Reduce claims processing costs and turnaround times with our end-to-end claims automation for insurers
“A fantastic example of a collaboration which provides a true solution to some of the issues that often stand in the way of creating customer loyalty and helping rebuild trust in our sector.”
Zurich’s Head of Customer, UK Claims
Sprout AI delivers claims automations that reduces operations costs, accelerates processing times and improves fraud detection. From receiving a claim to the final settlement, Sprout.ai assists your claims & fraud teams every step of the way, without ever disturbing your workflow.
Claims information extracted from claim documentation provided by customer
Text Extraction
Claim details extracted and checked against the policy to see whether it is included
Policy Checking
If claim does not fit the policy, claim handlers will need to verify if a claim is covered manually by checking policy and policy attachments
Claim is checked for to see if it is related to any fraudulent activity or if the customer has a fraudulent past using APIs
Fraud CheckIf possible fraud is found, claims will be manually checked based on claims handlers experience of whether this should be referred to SIU (Special Investigation Unit)
Items with missing invoices can be validated and claimed price of products are validated again with further APIs
Missing InvoicesIf the price of products cannot be validated, the claim is reviewed by the supplier network who will charge the insurer to find accurate prices of claimed items
Claim Turnaround Time
Operational Costs
Fraudulent Claim Detection
Claim Approved
Text Extraction
Claims information extracted from claim documentation provided by customer
Policy Checking
Claim details extracted and checked against the policy to see whether it is included
Fraud Check
Claim is checked for to see if it is related to any fraudulent activity or if the customer has a fraudulent past using APIs
Missing Invoices
Items with missing invoices can be validated and claimed price of products is validated again with further APIs
Claim ApprovedClaim Turnaround TimeOperational CostsFraudulent Claim DetectionIf claim does not fit the policy, claim handlers will need to verify if a claim is covered manually by checking policy and policy attachmentsIf possible fraud is found, claims will be manually checked based on claims handlers experience of whether this should be referred to SIU (Special Investigation Unit)If prices of items cannot be validated, the claim is reviewed by the supplier network who will charge the insurer to find accurate prices of claims items 30% of total claims enabled for STP during pilot (75-80% expected for BAU)
70% Uplift in fraud, waste and abuse resolution
97% Overall OCR accuracy
Better pre-processing and great automation help streamline and simplify the entire claims process thereby reducing efficiencies and lowering the total cost of ownership.
Increase overall use of automation reduces the risk of wasted effort and leakage while human checks and approval remain to prevent fraud in the most complex cases, provide the best of both worlds
Clearer, more consistent and effective process enabled by our platform leads to dramatic improvements in payment resolution and a more satisfying overall customer experience.
New languages and use cases can be made available within just 2-4 weeks..
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