Insurance Company – Automated Cashless Claim Processing

Overview

An insurance company processing cashless claims faced delays due to large volumes of documents—medical reports, invoices, and summaries. An AI automation solution was implemented to streamline document handling, improve accuracy, and reduce processing time.

Challenges Faced

• 2–3 days required to process each claim. 
• Manual data extraction from multiple documents.
• High manpower dependency and low accuracy. 

Solution Implemented

• Developed an AI-powered automation workflow using OCR and NLP. 
• Automated processing upon receiving emails with claim attachments.
• Extracted, validated, and populated data into Business Central and CRM.
• Automatically generated and sent reports to partner hospitals. 

Results Achieved

• Reduced claim processing time from 2–3 days to under 10 minutes.
• Accuracy improved to over 95%.
• Reduced manual effort and improved customer satisfaction.

Conclusion

The solution revolutionized claim processing by combining AI, automation, and integration. The insurer achieved speed, accuracy, and scalability, enhancing overall service quality.