Solution Overview

Front Desk Assistant-Claims

AI-powered FNOL and claim set up for sharper accuracy, boosted productivity, and a smoother customer experience

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When insurers are first notified of a claim, it is still usually via an email that contains data and documents in different formats, such as unstructured text, attachments, and image files. If carriers have to process this information manually, it delays processing the claim and keeps customers waiting. A situation made worse with seasonal spikes in claims and catastrophe events.

Automating the non-voice and email-based FNOL process has big pay-offs, including greater efficiency, higher productivity, and an improved customer experience. This digitized FNOL data then helps highlight more cases of fraud, supports subrogation opportunities, and lays the foundation for advanced analysis and analytics.

The challenge

Take the pain out of FNOL and claim set-up

Dealing with a large volume of loss notices is the business reality for P&C insurers. They usually arrive as emails from brokers or agents, and contain details about the insured, the vehicle or property, and the actual loss, either in an unstructured form in the email itself, or in attachments. Claims teams then need to:

  • Process all of this information across different documents and formats
  • Extract the key data elements
  • Check for completeness and accuracy
  • Apply a set of validations and business rules
  • Enter it into the claims system
  • Assign the claim to an appropriate adjuster

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Clearly, this is a demanding, tedious, and error-prone process when done manually. But the variability of the content and formats means it’s difficult to automate using traditional technologies such as optical character recognition and robotic process automation. Processing claims notifications often slows to a crawl and the overall cycle time takes a hit.
All of this is bad news for the customer.

Our solution

Front Desk Assistant - Claims. Smart and intuitive AI

Fortunately, AI can address the challenges where traditional technologies fail. Genpact’s Front Desk Assistant - Claims (FDA) automates the entire lifecycle of claim intake and set up. It’s an AI-powered, intelligent machine that automates multiple tasks when processing email FNOL requests. It can handle content ranging from unstructured data in the email body, to attachments in various formats – including Excel, Word, PDF, and scanned images.

It’s based on the Genpact Cora platform, and leverages natural language understanding (NLU) capabilities to read, understand, and interpret emails and attachments. Once the relevant data has been extracted, FDA can apply carrier-specific/stipulated validations and business rules to review the claim before it is routed to an adjuster. It can also leverage NLU to interpret the loss description and identify the cause of loss. This capability can be extended to coverage verification as well. FDA is highly configurable to specific carrier needs – with minimal programming. FDA can help insurers:

  • Automate the intake and set-up processes
  • Extract key data fields and interpret unstructured content such as loss description
  • Classify documents in a traceable way
  • Apply business rules and validations
  • Flagging fraud and subrogation case potential at the point of notification
  • Serving as a modular solution that can integrate into any existing enterprise applications without disrupting underlying processes

Loss notices with missing data, or that don’t meet validation or business rules, are routed to an exception queue. Claims teams only need to process these exceptions.

Business impact

Seamless FNOL and claim set up. Prioritized workloads. Happier customers.

FDA fuses our deep insurance domain expertise and advanced AI capabilities, transforming insurers’ business processes and delivering impressive results. These include:

  • Happier customers with real-time, straight-through processing
  • 100% accuracy, improved data quality, and elimination of human error in data capture
  • Quicker claims intake and set up times
  • More accurate claims analysis to identify the cause of the loss, verify cover, and flag subrogation potential
  • Up to 60% reduction in operating costs
  • Easily scalable operations, with the potential to extend
  • FDA to claim assignment and triage

Genpact and claims

Ever-increasing auto and natural catastrophe claims. Rising customer service demands. Aging legacy systems. These are just some of the challenges facing insurers that digital technologies like automation, AI, and analytics can help tackle. Our digital tools optimize the balance between customer satisfaction, accurate loss assessment, and loss-adjusting expenses, with solutions that span the claims journey, handling everything from fast-track claims processing to fraud and subrogation analytics. You can start with the module that addresses your biggest challenge and add from there. Or we can run your entire claims operation.

Global insurers and reinsurers, surplus lines insurers, a European insurer, even a top-ten Fortune company – we’ve transformed claims for them all over the past 15 years. We combine the digital understanding of an insurtech with claims expertise and business process know-how. Let’s put this to work for you.

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