Insurance companies that have digitized their business operations are outperforming slower adopters – and the proof is reflected in their financial performance. The McKinsey Global Institute reports that overall top digital insurers have reduced costs while almost doubling growth. Insurers want to continue to find ways to leverage new technology to optimize their businesses, particularly when it comes to lowering costs and rooting-out fraudulent claims.

Insurers have made substantial technology investments to make claims filing and processing easier and faster for customers through a multitude of channels, especially mobile. Those investments will continue, particularly in technology such as Artificial Intelligence (AI), as insurers look to automate many repeatable processes, save money and re-invest in the business.

Hello there
Nice to see you!

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I got in a fender-bender and need to submit a claim
I’m sorry to hear about your accident, let’s get started on filing your claim.

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Insurers also need to stay competitive and keep up with consumer trends, especially among younger generations who demand greater speed and efficiency in claim services. In a report from Capgemini, a majority of younger, tech-savvy customers surveyed said they would find new insurance providers if they received poor service or were unable to use their preferred digital channels.

When a company hires Amelia, the market-leading digital colleague, to join their team, they gain the ability to achieve all of these goals — make claims processing more efficient, while subsequently creating positive customer experiences.

What Amelia Can Do

Amelia can handle the end-to-end claims process faster than human agents, with a high degree of personalized service and an ability to learn and improve over time. She can also collaborate and guide her human colleagues in various customer interactions, assist in detecting possible fraud, and help the business remain fully compliant with industry regulations.

Filing claims: Using her advanced workflow and integration abilities, Amelia can intake customer insurance claims by the processes she learns through automated training. For example, if a customer needs to file a claim following an auto accident, Amelia can pull-up all relevant policy and customer data during her initial customer session, confirm identity, and walk the customer through the process step-by-step. She also can ensure a customer uploads all relevant information, such as photos of the damage or police reports, and inform a customer if they’ll need to pay a deductible. Amelia will submit all material to the customer’s insurer for assessment and processing.

There is so much data involved with even simple claims.

No problem, I aggregate relevant data from multiple sources and package it for insurance processors.

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General claims inquiries: Through her conversational interface, Amelia can answer a customer’s policy questions as they relate to an insurance claim, such as coverage information and potential liability. Amelia also can provide information and updates on claim status, including when inspections can be scheduled if necessary, or when a claim will be paid. Dealing with insurance claims, especially following an accident or home damage, can be a draining experience for customers. Amelia’s emotional intelligence allows her to detect sentiment and display empathy, assuring customers that their claims will be handled as fast as possible.

Fraud detection: For her human colleagues, Amelia becomes a valuable team member for claims processing, especially when it comes to weeding-out hackers or identifying fraud. With her advanced analytics, she can identify patterns that may indicate a caller is attempting to deceive an insurer; for example, she can record calls made from the same phone number for separate accidents in different locations over a short period of time, and flag those calls to live agents. Alternatively, she can recognize and report that a caller is claiming a car accident occurred in a deserted area with very light vehicular traffic. She can even ask clarifying questions of a caller who claims physical injury from an accident, compare that with the data she’s learned from previous interactions, and note whether the injuries are consistent with similar scenarios. With Amelia as a first-line investigator, she can cut down or eliminate the time that live agents would need to dedicate to the initial claims process, allowing them to make more detailed inquiries and determinations. With her self-learning capability, Amelia can assist insurance agents in the background as they interact live with customers, and she’ll observe those interactions discretely to learn how to handle similar questions in the future.

All of these services can be delivered on a platform that is highly scalable to handle high volumes, and available 24/7, so customers can file and manage claims whatever time of the day or night. With her natural language functionality, Amelia can recognize everything from full sentences to short phrases, so she can interact with customers in local languages.

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Results

As consumers demand faster services, Amelia brings new levels of efficiency and accuracy to the end-to-end claims process, delivering benefits to customers, insurers and their employees.

Amelia observes human agents’ interactions, which allows her to improve over time.

Decreased support costs: With Amelia’s intelligence and scaling at the center of the claims process, insurers can reduce high call volumes and take pressure off of their overworked IT support personnel and stretched technology budgets.

Claims processing and fraud detection: Amelia’s machine-speed integration allows her to provide fast, accurate services throughout the claims process, resulting in a measurable decrease in transaction times and accuracy levels of up to 85% for certain functions and transactions. She can provide similar benefits for fraud detection; for one customer, she is identifying user accounts correctly 99% of the time, and weeding out potential hackers and phishers.

Improved customer experience: Amelia is available whenever a customer needs to file a claim, so a customer always feels connected to and in control of the claims process, with full transparency. Amelia can make customers feel that an insurer values their business, building brand loyalty.

Enhanced workforce: Amelia helps human insurance agents and processors do their jobs more efficiently, raising overall workforce productivity. With Amelia handling more routine parts of the process, human colleagues can concentrate on processing and paying out claims, with Amelia informing policyholders when a claims payment is on the way.