Proposed Improvements

  • Recommendations:

    • Progressive, step-wise, implementation

    • Use various AI/ML tools and techniques to assist the adjusters

    • (Completely replacing humans is extremely hard. Helping them is much easier)

    • Provide support for low-level, repetitive tasks

      • Point out areas in need of review

      • Help with parsing and data extraction

  • Goals:

    • bring average processing time from 7h/claim down to 2h/claim

    • reduce human error by 80%

    • improve fraud detection by 25%

  • Requirements

    • More precise measurements of performance

      • at baseline

      • after every change/improvement