Process Discovery, Automation
& Monitoring
The scenario

Off late, an insurance company starts getting several complaints around claim handling from its corporate clients. To handle the spurt in complaints, it adds more service personnel, and tasks the sales reps to dig deeper into the issue. After a couple of weeks of analysis, the company realizes that a novice claims processing agent without much hands-on is the culprit. However, it took the entire department’s effort in figuring this out, while the company loses the customers’ trust.

Had the root cause been identified quicker, the insurer would have saved the entire effort. Had the issue been predicted right, the company wouldn’t have to worry about regaining the lost customer trust.

The scenario

Off late, an insurance company starts getting several complaints around claim handling from its corporate clients. To handle the spurt in complaints, it adds more service personnel, and tasks the sales reps to dig deeper into the issue. After a couple of weeks of analysis, the company realizes that a novice claims processing agent without much hands-on is the culprit. However, it took the entire department’s effort in figuring this out, while the company loses the customers’ trust.

Had the root cause been identified quicker, the insurer would have saved the entire effort. Had the issue been predicted right, the company wouldn’t have to worry about regaining the lost customer trust.

Our solution

TechSophy’s content aggregator extracts information from various sources (ticketing system, claim handling software, event logs, etc.) and the data is analyzed to come up with recurring patterns in the claims process. Then the system will generate alerts to the business owner and system administrator for necessary actions.

The contention points across the claims process mostly followed the defined path. In this case, the claim is considerably delayed for certain processes and further drill down confirms that the novice agent is the root cause. This process discovery is being achieved by leveraging Artificial Intelligence / Machine Learning models.

For more information on our Process Discovery services