Insurance and Claims processing solution

Insurance Services Case study

Short term and Life insurance services provider

Case study details

For this case study, our client is an Insurance service provider

The Customer provides short term and life insurance services. They also deal with external parties for which they process claims.

Claims and applications are received via various input methods

The challenge

The Customer business challenge was to process insurance claim documents as soos as possible. Especially death claims which had the highest priority. 20% were received by courier from various branches and had to be scanned. 80% of the claims were received electronically via fax and email into various email mailboxes. Multiple attachment types including PDF, TIF, JPEG, DOC, EXCEL etc. was sent.

Consultants used a very remedial capture solution to import the scanned and email documents. The email attachments had to be printed to a TIF printer before it could be viewed. Once the files were saved to local disk and uploaded to the system via manual batch creation processes, the consultants could then start to work on the indexing of the documents.

Turn around time for these claims were hours as the manual processes took up a lot of time. Once the documents were indexed, they were then exported as csv and image file. The files were them manually imported into their document management system.
Turn around time on claims was between 96-120 hours

Solution

DCM CORE was implemented in an on-premise solution to capture, classify, and extract and validate insurance documents.
First step was to consolidate and automate the incoming documents and the conversion to a standard processing format. Automated email extraction was configured whereby multiple email mailboxes could be monitored. New email bodies and attachments are automatically extracted and converted to PDF files for further processing. Via the central importing module all scanned documents and email are processed and batches are created without any user input.

Document classification and template matching is applied to the documents to assist with the indexing process. Documents are presented in a central capture interface with all documents securely store on the server and no local document processing is required.
Consultants can view the imported documents and perform index and data validations. Documents that were successfully classified and validated will be automatically saved for further processing

The system easily processes the current volumes of +/- 5000 emails with attachments per day. The processed documents have a 95% pass through rate, in other words 95% of the documents received are processed without human intervention.
On completion the documents are automatically ingested into their document management system and insurance workflow system
Turn around time of most of the documents is 2 -5 min per claim that must be indexed manually
This allows for a lot of time staff members can then spend on helping the business grow in different ways. DCM has not only saved time in processing of the documents but increased the speed of payouts to the claimants

Benefits

With DCM Core any file or document could be easily processed
Increasing staff productivity and time management
Delays looking for files and retrieving them was decreased by hours and sometimes days.
The paperless office saved the storage, printing and copying costs, was almost eliminated

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