Robotic Process Automation for Insurance

by CRMT | Apr 17, 2020 | Blog

We live in a world where the future is becoming less and less predictable every day. If insurers want to meet tomorrow’s needs, they will need to transform and become more agile in day-to-day business. According to experts, changing customer behavior, new technologies and business models are going to change the insurance industry in the next 5-10 years and it is already happening.

In order to stay ahead, more and more insurance companies are implementing automation as a way of reducing time-consuming processes in back-offices, which are high-volume and repetitive.

Today, in the form of Robotic Process Automation (RPA), we have robots do “simple” and “boring” tasks. Without human help, RPA can quickly and accurately automate processes and customer interaction that would normally require a high level of human involvement, freeing the employee to perform more knowledge work.

RPA implementation not only reduces labor costs and brings higher ROI, but also increases efficiency, removes the possibility of human error and reduces the time of data collection and improves their quality.

According to Gartner, Robotic Process Automation (RPA) is the fastest-growing segment in the worldwide enterprise software market. By the end of 2020, Gartner predicts that RPA services will be valued at £5.98 billion.

The ideal candidates for RPA:

  • High volume of processes
  • Repetitive tasks
  • Manual Data entry
  • Multiple Legacy Systems
  • Rule-based and structured process

Tasks 

Most insurance companies rely on old legacy systems that not communicate well with each other. Thus, a worker steps in to provide a “bridge” between these systems, which leads to spending hours and days on getting and transcribing data: opening e-mails, copy-pasting between systems and so forth, which decreases time used for more knowledgeable work and decision-making.

Here is where RPA comes to the rescue.

The list of tasks that RPA can perform is very long and I am listing a few most common examples here, for more you can visit our landing page here:

  • Opening e-mails and attachments
  • Reading and writing from databases
  • API calls
  • Reading and writing to Excel
  • Implementation of processes with IF-THEN-ELSE conditional
  • Data transfer between applications and systems

Use Cases in Insurance

There are several use-cases specific for the insurance industry, where the implementation of RPA can lead to better results and here are some of them:

1. Claims Processing – Typically, claims processing takes several days since agents need to collect and check data (medical reports, photos of damage, police reports, etc.). It can take even more time due to agents’ errors, such as typing in wrong financial data or customer details. Implementing RPA, the workflow of claims processing can be automated from receiving claims until claim settlement eliminating the possibility of human error. Automated claims processing can reduce the amount of manual work by 80% and cut time for the claim process by 50%. This will also lead to better customer experience since back-office tasks are performed faster, with fewer errors and delays.

2. Regulatory Compliance - Insurance companies deal with strict regulations and audit trails. Automation in insurance helps companies improve the accuracy of data which allows companies to monitor regulatory compliance data in real-time through internal reviews and can be prepared in case of external audit. Basically, with RPA you can automate all your internal and external reports.

3. Underwriting – Another use case of automation in insurance is underwriting. RPA can help in gathering and analyzing information from different sources such as health risk, financial limits, credit-score, duplicate policies, etc. All mentioned reduces the risk of fraud.

4. Business and process analytics – Using RPA, insurance companies are able to improve their data collection and analytics, which gives the ability to employees and decision-makers to track and record all actions undertaken. This means less workload on employees, which allows them to focus more on customers and their needs.

Case Study

In this RPA use-case example, agent XY processes insurance claims through the company’s various systems and applications. Each claim takes a certain amount of time and the agent has a queue of pending claims, which is the reason a claim can take few days to be processed and it takes a long time for policyholders to receive money.

Here’s how a pre-RPA workflow looks like:

  • Agent receives new mail with new claim and documentation. First, agent needs to save the email and attachments in a dedicated claim folder.
  • Agent opens the claim, copies the account number to a specific company and finds a policyholder account.
  • Then agent opens claims program and compares all information in claim and checks if everything matches the policyholder account.
  • Agent copies all required information (such as name, date of birth, account number, claim number, etc.) into the claims system and finally attaches the PDF file.
  • Agent removes PDF from the queue and sends an email to the payment department, notifying that claim is complete and can be paid.
  • But in meantime, while processing this claim, agent received another 10-15 claims which are now in the queue and she needs to be an expert in copying and pasting, so she can manage to process all claims in the queue.

And this is post-RPA workflow:

  • Agent receives mail and runs robot (RPA).
  • Robot searches for agent’s claims mail folder and saves email and attachment in the claim network driver folder.
  • Robot opens claim, searches for policyholder’s account number, copies it to claims system program and checks all necessary information between the claim and the account. If there are any information discrepancies, robot will move those claims in a special folder, called “Needs to be checked”, thus helping the employee to find all unprocessed claims.
  • If information matches, robot continues processing and attaches the PDF.
  • Finally, robot uses a pre-made email template to send emails to the payment department, notifying them that the claim is completed and ready to be paid.
  • Robots runs on a loop and it continues to next claim in queue.
  • Agent goes home but leaves the robot running. Next day agent comes to work, robot processed all claims from day before, letting agent to deal with only “Needs to be checked” folder and fix any discrepancies.

And the best part is, if you are using a robot for claims processing 2 hours, you have 22 hours left for other processes to automate because a robot is available 24/7.

The situation with COVID-19 showed us all weaknesses and flaws of the global economy.  The companies, small and medium-sized enterprises that are late with digital transformation suffer great losses and some don’t even exist anymore. While the global economy preparing for big changes, RPA is taking the center stage.

Whether we like it or not, robotic ages are here and if you are ready for your next employee of the year, contact us for more information.

To jumpstart your digitalization project in your company, we are offering FREE Robotiq.ai software use until the end of May 2020. To grab this opportunity click here

 

Sources:
https://hackernoon.com/7-robotic-process-automation-rpa-predictions-for-2020-bpl434zt
https://www.entrepreneur.com/article/334522
https://thelabconsulting.com/rpa-in-insurance-robot-process-automation-in-insurance-claims-processing/
https://blogs.perficient.com/2017/08/08/rpa-drives-further-automation-in-digital-transformation/