Insurance
Claims Processing Automation
for a National Insurer
Key Results
70%
Faster
Adjudication
$4.1M
Annual
Savings
96%
Accuracy
Rate
The Challenge
A national insurer processed 100,000+ claims monthly with significant backlogs. Manual review created delays and inconsistent decisions.
Pain Points
- 14-day average claim resolution
- 25% of claims escalated for review
- Inconsistent adjudication decisions
- Growing customer complaints
The Solution
We built an intelligent claims processing system:
1
Auto-triage
ML-based routing to appropriate handlers
2
Document analysis
Automated extraction of claim details
3
Decision support
Recommendation engine for adjusters
Timeline: 14 weeks to production
The Results
Before
- 14-day resolution
- 25% escalation rate
- Inconsistent decisions
- High complaints
After
- 4.2-day resolution
- 9% escalation rate
- Consistent outcomes
- NPS up 34 points
"Claims that used to take two weeks now resolve in days. Our adjusters focus on complex cases while AI handles the routine."