Intelligent Automation for Insurance Claims Processing

Authors: Mahaboobsubani Shaik

DOI: https://doi.org/10.5281/zenodo.14352226

Short DOI: https://doi.org/g8t7nc

Country: India

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Abstract: The transformational effect of intelligent automation through machine learning models on insurance claim processing. Traditional manually operated workflows within claims processing are always vulnerable to inefficiency, inaccuracies, and fraudulent cases. Intelligent automation overcomes these challenges by streamlining processes that offer rapid claim validation and more accurate detection of fraud cases. The research work illustrates an integrated claims-processing mechanism that leverages predictive analytics and anomaly detection to filter out fraudulent patterns. Accuracy rates, time-to-resolution, and cost savings have seen significant enhancement compared to a purely manual process. Empirical analysis suggests that automated systems reduce the processing time by as high as 70% and can detect fraudulent claims with an accuracy of above 95%. Besides, intelligent systems provide scalability, flexibility to policy changes within insurance, and customer satisfaction through the acceleration of the processing of genuine claims. The results highlight how ML-driven automation can transform claims management into more efficient, reliable, and trustworthy ways in the insurance industry.

Keywords: Intelligent automation of claims, machine learning, fraud detection, predictive analytics, workflow for claims, efficiency in processes, detection of anomalies, customer satisfaction, reduction in time taken.

Paper Id: 231793

Published On: 2019-07-05

Published In: Volume 7, Issue 4, July-August 2019

Cite This: Intelligent Automation for Insurance Claims Processing - Mahaboobsubani Shaik - IJIRMPS Volume 7, Issue 4, July-August 2019. DOI 10.5281/zenodo.14352226

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