Executive Summary

A travel insurance provider sought to enhance operational efficiency and improve customer satisfaction by automating the processing of low-complexity claims, such as baggage delays and trip cancellations.

Project Overview

The pilot focused on automating the processing of baggage delay claims, a common yet time-intensive claim type. By implementing a rule-based system, the project aimed to reduce manual intervention, enhance processing speed, and improve customer satisfaction.

Key Challenges

High Volume of Claims

  • Manual processing of low-complexity claims caused delays, especially during peak travel seasons.

Inconsistent Data

  • Claims often included varying formats for supporting documents, making manual validation important.

Customer Expectations

  • Policyholders demanded faster claim resolutions with real-time updates.

Plan of Action

  • Select a Focus Area: Chose baggage delay claims as the focus due to their straightforward validation criteria.
  • Design an Automated Workflow: Developed a rule-based system to handle claim submissions, validations, and approvals.
  • Implement OCR Technology: Automated the extraction of data from uploaded documents to minimize manual input.
  • Integrate Notifications: Provided real-time updates to customers throughout the claim lifecycle.

Key Objectives

  • Reduce claim processing time from days to minutes.
  • Automate at least 70% of baggage delay claims.
  • Enhance customer satisfaction through faster resolutions and real-time updates.

Approach & Execution

#1. Digital Claim Submission

  • Developed a user-friendly web interface to submit claims and upload supporting documents.
  • Integrated OCR technology (AWS Textract) to extract data from documents like airline delay confirmations and receipts.

#2. Rule-Based Adjudication

  • Implemented a rule engine to validate claims based on predefined criteria:
  • Was the delay longer than the policy threshold (e.g., 6 hours)?
  • Were all required documents submitted?
  • Automatically approved valid claims and flagged incomplete or suspicious claims for manual review.

#3. Automated Notifications

  • Set up email alerts to notify customers about claim status updates, requests for additional documents, and claim approvals.

#4. Analytics and Monitoring

  • Tracked key metrics such as processing time, claim approval rates, and automation success rates using a real-time dashboard (Power BI).

Results

Processing Time

Reduced average claim processing time for automated claims.

Automation Rate

Successfully automated baggage delay claims during the pilot phase.

Customer Satisfaction

Improved customer satisfaction by 25%.

Operational Efficiency

Reduced manual workload for claims processing teams by 60%, allowing them to focus on more complex claims.

Team Composition

  • Project Manager: 1
  • Backend Developer: 2
  • Frontend Developer: 1
  • Data Engineer: 1
  • Quality Assurance Specialist: 1

Conclusion

The pilot project successfully demonstrated the potential of automating low-complexity claims in the travel insurance industry. The solution delivered faster claim resolutions, improved customer satisfaction, and reduced operational costs.

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