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CLAIMS ANALYTICS


Critical moment of truth for the Insurance business

Insurance claims are tricky. By using effective claims analytics models, insurers can predict claims and identify potential fraud in advance, as well as optimize claim outs and deliver a much superior customer experience.

CLAIMS IS A COMPLICATED BUSINESS

A typical claim process comprises of intimation, registration, handling and settlement as sub-steps. Each of these sub-steps impact the claim experience for a policy-holder or representatives of a policyholder. Simultaneously, each sub-step has multi-dimensional impact for an insurance carrier and as well intermediaries involved, if any. The claim process subsumes a number of decision points that include operations, risk management, settlement amount and loyalty.

CLAIM YOUR DATA

For each claim decision point, data points are generated and available with Insurers. The available data on claims varies with the line of business, the size of the business and the defined claim process. A typical claim process comprises data across structured and unstructured formats. Analysis of these datasets has potential to impact business dimensions such as loss ratio, claim settlement ratio, risk profiling and so on. Since the claim data is long term in nature, it is ideal for the development of predictive models that can drive optimized claims analytics.

CLAIMS ANALYTICS

Aureus claims analytics solution empowers an Insurer to aggregate structured and unstructured datasets across each sub-step and drive impact using both predictive and point of decision frameworks. CRUX can model claim analytics for each insurer based on the key factors that specifically impact their business, and is able to work with multiple systems involved in the claims cycle and process large amounts of structured and unstructured content recorded historically.

By using advanced predictive analytics and machine learning, CRUX helps organizations develop better customer risk profiles and cut down the total time in claims settlement. Better claims settlement TATs help make the customer experience easier and hassle free, while at the same time making it tough for fraudulent claims to pass through.




Resources


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