Challenges

A multinational financial services company with a market capitalization of over $100 billion, faced significant challenges in its claims processing operations. The company offers a diverse range of products, resulting in complex policy documents and multiple product categories, leading to delays and inefficiencies in claim settlements. The existing claims process was mostly dependent on manual operations. Over 100 medical professionals were engaged in thorough investigations, comparisons, and verification of claims, causing further delays and escalating operational costs. The back-and-forth communication required to gather necessary information and clarify details added to the complexity and time consumption of the process. The company sought a solution to streamline the claims process, enhance accuracy, and improve the overall customer experience.

Solution highlights

ThoughtMinds implemented an innovative Auto-Summarization Solution for this company: 

• AI Assistant for Assessors: This intelligent tool automatically analyzed and summarized complex policy documents, product information brochures, and standard operating procedures (SOPs), condensing them into concise and easily digestible summaries. Assessors could now quickly grasp the key details of each claim.
• Streamlined Information Access: By providing assessors with instant access to relevant summaries, the solution eliminated the need to go through lengthy documents. This streamlined the claims review process, allowing assessors to focus on decision-making and accelerating the overall claim settlement timeline.
• Improved Accuracy and Efficiency: The AI-powered summarization not only saved time but also improved the accuracy of claims assessments. By presenting key information in a clear and concise format, the solution reduced the errors and inconsistencies arising from misinterpretations or oversights. 
• Scalability and Adaptability: The Gen AI Studio-based solution was designed to be scalable and adaptable to evolving business needs. It could be easily trained on new document types and policy updates, ensuring its continued relevance and effectiveness in the face of changing requirements.