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.
Learn what Newgen’s AI-powered Claims Automation Solution can do for you
Multichannel Initiation and Claims Handling
Customers can initiate claims through multiple channels, including self-service portals, websites, and social media. Our user-friendly solution supports individual and group policies with claim types like death, maturity, critical illness, permanent total disability (PTD), temporary total disability (TTD), and involuntary loss of employment. For operations in Saudi Arabia, the platform integrates with critical national systems, such as Yakeen and Masdr, enhancing the accuracy of customer identification and compliance with local health insurance data standards.
Automated Assessment
Automatically classify claims as “fast track” or “non-fast track” and identify admissible/non-admissible claims with built-in rules. The system performs product-based calculations for reserve, death benefit, disability benefit, critical illness, and final payouts, generating a comprehensive claim summary sheet. Integration with the Council of Cooperative Health Insurance data also ensures automated eligibility checks, minimizing claim denial errors while meeting local regulatory requirements.
Fraud Detection and Reserve Management
Leveraging AI and machine learning to conduct robust fraud checks on claims can mitigate risks and prevent financial losses. The solution manages reserves based on claim complexity, ensuring adequate provisions for potential liabilities. Saudi-specific fraud detection is enhanced through integration with local databases, supporting accurate identity and claim validations in compliance with regulatory standards.
Automated Claim Payout and Settlement
Reduce manual efforts and minimize errors with the help of rule-based payout determination. Integration with local payment gateways like MADA, UR Pay, and STC Pay ensures seamless and compliant claim disbursements for customers in Saudi Arabia.
Multichannel Initiation and Claims Handling
Customers can initiate claims through multiple channels, including self-service portals, websites, and social media. Our user-friendly solution supports individual and group policies with claim types like death, maturity, critical illness, permanent total disability (PTD), temporary total disability (TTD), and involuntary loss of employment. For operations in Saudi Arabia, the platform integrates with critical national systems, such as Yakeen and Masdr, enhancing the accuracy of customer identification and compliance with local health insurance data standards.
Automated Assessment
Automatically classify claims as “fast track” or “non-fast track” and identify admissible/non-admissible claims with built-in rules. The system performs product-based calculations for reserve, death benefit, disability benefit, critical illness, and final payouts, generating a comprehensive claim summary sheet. Integration with the Council of Cooperative Health Insurance data also ensures automated eligibility checks, minimizing claim denial errors while meeting local regulatory requirements.
Fraud Detection and Reserve Management
Leveraging AI and machine learning to conduct robust fraud checks on claims can mitigate risks and prevent financial losses. The solution manages reserves based on claim complexity, ensuring adequate provisions for potential liabilities. Saudi-specific fraud detection is enhanced through integration with local databases, supporting accurate identity and claim validations in compliance with regulatory standards.
Automated Claim Payout and Settlement
Reduce manual efforts and minimize errors with the help of rule-based payout determination. Integration with local payment gateways like MADA, UR Pay, and STC Pay ensures seamless and compliant claim disbursements for customers in Saudi Arabia.
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