NewgenONE Platform for
AI-powered Claims Management for Auto (Motor) Insurance
Deliver improved accuracy and faster processing across your claims lifecycle for faster and accurate payouts to policyholders
Streamline your claims process and improve customer satisfaction, with an AI-powered comprehensive, secure, flexible, and scalable claims management system. Process general insurance claims in an integrated low code application development environment powered by AI. Expedite the claim processing cycle through a combination of automated policy verification, adjudication, and fraud control checks. Enable agents, branch employees, surveyors, claim handlers, and claim settlement teams to initiate, adjudicate, settle, review, and track claim within defined TATs.
Features of AI-powered Claims Management Solution for Retail/General Insurance
Omnichannel Initiation
Allow customers to submit requests from all channels – branch walk-ins, portals, mobile apps, website, social media, scanning solutions, etc. The customer self-service portal gives a comprehensive view of customer’s active policies. They can select a policy for initiating a claim and upload a video/ image/document supporting it. They can also track claims in real-time.
First Notice of Loss
Auto-retrieve policy information by entering key indexing fields, prevent claims duplicity and flag duplicate entries, and analyse the claim and policy-level attributes at the First Notice of Loss to build a relationship between claim severity and various policy attributes at an early stage of a claim’s life cycle. The intelligent document classifier feature helps identify if all the required documents have been received and raises missing document request to claimant.
Claim Registration
Auto-prioritize and intelligently allocate cases at different queues and work steps and get a consolidated view of case details for reviewing a particular claim. Leverage defined checks and validations like Duplicity Check, AML Check, Blacklist Check, etc. The system supports auto- adjudication and fast-tracking of low severity and low complexity claims, triggers activities like initiating recovery or identifying co-insurance cases, and generates letters and communication to the customers/agents via e-mail, SMS, and WhatsApp. AI capability can help with claims reserving and expense set-up.
Repairer & Surveyor Allocation
Get a list of repairers based on the identified location, auto-allocate repairer and surveyor based on geolocation, user workload, ratings, claim amount, etc., and capture estimates with user-friendly forms. The portal/mobile app extended to repairers and surveyors ensures a connected ecosystem that allows the uploading/capturing of videos and images on the go. The system can auto-trigger communication for re-estimation of estimates and perform comparative analysis of previous and revised estimates in a single view.
Claim Assessment
Allocate cases based on case complexity, past user performance, user workload, etc. Resolve discrepancies using pre-defined rules, undertake a detailed assessment of each claim with an all-inclusive dashboard, and process multiple referral activities in parallel. The system provides a fraud assessment model to identify probable frauds, probability of default, and case allocation recommendations. It also supports intelligent data processing for identifying trends to triage the claims and recommends decisions and next best action.
Claim Review & Approval
Get repairer & surveyor estimates on a consolidated screen, recommend the best repair estimate, and send communication to the repairer along with the Purchase Order documents. Receive and archive the invoice of expenses from the repairer and calculate estimated amount, negotiated amount, discount %, and more.
Claim Settlement
Use AI/ML-based models for final payable calculations and enable partial and full payment processing. Generate documents like Final Claim Settlement Letter and Debit Notes within the system.
Integrations
Leverage seamless integration with the Finance System. Integration with the Policy Admin System helps push data like Claims Summary, Payable Details, etc.
Monitoring and Insights
Define KPIs to monitor and measure the efficiency of the users using the highly configurable user dashboard screen. Ensure a transparent and timely claims processing with escalation matrix and monitoring reports.
Omnichannel Initiation
Allow customers to submit requests from all channels – branch walk-ins, portals, mobile apps, website, social media, scanning solutions, etc. The customer self-service portal gives a comprehensive view of customer’s active policies. They can select a policy for initiating a claim and upload a video/ image/document supporting it. They can also track claims in real-time.
First Notice of Loss
Auto-retrieve policy information by entering key indexing fields, prevent claims duplicity and flag duplicate entries, and analyse the claim and policy-level attributes at the First Notice of Loss to build a relationship between claim severity and various policy attributes at an early stage of a claim’s life cycle. The intelligent document classifier feature helps identify if all the required documents have been received and raises missing document request to claimant.
Claim Registration
Auto-prioritize and intelligently allocate cases at different queues and work steps and get a consolidated view of case details for reviewing a particular claim. Leverage defined checks and validations like Duplicity Check, AML Check, Blacklist Check, etc. The system supports auto- adjudication and fast-tracking of low severity and low complexity claims, triggers activities like initiating recovery or identifying co-insurance cases, and generates letters and communication to the customers/agents via e-mail, SMS, and WhatsApp. AI capability can help with claims reserving and expense set-up.
Repairer & Surveyor Allocation
Get a list of repairers based on the identified location, auto-allocate repairer and surveyor based on geolocation, user workload, ratings, claim amount, etc., and capture estimates with user-friendly forms. The portal/mobile app extended to repairers and surveyors ensures a connected ecosystem that allows the uploading/capturing of videos and images on the go. The system can auto-trigger communication for re-estimation of estimates and perform comparative analysis of previous and revised estimates in a single view.
Claim Assessment
Allocate cases based on case complexity, past user performance, user workload, etc. Resolve discrepancies using pre-defined rules, undertake a detailed assessment of each claim with an all-inclusive dashboard, and process multiple referral activities in parallel. The system provides a fraud assessment model to identify probable frauds, probability of default, and case allocation recommendations. It also supports intelligent data processing for identifying trends to triage the claims and recommends decisions and next best action.
Claim Review & Approval
Get repairer & surveyor estimates on a consolidated screen, recommend the best repair estimate, and send communication to the repairer along with the Purchase Order documents. Receive and archive the invoice of expenses from the repairer and calculate estimated amount, negotiated amount, discount %, and more.
Claim Settlement
Use AI/ML-based models for final payable calculations and enable partial and full payment processing. Generate documents like Final Claim Settlement Letter and Debit Notes within the system.
Integrations
Leverage seamless integration with the Finance System. Integration with the Policy Admin System helps push data like Claims Summary, Payable Details, etc.
Monitoring and Insights
Define KPIs to monitor and measure the efficiency of the users using the highly configurable user dashboard screen. Ensure a transparent and timely claims processing with escalation matrix and monitoring reports.
Horizontal Platforms for Insurance Providers
Brands using Newgen Platform
Brands using Newgen Platform
