Operating in a highly complex, dynamic environment, insurance companies are often challenged by stringent government regulations and skyrocketing customer expectations. Apart from keeping up with industry trends, efficient claims management plays an important role in driving success rates of both large and small insurance companies. Insurance is one of the oldest sectors that have leveraged statistics and analytics. Predictive analytics in insurance claims uses historic data to identify past patterns and trends to predict the upcoming results. Today the competitive landscape and technological advancements have prompted insurance companies to apply claims data analytics in various processes for driving the efficiency of operations.
About the Client
The client is a health insurance company based out of the US with several business units spread across the globe.
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This insurance provider was looking forward to gaining visibility and better insights into their claim operations. They approached Quantzig to leverage advanced analytics solutions to identify the potential high-risk claims and analyze data to gain meaningful insights. High-risk claims always end up creating chaos in an insurance organization, mainly because the client’s methodology of identifying potential high-risk claims was based on a conventional predictive model that lacked the power of claims analytics. Thus, the client was unable to identify the upcoming claims.
This insurance provider also wanted to leverage claim data analytics to develop an efficient analytical framework to identify both high and low risk claims. Key challenges of the client included-
Problem Statement 1:
High turnaround time for claims processing- Due to lack of claims data analytics integration in the system the client was taking a lot of time to process existing claims which was hampering their customer satisfaction rates
Problem Statement 2:
Extensive work to calculate claims metrics- The conventional claims calculation approach was leading to inaccurate results and huge losses for the client
Problem Statement 3:
Unintegrated datasets- This insurance provider had access to a vast pool of data generated from various sources and locations which were leading to data silos.
To gain a competitive edge in the marketplace, insurance providers must improve their cost efficiency in order to achieve operational excellence. Our customized claims data analytics solution can help you to enhance business outcomes. Request a free demo to know more about our claims analytics solutions portfolio.
Solution Offered and Value Delivered
Quantzig’s claims data analytics engagement combined analysis to classify the types of claims. To meet the requirements of the client the analytics experts analyzed a variety of data sets including payment details to the tenure of claims using claims analytics. We identified the scope of predictive analytics in insurance claims and identified risk probabilities. The claims analytics solutions offered also helped in calculating the tentative future cost and cutoff values. In a very short span of time the client was able to identify the tendency and outcome for each claim.
Quantzig adopted a four-pronged approach to help the client address their challenges, the details are as follows:
The first phase of this engagement revolved around data standardization, data integration, and a detailed analysis. Our experts integrated data from various platforms into a unified source that was available to every employee involved in claim processing.
In the second phase claims data analytics experts worked on reducing the turnaround time for the client by examining the roadblocks in the current processes
The third phase of this claims analytics engagement focused on automation of key processes to drive improvements through the use of artificial intelligence and machine learning for generating metrics for claim processing.
Faster claim processing leads to a great brand value for insurance providers. Thus, leveraging predictive analytics to interpret workflow data in the last phase offered valuable insights that aided the insurance provider to devise a better claims management workflow.
Our claims analytics solution can help you understand the opportunity for your services in the marketplace. Request for more information on our analytics solutions.
Quantzig’s Claims Analytics Solution also helped the client to:
- Improve claims processing efficiency
- Predict high-risk claims
- Enhance customer retention rates by 47%
Why Choose Quantzig as Your Next Claims Data Analytics Partner?
Claims analytics is an important solution for every insurance provider across the globe that deals with economic uncertainty in the global market. Claims analytics helps insurance companies to stay prepared beyond the current period by identifying probable risks. Insurance firms can also leverage claim data analytics to identify unsatisfied customers. With years of experience in the field of claims analytics, we have created a niche for us in the advanced analytics field. We believe in delivering actionable insights and customized solutions that fit your business requirements while ensuring value for money.