Mechanising Insurance Claim Adjudication - Is This Possible?

by richard / July 27,2017 / Published in Industry News,
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We have been mechanising tasks since the industrial revolution, which created opportunities for the people it replaced. The internet has been alive with news of robots taking away our jobs too. Business Insider thinks low-wage-low-tech jobs are most likely to feel the crunch.

The Guardian cites the example of create-your-order-kiosks in fast food outlets, and fingers this as positively disruptive. But, is mechanising insurance claim adjudication feasible?

How Feasible is Insurance Claim Automation Really?

[caption id="attachment_23090" align="alignright" width="339"]auger drainage and investigation services Clearing Blocked Line Fotolia 87017607[/caption] David Johnson writing for TIME Magazine has been delving into the generics of jobs most likely to go to robots. He thinks these will be in ‘non-challenging environments’ meaning that plumbers and electricians are safe. However, computers are beginning to make straight-line financial decisions in corporates too. If there is only one logical answer to choose from, surely it makes sense for computers to decide. Judith Aquino takes a different tack in NBS News Careers. Since robots are good at analysing documents, are ‘becoming smarter than people, and don’t get bored’, she thinks we should use them for picking prescriptions at dispensaries, doing legal reviews of documents, and perhaps teaching as well. This opens up the question, why not insurance claim mechanisation if computers can read the input documents.

Assessing the Possibility of Automating Claim Decisions

[caption id="attachment_23091" align="alignleft" width="426"]auger drainage and investigation services Multi Function Device Fotolia 105628949[/caption]

Insurance Nexus depended on some heavy lifter opinions when it published Rise of the Machines: Automation and the Insurance Claim. However, you will have to read that for yourself since they reserve intellectual property rights. Auger thinks the time could be ripe for of insurance claim automation. Processing would be faster, and the anxious uncertainty would be over sooner.

Moreover, the mechanised system could produce a report for forwarding to the client when accepting, or rejecting their claim. Perhaps some form of oversight would be necessary before announcing the decision though. Would this be by another computer, do you think, or should a human review? Please write and tell us what you think about insurance claim mechanisation. We are currently experimenting with ways to improve customer service through machine learning and artificial intelligence. These have already shortened our average claim processing duration. Whatever it takes ... we’ll get the job as quickly and efficiently as possible. We walk the extra mile with you.

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