Claims

Life and health insurers are constantly on the lookout for new ways to differentiate themselves from competitors in what is increasingly becoming a commoditized industry. Many insurers consider superior claims management at the top of the list. Life & Health insurers have historically under-invested in claims systems modernization as compared to P&C insurers. With customer expectations rising, especially with the rapid growth of voluntary insurance products, claims management is becoming an area of focus for most life & health insurers. 

There are several opportunities to transform claims operations: 

• Improving the claims intake process: Making it easier for customers to submit claims by guiding customers through reflexive questioning and prefilling data 
• Leveraging AI to extract the required information from supporting documents such as hospital bills, diagnostic reports 
• Skill-based routing, triage, and auto-adjudication resulting in a higher level of straight-through processing 
• Faster turn-around time 
• Proactive communication 
• Using advanced analytics and AI, third-party data for fraud scoring
   

Coforge has over a decade of experience in helping life & health insurers transform their claims and benefit systems. Our deep domain expertise in this space helps us understand the key challenges of insurance carriers. Our L&A domain experts also track the industry trends closely and develop accelerators and solutions. These accelerators and solutions enable us to help our customers to achieve their goals faster.