Revolutionizing Fraud Detection in Insurance with AI/ML-Powered RPA

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20%

Reduction in claim processing time

25%

Improvement in operational efficiency

36%

Increased cost savings

About Client

The client is a prominent insurance provider that specializes in healthcare, travel, and accident coverage and is dedicated to maintaining the industry’s highest claim ratio. They aim to retain a leading position within the sector through contemporary technologies such as AI in insurance and ML.

Unveiling Success

Improving Operational Efficiency and Overcoming Business Issues with Leading Tech Solutions

The client wanted to move away from conventional methods requiring much manual intervention. They wanted to automate their insurance claim process solution with AI/ML to spot unusual patterns that are unnoticeable by the human eyes. The overall goal was to use deep anomaly detection to anticipate fraud detection in insurance claims quickly, reduce the loss ratios, and fasten the claim processing.

Challenges

Manual intervention in insurance claim process resulted in financial losses and inefficiencies

The lack of RPA fraud detection in insurance claims left the company vulnerable to fraud

Inflexible processes and human intervention hindered data analysis and critical detail detection

Solutions

Implemented AI RPA for fraud detection in insurance claim process, reducing fraud-related financial losses

Leveraged predictive analytics, AI, NLP, and image recognition to monitor customer behavior, enhancing customer satisfaction

Delivered AI/ML-driven RPA solutions for fraud assessment and operational excellence, resulting in cost savings

Tools and Technologies Deployed

Maximizing Business Value

The Business Impact and ROI Realized Through Our Advanced Solutions

Advanced Anomaly Detection

Achieved swift identification of unusual behaviors and fraud patterns, enabling quicker response and intervention by leveraging RapidMiner.

Streamlined Claims Processing

Streamlined the claim review process, ensuring that claims underwent fraud detection checks before payment instructions were transmitted to the bank with the help of an AI virtual assistant.

Enhanced Fraud Prevention

Mitigated financial risks and enabled a more sophisticated and supervised approach to detecting and preventing fraud by implementing predictive analytics in healthcare.

Why Kanerika?

Kanerika is a premier provider of data-driven software solutions and services that facilitate digital transformation. Specializing in Data Integration, Analytics, AI/ML, and Cloud Management, Kanerika prides itself on its expertise in employing cutting-edge technologies and agile methodologies to ensure exceptional outcomes. With a proven track record across various industries, Kanerika maintains rigorous quality standards, backed by ISO 27701 & 27001 certification, SOC II, and GDPR compliance. We are also CMMi Level 3 appraised, further accentuating our commitment to quality service delivery. As a distinguished partner of Microsoft, AWS, and Informatica, Kanerika’s commitment to innovation and strong partnerships positions it at the forefront of empowering businesses for their growth.

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