Claims processing is a key function in insurance. This is the point where claims can get rejected, leading to dissatisfaction. It is also the stage where fraudsters try to trick the system and get fraudulent claims passed. Thankfully, technology is helping insurers make claims processing more efficient. Artificial Intelligence and Machine Learning is transforming the way insurers are working, we look at this in detail.
AI and ML in Claims processing
AI or Artificial Intelligence is a technology that allows computers to mimic humans and work like them. Machine Learning or ML gives computers the ability to learn from experience just like humans do. AI and ML are revolutionary technologies that are transforming the insurance industry. In the area of claims processing, AI and ML plays a key role in Fraud detection and also makes claims processing more efficient.
Fraud detection using AI and ML
306 billion dollars is the cost for insurance companies due to fraud. Insurance fraud leads to insurers increasing prices to cope up with risks, which leads to unhappy customers. AI and ML can help in detecting and even preventing fraud. This would lead to huge savings for insurers, which can then benefit customers. Here’s how AI can help:
- On a real-time basis, AI and ML systems can spot anomalies at the time of receiving notice of loss. Using data from past claims and internal database on fraud patterns, AI can trigger potential fraud alert.
- AI can do a deep investigation of users looking into their social media activity and data from external sources. Such an investigation helps in deciphering user behavior, which can then be used to detect fraud.
- The learning ability of ML puts insurers one step ahead of fraudsters allowing them to predict what they would do, rather than wait for a fraud to be committed.
Enhanced Claims Processing
Claims processing can take up a lot of time and requires a lot of effort. AI can help in reducing cycle time and improving overall efficiency. The following explains how:
- AI chatbots can save time and effort spent by executives in manual processes.
- The claims processing is sped up when automated.
- AI ensures claims processing is error-free saving costs.
- Ability to detect frauds easily ensures for faster claims processing.
Enhanced claims processing improves customer satisfaction, which can benefit insurers. Investing in AI and ML can help insurers save money and provide a better user experience. The article has been written by Bahaa Abdul Hussein and has been published by the editorial board of Fintek Diary. For more info, please visit www.fintekdiary.com.
