The Challenge
The insurer identified a critical opportunity to harness GenAI technology to dramatically reduce the time spent reviewing claim notes. Traditional manual review methods were time-consuming, inconsistent, and created processing delays. This affected customer satisfaction, adjuster productivity, and overall operational efficiency across the claims department.
Claims adjusters were spending hours reading through extensive claim documentation for each case, creating bottlenecks and delays in the workflow. The manual review process was not only time-consuming but also inconsistent, leading to processing delays that impacted the overall efficiency of the claims department.
Objectives
The company’s objectives were clear: deploy an AI solution to automatically extract and summarise key information from claim notes, reduce processing time, improve accuracy, and eliminate processing bottlenecks.
The Solution
Strategies
The leading insurer decided to adopt a GenAI-powered claims notes summarisation system to analyse complex claim documentation and provide instant, structured summaries.
Collaboration
To successfully achieve these objectives, they collaborated with Advancing Analytics, a specialised consultancy with deep expertise in applying AI solutions to transform business operations. Advancing Analytics worked closely with their claims team to understand their requirement before deploying the solution.
Tools & Technologies
The implementation leveraged state-of-the-art large language models, to ensure accuracy and relevance in extracting critical claim information.
The Results
This transformation unlocked the following benefits:
Dramatic Time Savings: Processing time for each claim reduced from 30 minutes to just 10 seconds. That is a remarkable 99.4% reduction that eliminated workflow bottlenecks
Enhanced Adjuster Focus: Claims adjusters now spend their time on critical decision-making rather than document review, optimising their expertise and improving job satisfaction.
Structured Information: The AI system delivers consistent, structured summaries that improve understanding and standardise the claims evaluation process.
Operational Efficiency: With the significant reduction in processing time, the claims department can handle much higher volumes without additional staffing requirements.
Key Learnings
The company’s partnership with Advancing Analytics was instrumental in the successful implementation of their AI-powered claims summarisation solution. The collaboration not only dramatically improved processing times and operational efficiency but also enhanced the quality and consistency of claims decisions.
