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Automating the claims management process in insurance

By Merlyn Evans, Advisory Architect, Integrated Strategy & Solutions, Ricoh USA


Insurers must automate their claims management processes to attract and retain customers

Read time: 4 minutes

Digitization and automation in the insurance sector have both been gathering momentum over the last five years, with an exponential boost provided in 2020. The impetus to automate continues to gather importance for a host of reasons.

  • A new kind of customer has emerged.

  • Digitally savvy competitors threaten market share.

  • The regulatory landscape is constantly changing.

  • Data breaches are growing in both frequency and sophistication.

It’s no surprise, then, that insurers are accelerating the automation of their claims management process.

As revealed in a recent Deloitte survey¹, a staggering 95% of insurers say they are currently laser-focused on accelerating their digital transformation initiatives. That focus is largely on claims intake which, according to Deloitte, is the new behind-the-scenes battleground for evolution, differentiation, and importantly, automation. Considering that typical straight-through processing (STP) rates are at less than 10%, it’s easy to see why insurers must take advantage of technologies that can dramatically boost data accuracy and help set up “clean claims.”²

What does an STP rate of less than 10% mean for insurers? To learn more, Ricoh commissioned a survey, conducted online by The Harris Poll among 1,900 Americans with home/auto insurance. The survey revealed that:

  • Nearly 1 in 3 Americans who filed a home or auto insurance claim within the last 5 years (31%) rate their claim filing experience as fair/poor/terrible.

  • Younger adults ages 18-44 who filed a home/auto insurance claim within the last 5 years were more likely than those ages 55+ to describe the experience as terrible, poor, or fair (34% vs. 21%).

“Most customers churn as a result of poor service with 29% churning after just 1 negative experience. This shows that customers are unwilling to give an insurance provider a second chance, and expect high service quality as part of their insurance policy.”

- TechSee, 2022 State of Customer Churn in Insurance

What does this tell us? Insurance companies are especially vulnerable as the claims process adds friction and customer effort. Insurers need to evolve their claims management process to:

  • Instantly and automatically extract and validate claims data

  • Improve data accuracy and reduce costly errors

  • Set up clean claims and straight-through processing of document intake

  • Protect business continuity and enable anytime-anywhere secured access

  • Unlock analytics insights and support data-driven decision-making

  • Accelerate claims resolution to boost NPS, CSAT and retention

RICOH Claims Management automates and accelerates claims processing

RICOH Claims Management is built on our Intelligent Business Platform (IBP), a workflow and process automation ecosystem designed to automate and accelerate the capture, intake and validation of all your inbound claims, across digital and physical channels — as well as provide robust analytics, SLA reporting, an intuitive dashboard, and application hosting. It seamlessly integrates with your other systems and workflows, automatically populating claims data to drive efficiencies across your day-to-day workflows and operations. It’s HITRUST and PCI-certified, and it’s purpose-built from the ground up to deliver access to business-critical claims information with the security that meets your compliance requirements. The solution also features:

Multiple AI solutions combined

We combine OCR (Optical Character Recognition) and NLP (Natural Language Processing) to read the characters and digest the information - noting characteristics and associating them with the image or document type. Advanced ML (Machine Learning) provides an accelerated “training process,” with the result that automation can quickly figure out what to look for in defining a document type. We also tell the AI what key data fields to pull out of each document type — and where to feed that data.

Efficient deployment

Because the claims management solution is delivered in a consumption-based, as-a-service model, you can deploy quickly without requiring a big upfront capital outlay — and easily scale up and down with your needs.

Computer vision

The process begins with the collection of claims documentation from any source — aggregating digital documents from relevant sources and collecting physical documentation. Computer vision then rapidly recognizes claims documents with laser accuracy. In fact, our proven, AI-powered computer vision technology is exceptionally accurate, eliminating the common errors of manual intake and helping you set up “clean claims” and achieve an STP rate of up to 85%.

AI-powered data enrichment functionality

Each document is classified by type. Key data, or index values, are then extracted. Our AI-powered data enrichment functionality then automatically pulls in additional, relevant data a document may contain. For example, recognizing a member ID on a claim form —and then matching and linking that claim form to the central claims management database.

Cloud archive

Extracted data is automatically sent up to the cloud, where you can easily and securely retain, access, search, and filter in order to find specific documents, and use past data to drive analytics and inform decision making.

Work queue: custom exception feature

Customers can apply configurable business rules to flag and prioritize documents that contain exceptions, such as identifying null data in fields (i.e.: missing claim number.)

A smarter user experience

RICOH Claims Management makes it easy and intuitive for managers to see key claims processing performance metrics, and quickly dig into analytics insights, all from a single dashboard. With it, you have instant, secured access to all claims data from any device, anytime, anywhere; eliminate time searching for physical documents or recreating lost information; access relevant, actionable insights that can drive further enhancements; see performance data in near real time.

Flexible deployment

RICOH Claims Management is offered in a hybrid deployment model where our highly trained experts are right there in your mailroom to handle mail prep and scan activities. We also offer a fully off-site model where we deliver the same digitization and automation services from one of our Business Information Services centers.

Center of Excellence support

A dedicated team of experts builds your customized claims management solution that aligns with the top-level business objectives and outcomes that matter most to the customer. Throughout the process, we fine-tune and improve how the solution is deployed. And, we’re always always there, ready to provide support and guidance for continuous improvement, as well as targeted initiatives.

Build trust, loyalty, and ROI

A claim is a meaningful touchpoint that can transform a skeptical customer into a loyal, lifelong advocate. Ideally, it converts a transactional relationship into something more like an enduring, mutually beneficial partnership, based on a high degree of customer loyalty and trust, along with a clear sense of value.

As the number and severity of claims continues to rise, along with prices, interest rates, and a customer who has little patience with the claims management process, it’s imperative that you manage claims efficiently. RICOH Claims Management can help you address the pressures of today’s marketplace, as well as those of tomorrow.

View the RICOH Claims Management solution

Ready to see how RICOH Claims Management could help your business?

Merlyn is a customer-obsessed design professional with more than 20 years of experience working in service industries. Citing curiosity as his most important attribute, Merlyn is passionate about reimagining business user experiences to transform how people work so we can unleash their potential and creativity.

Merlyn Evans

Advisory Architect, Integrated Strategy & Solutions

Ricoh USA

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  1. 1Deloitte. The future of claims. August 2020.
  2. 2GlobalData. Cybersecurity in Insurance: Thematic Research. June 8, 2022.