case study

Processing claims with speed, and delivering greater accuracy and insights

Industry
Insurance
Challenge
Manual transfer of new insurance claims to detect fraud and create reporting.

For every insurance company, efficient claims processing and the ability to detect fraud are paramount. yourCompany helps insurance companies to streamline their new claims process, which is by nature a labour-intensive job where risk management and compliance are a top priority. With help from Yarado, yourCompany enabled their clients to detect fraudulent claims much faster and process claims with greater accuracy. Furthermore, claims have now been pushed into a dashboarding system, providing full visibility into the fraud detection analysis.

YARAdo IMPACT
40%

Faster order processing


100%

Accuracy

1000

Hours saved in manual work

outcomes

Automated insurance claims processing

Quick and efficient detection of fraudulent claims

Error-free, compliant data

Saved time and resources

The challenge The challenge The challenge

the challenge

In order to detect and keep track of fraud, new claims need to be moved from the claim system into two separate systems: a fraud detection tool and a dashboarding tool. Transferring claims from one system to the other requires manual effort. Information about each claim (such as event time and name of policy holder) is inserted in the fraud detection system by hand, which is time consuming and creates errors. To make matters even more complex, the corresponding fraud assessment has to be fed back into the dashboarding tool again.

The before The before The before The before The before

The before

Prior to working with Yarado, yourCompany's clients invested considerable time and effort in manually moving claim information between the separate systems.

The process entailed several steps:

  1. Log in to claim system to extract necessary information, such as event time, event date and name of the policy holder.
  2. Log in to a fraud detection system to create a claim based on information extracted from the claim system.
  3. After fraud detection system has generated a fraud assessment, the staff member had to log in and enter that output in the claim system.
  4. Access dashboarding tool to input information from the fraud assessment.
  5. If the claim was approved, the staff member had to log in to the claim system and pay out the claim.

The after The after The after The after The after The after The after

THE AFTER

With the help of Yara’s software robot, the fraud detection system and dashboarding tool are now updated automatically. As a result, claims are processed faster than ever before, while Yara makes sure that clients are compliant at all times and dispose of accurate reports for risk assessment, among others. As manual transference of information is no longer necessary, staff members are able to focus on higher value work – such as deriving insights from dashboards and engaging with customers.

Yara, the software robot, takes the following actions:

  1. Extracting information from claim system
    Yara extracts information from new claims – such as event date, event location and name of policy holder – after logging in to the claim system.
  2. Creating a new claim
    Yara logs in to the fraud detection system and navigates to the appropriate tab to create a new claim.
  3. Entering information into fraud detection system
    Based on the extracted information, Yara fills in the required fields associated with the new claim and saves it.
  4. Retrieving fraud assessment
    Yara retrieves the fraud assessment generated by the fraud detection tool.
  5. Updating claim
    Yara logs in to the claim system to update the claim with the corresponding fraud assessment.
  6. Entering information into dashboarding tool
    Yara accesses the dashboarding tool to enter necessary information from the fraud assessment, such as fraud score, which enables risk assessment reporting, for example.
  7. Paying out claim
    If the claim is approved in the claim system, Yara pays out the claim instantly – in accordance with the company’s procedure.