How to Automate Insurance Claims Processes

The insurance claims process is the process by which policyholders submit claims to insurance companies for reimbursement or compensation. This process can be complex and time-consuming, involving the collection and submission of a large amount of information and documentation.

How the Traditional Insurance Claim Process Works

The first step in the insurance claims process is for the policyholder to collect the necessary information and documentation. This can include the details of the loss or damage, such as the date, time, and location of the incident, as well as any supporting documentation, such as photos, receipts, or reports.

Once this information has been collected, the policyholder must then prepare and submit the claim to the insurance company. This typically involves filling out a claim form and attaching all of the necessary documentation. The claim form and documentation are then sent to the insurance company for review and processing.

The insurance company will then review the claim to ensure that it is complete and accurate. This can involve verifying the policyholder's coverage, the details of the loss or damage, and the supporting documentation. The insurance company may also contact the policyholder to request additional information or clarification if needed.

Once the claim has been reviewed and any necessary information has been obtained, the insurance company will determine the amount of reimbursement or compensation that is owed to the policyholder. This amount is based on the policyholder's coverage and the details of the loss or damage. The insurance company will then issue a payment to the policyholder for the amount of the reimbursement or compensation.

The entire insurance claims process can be complex and time-consuming, involving the collection, submission, and review of a large amount of information and documentation. This can result in delays in reimbursement or compensation for policyholders, which can impact their financial health and ability to recover from a loss or damage.

How Does Automation Fit into All of This?

Robotic process automation (RPA) can help speed up the insurance claims process by automating certain tasks and reducing the need for human intervention. For example, RPA can be used to automate the collection and submission of information and documentation, as well as the review and processing of claims by the insurance company.

By using RPA, insurance companies can streamline their claims process, reducing the amount of time and effort required to collect, submit, and review claims. This can result in faster reimbursement or compensation, which can improve the financial health of policyholders and enable them to recover more quickly from a loss or damage.

In addition to speeding up the claims process, RPA can also help improve the accuracy and compliance of claims. By automating the collection and submission of information and documentation, RPA can help ensure that claims are complete and accurate, reducing the risk of errors and rejection by insurance companies. This can improve the chances of successful reimbursement or compensation and help insurance companies avoid financial penalties for non-compliance.

RPA vs. BPO

While RPA is well-suited to automating certain tasks in the insurance claims process, there are some use cases in the insurance industry that are better suited to business process outsourcing (BPO) than RPA. BPO involves outsourcing certain business processes to third-party service providers, and it can help insurance companies access specialized expertise and economies of scale.

For example, BPO can be used to outsource the management of complex and time-consuming processes, such as underwriting and risk assessment, to specialized service providers. These providers have the expertise and resources to handle these tasks efficiently and accurately, which can help insurance companies save time and money.

In addition, BPO can be used to outsource the management of large volumes of data, such as policyholder information and claims data. This can help insurance companies reduce the need for expensive and complex information technology systems, and it can also help them ensure the privacy and security of policyholder data.

Stealth Scaling's Hybrid Solution

By combining the best use cases of both RPAaaS and BPO, Stealth Scaling is providing an affordable solution to automation for mid-market companies. By having a human-in-the-loop supervise and handle exceptions made by our bots, we take what's best about BPO services and what's best about RPA and combine them into one, ultimate service.

If you would like to get a free automation evaluation please fill out our contact form and our automation specialists will get in touch with you right away!