How RPA Helps the Insurance Industry Optimize Claims Processing

Robotic Process Automation for claims processing

Before we discuss how Robotic Process Automation helps insurance optimize claims processing, it will be unfair to not discuss the importance of claims processing. Claims processing is an integral part of the insurance industry. Accuracy and efficiency in claims processing directly reflect on different areas of a business. For example, it helps the business meet its commitment towards its customers, set service standards, engender customer loyalty, and fulfill obligations. Claims processing is subject to speed and accuracy for ensuring that the customer demands are met. It involves collaborations and contributions from various stakeholders working under administrative, managerial, and customer service departments to accomplish information-intensive manual tasks.

What are the major challenges before claims processing?

The use of RPA in insurance solves various use cases but claims processing is the best candidate for the implementation. Lying at the center of the insurance industry claims processing affects multiple areas of a business. When efficiently handled, it can help a business reimage customer experience and opinion. As insurance cannot be imagined without claims processing, claims processing cannot be imagined without certain challenges. Let’s discuss the, in brief.

Manual Data Entry

Conventional claims processing systems heavily rely on the human workforce to carry out labor-intensive manual work to deal with data stored in high volumes, disparate locations, and problematic document formats. Extreme dependency on manual labor results in highly inconsistent and error-prone claims processing. Moreover, complications add up when the projects are outsourced to third-party companies.

When sensitive data is handed to external employees, data security, and integrity issues pop up. Besides, dependency on unconcerned and unreliable workers leads to increased costs and additional time consumption in driving results.

Disparate Data Sources

Data is generated through various systems and comes from a number of paper-based as well as paper-less sources. Offline forms, electronic documents, images, emails, are just to name a few. In addition to this, websites and mobile apps also fetch a large amount of crucial yet voluminous data. As the data handling processes and systems are distinct, results lack fidelity and accountability.

Legacy Systems and Outdated Applications

The businesses dealing under the insurance sector find themselves trapped within a rigid framework comprised of legacy apps driving the key processes. Often, these apps aren’t compatible with advanced solutions as they weren’t designed for the newer and more updated technology.

Data Retrieval

In the morass created by software, processes, systems, and applications, data gets buried somewhere or becomes exceptionally difficult to retrieve. As a result, data retrieval may require higher costs, time, and efforts, thereby causing delays and inefficiency in claims processing.

Regulatory Compliance

Changes in regulations can affect claims processing in terms of time, efforts, and costs it takes. Sometimes, insurance needs to call off the entire process and investigate whether it meets the mandatory regulations. This can further come with its own set of challenges and roadblocks for the companies that operate in multiple locations, each with its own distinct set of laws and regulations.

What are the advantages of implementing Robotic Process Automation in claims processing?

The insurance industry can reduce turnaround time and increase efficiency by introducing a robotic workforce to handle claims processing and associated tasks. Let’s have a look at how software bots improve claims processing.

Streaming the Entire Process

Implementation of RPA in insurance eases claims settlement by streamlining various processes, including data entry from multiple channels, coverage verification, and issuance of settlement notifications. RPA helps companies gather data from sources such as online forms, emails, and mobile applications. RPA powered bots can eliminate tedious manual tasks like validating claims against the policy and reviewing for fraud. RPA can speed up the claims-related processes, including data collection, extraction, and transmission, without active participation from humans.

Reduction in Turnaround Time

As we discussed in the previous point, software bots can work in unattended mode and relieve employees to focus on activities that require reasoning, cognitive, and decision-making skills. With RPA in insurance, the staff working in this sector can engage better with customers and escape tedious and frustrating paperwork. By increasing efficiency through automating data organization, extraction, and transfer, RPA reduces the time required for processing a vast number of claims.

Higher Accuracy

RPA doesn’t only reduce the backlog in claims processing but also eliminates human errors. For example, insurance providers dealing in properties need to evaluate the damage estimates carefully. As this information comes from various sources, including paper-based as well as PDF files, maintaining 100% accuracy gets difficult when the processes are performed manually. RPA, on the other hand, can ensure accuracy and precision claims adjudication and settlement.

Higher Compliance

Businesses in insurance are bound by laws and regulations mandated by various local, national, and global regulatory and governing bodies. RPA can ensure optimum compliance with these laws and regulations by letting the software bots document all the steps of claims processing. As a result, it significantly improves insurance compliance as businesses can track and audit the records as and when needed without worrying about inaccuracy or loss of data.

Ability to Scale Up and Down

One of the most significant benefits of Robotic Process Automation is its feature that allows companies to create a virtual, digital workforce that can be scaled up and down depending upon seasonality. RPA can rescue your staff when work pressure is tremendously high, and claims requests are at the peak. Upscaling or downscaling operations can be done instantly. There is no additional cost involved with the increased volume.

Seamless Integration

Robotic Process Automation can be integrated into different systems and software seamlessly. Software robots can work in alliance with CRM, ERP, Helpdesk, Claim Application Software, and more. What’s more? In some cases, RPA can even boost your legacy applications and help you drive maximum value out of existing infrastructure.

In summary, is RPA the best fit for claims automation?

The one-word answer to this question is “Yes,” as Robotic Process Automation offers a vast range of benefits for insurance and claims processing. It enables claims processing to overcome various challenges, reduce processing time, and enhance customer satisfaction. RPA bots take care of burdensome and repetitive processes so that employees can focus on tasks that demand higher-level logic and judgment skills. Robots not only improve claims handling but also integrates enterprise systems without disrupting the existing processes in place. The bottom line, RPA automates rule-based tasks such as information gathering, report generation, data sharing, and managing process flow to help the insurance industry enhance customer experience, save costs, and increase operational efficiency.

Tareq Ali is enriching the web through storytelling where most of his stories revolve around humans and things influenced by fashion, fitness, and technology.