





Normally, we require that all companies involved in an eWEEK IT Science case study be named, but this one required anonymity for legal reasons, and we granted it.

Today’s Topic: Shortening Claims Processes, Improving Customer Experience With Intelligent Automation

Name the problem to be solved: A Fortune 500 insurance company was dealing with nearly 650,000 open pregnancy claims annually, a process that was completely manual. At the time, the insurer, who wishes to remain anonymous for this story, relied on contact center agents to make phone calls and send emails to process customer claims. On average, agents attempted to reach claimants six times before being able to collect key dates to process disability claims. They would need to reach out to the claimant on predetermined dates to confirm if claimants had stopped working and then, based on those answers, there would be follow-up questions. Each call cost the insurer roughly $17, and the average time to process a disability claim was three weeks.

List the key components in the solution: Using Ushur FLOW builder, the claims executives at the insurance company constructed the processes and conversation paths to reach claimants over automated two-way text messages. With Ushur, it’s as simple as mapping out current manual processes and designing an automated workflow via the visual builder. Using Ushur APIs, the insurer brought claimant responses back into its proprietary and legacy claim management system. Ushur also provided an additional safety net by providing compliance to regulatory requirements in multiple countries. The insurer was able to transform its decades-old CRM system to deliver self-service for its mobile customers within a matter of days without having to invest millions developing a solution in-house.

Describe the strategy that went into finding the solution: The insurance company had already deployed Ushur for a couple of other use cases and so the solution was on the forefront of their minds at the time. The company was looking for a solution that would not require extensive IT investment and something that could be deployed quickly and efficiently. The solution it chose also had to integrate with its current claim systems, because if it couldn’t bring the information retrieved from claimants back into the company’s back end automatically, it was a nonstarter. Data entry continues to consume a large amount of time for claims departments, and the insurer felt that automation should be able to handle those low-level repetitive tasks so claims executives can focus on more important initiatives.

Describe how the deployment went, perhaps how long it took and if it came off as planned: From conception to ideation to deployment, the process of deploying Ushur for this particular use case was a matter of weeks.

Describe ROI and staff time savings, if any: After deploying Ushur, the insurance company has been able to demonstrate 90 percent response rates from customers with Ushur-based interactions, greatly elevating its Net Promoter Scores (NPS). The claims process was fully automated and resulted in $12 million in savings, returning a greater than 10X return on investment (ROI). What’s more, the average time to complete the claims went down from three weeks to under one hour. Agents became available for more important tasks instead of wasting time calling claimants repeatedly. But perhaps more interesting, while the software initially made some agents wary, fearing the new technology would be coming after their jobs, they ultimately found that the Ushur platform helped to augment their jobs, essentially enabling agents to effectively delegate the more menial aspects of their job tasks to software.


Chris Preimesberger

Chris J. Preimesberger
