometimes the claim adjuster forgot to close the claim on the legacy system that resulted in reconciliation issues later that took lot of time.

UiPath attended bot that was able to take the policy number and date of issue as input from the claim adjuster and go to Conversense to search for the claim. Once found went to the legacy system and found the claim, close all subfiles under the claim and close the claim on Legacy system before heading over to the web application to close the claim there and put standard comments . The bot had its own credentials which were recorded under the closed claim for audit purposes.

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