Automated Claims Processing System for a Leading Insurance Firm (USA)

Project Overview:
We partnered with a top-tier insurance company in the United States to revolutionize their claims processing operations. The client faced challenges with slow turnaround times, manual errors, and rising operational costs due to heavily paper-based workflows and manual data entry.

Our Solution:
We designed and implemented an end-to-end Robotic Process Automation (RPA) system to streamline claims processing from initial intake to final resolution. Key components included:

• AI-powered document scanning and Optical Character Recognition (OCR): Enabled automatic extraction of key data points from scanned claims forms, eliminating manual input errors.

• Workflow automation: Built RPA bots to handle repetitive tasks such as data validation, policy checks, and claims adjudication routing across multiple internal systems.

• System integration: Integrated the RPA platform with the client’s existing claims management software, CRM, and legacy databases for seamless data flow and reporting.

• Exception handling protocols: Developed rules to escalate complex or incomplete claims to human agents, ensuring accuracy without sacrificing speed.

Results & Impact:

• Reduced claims processing time by 70%, bringing average turnaround time from 10 days down to 3 days

• Improved customer response time, enabling quicker settlement and enhanced customer satisfaction

• Lowered operational costs by 45% by reducing manual labor and eliminating bottlenecks

• Increased accuracy, reducing claims processing errors by over 90%

• Freed up claims agents to focus on complex, high-value cases instead of repetitive administrative tasks