Proposed Improvements

  • Recommendations:

    • Progressive, step-wise, implementation

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

    • Provide support for low-level, repetitive tasks

      • Point out areas in need of review

      • Help with parsing and data extraction

      • Reduce repetition fatigue

  • 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