Claims Processing Automation
How our agentic AI solution reduced claims processing time by 68% while improving accuracy for a major insurer
Client Overview
The Challenge
A leading insurance provider was struggling with inefficient claims processing workflows that were causing significant delays and customer dissatisfaction. Their existing system relied heavily on manual review, resulting in:
- Long processing times — Claims took an average of 9-12 days to process, causing customer frustration
- High error rates — Manual processing led to inconsistent decisions and a 12% error rate
- Escalating operational costs — The company was spending over $14M annually on claims processing operations
- Limited scalability — During peak periods, backlogs would form, further delaying processing
The company needed a solution that could dramatically improve processing speed and accuracy while reducing costs and improving the customer experience.
Our Solution
Agentic AI Claims Processing System
We developed a comprehensive agentic AI solution that transformed the client's claims processing workflow. Our system combined multiple AI technologies to create an end-to-end automated solution:
- Document Analysis AIAdvanced OCR and NLP to extract and interpret information from claim forms, medical reports, and supporting documentation
- Fraud Detection SystemMachine learning algorithms that identify potential fraud patterns and flag suspicious claims for review
- Decision-Making EngineAI agents that apply policy rules and make consistent approval decisions based on claim data
- Customer Communication SystemAutomated updates and personalized communications throughout the claims process
Implementation Process
Results & Impact
Key Performance Improvements
Transformative Business Outcomes
Average claim processing time reduced from 9-12 days to just 3-4 hours for standard claims
Error rates dropped from 12% to less than 3%, with continuous improvement through machine learning
Annual operational costs reduced by 42%, resulting in $5.9M in savings in the first year
Customer satisfaction scores increased by 56%, with NPS improving from +12 to +45
Client Testimonial
"The agentic AI solution developed by AscendAI has completely transformed our claims processing operations. Not only have we dramatically reduced processing times and costs, but we've also significantly improved accuracy and customer satisfaction. The system's ability to handle complex claims and adapt to changing conditions has exceeded our expectations."
Ready to Transform Your Claims Processing?
Contact us today to discuss how our AI solutions can help your insurance business achieve similar results and drive innovation in your operations.