Conventional claims authentication is often time-consuming and vulnerable to capturing faulty data. The claim intake processes are irregular resulting in staggered claim data. Documents from customers, agents, field adjusters and other stakeholders come in a variety of forms and consume a lot of time and effort to extract meaningful claim data manually. As a result, organizations are more suspectable to Insurance fraud which is quickly becoming one of the most serious issues in the insurance industry.
Most existing claim systems can’t identify potential frauds with accuracy and tend to address it at the very initial stage for detailed scrutinization. Traditional statistics-driven fraud detection techniques incur high costs. The cost of employing an Insurance investigator can run into millions over a year for an insurance company depending on the volume and type of claim supported.
The Coforge DigitAll Claim Authentication solution is powered by the Pega Customer Decision Hub (CDH) platform to enable end-to-end digital claim authentication process flow specifically for Motor lines of Insurance.
The process lifecycle, data fields, document templates are all designed to take care of the claim authentication process of a Motor Insurance claim. The solution collects claim information from different peripheral systems as well as customer digital devices like smartwatch, IoT implants in the vehicles etc. and applies Photo analysis, document extraction and predictive analytics capabilities to accurately establish the authenticity factor of a Motor Claim.
The solution can be extended to other lines of P&C Insurance by making certain configurable changes to the analytics parameters and the decisioning business rules.
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