Improved claims processing accuracy and efficiency

Case Study

Problem Statement 

TATA AIA needed to improve their claims operations to effectively, quickly and accurately handle their high volume of claims. Ensuring a good customer experience was a necessary business outcome. The current legacy policy administration system - combined with manual processes - could not handle the amount claims to be processed resulting in inaccurate computations and significant processing time. Moreover, compliance, along with audit and regulatory requirements necessitated the need for an automated and streamlined claims system.

 

The Solution 

The implemented Intellect Claims solution supported Individual Life and Disability Health lines of business. This comprehensive and configurable solution catered to several claim types including Critical Illness, Hospitalization, Death and Accidental Death & Dismemberment. The cutting edge user interface utilized IBM WebSphere Portal while the claims process orchestration was performed through the IBM Process Server. The simple to use the solution provided an automated claim benefit calculator based on predefined criteria and rules, configurable workflows, rule based triggers and user management. Intellect Claims provided seamless integration with existing third party systems included OLAS (Policy Admin), Global 360 (Document Management) and SAP based Accounting systems.

The Benefits

  • 75% improvement in claims processing time
  • 70% improvement in recording claims notifications
  • Fully integrated system with complete traceability
  • Ability to quickly and easily introduce new products
  • Consistency in claims processing
  • Automation of payout calculation eliminated of payout errors
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