NewgenONE Platform for
Expedite Claims Processing, from Rule-Based Computation to Fraud Prevention
Optimizing claims by maximizing straight-through processing and streamlining settlement across claim types to elevate customer satisfaction and retention.
“With Newgen’s Claims Management Solution, we achieved a 40% reduction in claims leakage through AI-driven fraud detection, improved TAT for non-early claims by 50%, and accelerated settlement time for living claims by up to 40%.”
VP, Insurance Claims
Learn what Newgen’s AI-powered Claims Automation Solution can do for you
Multichannel Initiation and Claims Handling
Allow customers to initiate claims from multiple channels, including self-service portal, website, and social media using convenient and user-friendly online platform. The solution is capable of handling claims against individual as well as group policies. The various types of claims include death claims, maturity, critical illness, permanent total disability (PTD), temporary total disability (TTD), and involuntary loss of employment.
Intelligent Claims Assessment
Automatically classify claims as “fast track” or “non-fast track” and identify admissible/non-admissible claims with built-in rules. The system can perform product-based calculation rules for reserve, death benefit, disability benefit, critical illness, and final payable, and generate a claim summary sheet. The solution has provisions for Investigation Portals and mobile apps. Leveraging AI/ML algorithms, the system performs comprehensive fraud checks on claims, mitigating risks and financial losses.
Operational Insight and Monitoring
Monitor and measure user efficiency with defined KPIs to address gaps. Ensure transparent and timely life insurance claims processing with escalation matrix and monitoring reports, and effectively track claims processing across departments.
Automated Claim Payout and Settlement
Reduce manual efforts and minimize errors with the help of rule-based payout determination. Claim amount is processed upon confirmation provided by the claimant.
Multichannel Initiation and Claims Handling
Allow customers to initiate claims from multiple channels, including self-service portal, website, and social media using convenient and user-friendly online platform. The solution is capable of handling claims against individual as well as group policies. The various types of claims include death claims, maturity, critical illness, permanent total disability (PTD), temporary total disability (TTD), and involuntary loss of employment.
Intelligent Claims Assessment
Automatically classify claims as “fast track” or “non-fast track” and identify admissible/non-admissible claims with built-in rules. The system can perform product-based calculation rules for reserve, death benefit, disability benefit, critical illness, and final payable, and generate a claim summary sheet. The solution has provisions for Investigation Portals and mobile apps. Leveraging AI/ML algorithms, the system performs comprehensive fraud checks on claims, mitigating risks and financial losses.
Operational Insight and Monitoring
Monitor and measure user efficiency with defined KPIs to address gaps. Ensure transparent and timely life insurance claims processing with escalation matrix and monitoring reports, and effectively track claims processing across departments.
Automated Claim Payout and Settlement
Reduce manual efforts and minimize errors with the help of rule-based payout determination. Claim amount is processed upon confirmation provided by the claimant.
Brands using Newgen Platform
Recommended For You
Find Your Winning Strategy with Newgen
Request a demo to explore our solutions for omnichannel onboarding, fast policy issuance, and intelligent underwriting for life insurance journey automation.
Request a demoGot Questions?
Enter your information, and a Newgen representative will be in touch shortly.
Frequently Asked Questions
Customer retention is a priority for insurers, and automating the claims process will be crucial in reducing the churn rate. Newgen’s AI-powered Claims Automation Solution for life insurance offers intelligence at every step of the journey, from claim initiation and validation to settlement, enhancing the moment of truth for policyholders.
Challenges of Life & Annuity Insurance Claims Journey include:
- Legacy systems cause higher occurrence of fraud and gaps in discrepancy resolution
- Siloed systems, multiple screens, and large volumes of paper trail reduce productivity
- Excessive administrative tasks lead to longer turnaround time for coverage determination, claim summaries, and claims calculations
- Physical storage and manual tracking of documents lead to inefficiencies and higher operational spends
- Ineffective customer communication causes low customer satisfaction scores and high churn rate
The types of Claims covered are as follows:
- Living Claim
- Death Claim
- Permanent Total/Partial Disability Claim
- Temporary Total/Partial Disability Claim
- Critical Illness Claim
- Involuntary Loss of Employment Claim
- Group Claim (Micro-Insurance Products, GCL, GTL)
The Core Features of Newgen’s Claims Automation Solution are:
- Omnichannel Claims Initiation
- Intelligent Document Processing
- Bank Details Validation
- Investigation Allocation
- Fraud Detection and Admissibility
- Policy Search and Dedupe
- Payout and Settlement
The Omnichannel Claims Initiation feature helps by:
- Allowing customers to initiate claims on a convenient and user-friendly online platform
- Supporting the sharing of images and interactions across channels and devices, such as the web, contact center, mobile devices, or social media
Intelligent Document Processing feature helps to:
- Facilitate automated coverage check through digital document validation
- Integrate with core systems to auto-retrieve individual policy information by entering key indexing fields
- Automate the KYC process with admissibility checks and claimant verification
- Provide OCR extraction to support manual document upload
The Bank Details Validation feature helps ensure accuracy by employing the penny-drop method to validate bank account details provided by the insured.
Investigation Allocation manages investigations by:
- Automating the assignment of cases for external and internal investigations based on workloads, ratings, and the performance of the investigation agencies
- Supporting on-field investigators with OTP-based investigation portal/mobile apps and communication triggers
The Fraud Detection and Admissibility feature functions to:
- Run comprehensive fraud checks on claims by leveraging AI/ML algorithms and BRMS
- Mitigate risks and financial losses by flagging high-risk cases
The Policy Search and Dedupe feature improves efficiency by:
- Generating a single notification number for claims filed against multiple policies
- Performing dedupe checks to rule out duplicate policy matches against the insured
The Payout and Settlement feature helps to:
- Leverage rule-based claim segmentation considering payout limits and fraud scores
- Reduce errors with automated payout calculations and digital summaries
- Utilize defined KPIs to monitor and measure user efficiency, and escalation matrix for timely life insurance claims processing
The Benefits of Newgen’s AI-led Claims Automation Solution are as follows:
- Reduced Turnaround Time: Lateral handling, straight-through-processing of non-complex claims, and integration with core and peripheral systems ensure faster acceptance of settlement and automated payment processing
- Intelligent Claims Management: Automated claims routing, omnichannel claim tracking, and rule-driven logic enhance claims admissibility
- Accurate Claims Processing: Rule-based processing reduces manual intervention and minimizes errors
- Improved Compliance: Assured adherence to compliance standards, including GDPR, SOC2 Type 2, and ISO 27001, leads to lower legal cost
- Automated Dedupe: The authentication process increases security, eliminates rework, and reduces processing cost
- Better Customer Experience: Multichannel communication and real-time status tracking of claims boost service delivery
