Improving Claims Processing with Robotic Process Automation

17 Dec, 2019 | Blogs

Insurance companies face multiple challenges. Customers’ expectations in terms of turnaround time, and omni-channel access continue to increase. Further, operationally intensive activities such as claims processing continue to erode profitability. Claims processing involves several managerial, administrative and customer service functions that perform information-intensive manual tasks to protect the company against fraud or errors. Despite all of this, in the US alone, the insurance industry is estimated to lose $80 billion every year due to fraud (The Coalition Against Insurance Fraud). No wonder claims processing with RPA is emerging as the new trend in the insurance industry.

With the company’s standards of service and its commitment to customers at stake, the scope for errors is next to none and the price of accurate claims processing cannot be underestimated. That is why more and more companies are turning towards Robotic Process Automation (RPA) as a solution to combat these problems. Some of the challenges to effective and error-free claim processing include:

All these challenges hinder the insurance companies’ efforts to drive operational efficiencies, reduce cost and enhance customer experience. This is where RPA can help.

Claims processing with RPA not only ensures error-free tasks, but also simplifies data entry and streamlines processes that result in lower operational cost, faster turnaround, and higher compliance. Some specific examples of claims processing that RPA can automate include:

  1. First Notice of Loss
  2. Validation of No Claims Discount
  3. Review Fraud and Risks
  4. Policy renewal

Benefits of Claims Processing with RPA

Streamline Entire Process

RPA helps insurance companies smoothen claims processing by streamlining multiple processes including entering data into the system from various channels such as emails, phone or online forms, verifying coverage, and issuing settlement notices. A claims adjuster bot like an IQ Bot can eliminate tedious manual processes of validating claims against the policy and review for fraud. The bot can make the processes move faster – right from data organization, extraction, to transmission – without human intervention.

Speed Up Claims Processing

Following on the previous point, an unattended bot allows employees to focus on engaging better with customers than pushing paperwork from one department to another. It increases efficiency by bringing structure to vast amounts of claims data flowing through the department and improving customer satisfaction by speeding up the claims process. It frees up the claims processor from manually validating and executing data to focus on other steps that require human intervention for decision making.

Higher Quality and Accuracy

Not only does RPA reduce the backlog of work, but it also reduces inevitable human errors. For instance, property and casualty insurance providers need to accurately assess the damage estimates. But since this information comes from various paper-based or PDF forms, it can be difficult to have razor-sharp accuracy every time when done manually. Having a bot to manage monotonous tasks like data entry, validation, and cross-checking coverage requirements can lead to a quick, efficient, and precise claims adjudication process. In the case of inaccuracy or deviations, the bot can demand human intervention for further investigation.

Higher Compliance

Insurance companies are strictly regulated and must adhere to laws laid out by various local and global regulatory bodies. Ensure higher compliance with these regulations by letting the bot document every step of claims processing. This will significantly improve insurance compliance and governance as companies can monitor and audit the records on an ongoing basis without worrying about errors or missing data.


One of the biggest benefits of RPA is the creation of a virtual, digital workforce that can be easily scaled up or down based on seasonality. With increased work pressure during peak periods, RPA can be a saviour for claim handlers. These bots ensure that work continues without any delays and the policyholders do not suffer due to a spike in claims processing, all while being 100% accurate.

Final Words

Begin your journey to success by embracing RPA for the claims handling process. Automation not only improves the business process but also integrates the application system without disrupting the existing processes in place. RPA can automate mundane tasks like information gathering, data distribution, managing process flow, investigating fraud, etc., to help you improve customer experience, save cost and increase operational efficiency.

Ready to get started on your RPA journey? Book a free consultation now! You can also read how an insurance company increased profitability by 20%!