3 Must-Haves in Claims Management Software

 Insurance buyers need the security of policies they can bank upon more than ever in these distressed times. Yet, research by the Mactavish Group, an insurance governance firm, shows that as many as 45% of major commercial claims are disputed, an outcome that adversely affects buyers, businesses as well as the insurance industry. Designing efficacious, unambiguous insurance products is one way to run complex claims efficiently. The other is to manage claims effectively.

The modern insurer requires a battery of modern technology which is capable of efficiently streamlining insurance claims processes, thereby cutting down on time, costs, and inconvenience. Claims management solutions that have the ability to quickly root out fraud and minimize the risk of losses or litigations provide insurance teams the leeway to focus instead on areas which require their expertise the most. There are three cornerstones necessary for improving claims operations: demand management, fraud network analytics and a responsive and easy-to-use customer access.

Support for Efficient Claims Handling

Efficient claims management solutions for insurance carriers are necessary for crafting goodwill between client and company, and this translates to speed, convenience, and consistency. The use of technology is growing increasingly central for this process, with machine learning (ML) and artificial intelligence (AI) quickly becoming imperatives for improving efficiencies. Text mining and MLcan iron out the creases in the earliest parts of the process and also continually keep discussions with attorneys organized and swiftly available.

Smooth, hassle-free processes supported by an effective insurance software solution are mutually beneficial for all parties involved. The likelihood of demands transitioning into litigations and bad faith decrease and make the next steps of any such process easier to handle.

Early Identification of Claims Fraud

Keeping up with claims frauds requires the use of advanced technology and an intelligent claims management solution to identify fraud at the earliest instance and prevent it from consuming too much of the insurance provider’s time.

As with claims handling, innovative and adaptive technology are central to the progress in the facet of the process. ML and AI have been game changers in tracking behavioral trends evident in previous fraudulent cases and alert the carrier to potential red flags.

Claims fraud need an insurance software solution that can keep pace with it. Technology which not only makes the process quicker and more efficient but also more foolproof is an essential ally for insurers.

Customer-centricity

The customer continues to be at the epicenter of the entire process. Their goodwill requires processes that are geared towards improving customer experience. Claims management systems that allow easy ‘anytime, anywhere’ loss reporting, convenient claim tracking and the ability to handle multiple lines of business can help elevate customer experience.

The generation of goodwill through customer satisfaction and loyalty stands firmly at the top of an insurance carrier’s to-do list. As important as rooting out fraud is, satisfying genuine insurance claimants is the top priority to ensure high customer retention rates and also the chance to network and extend the outreach of a firm. The right insurance software solution can aid all parties by helping the customer stay on top of their own claims and allowing efficient, tightly-bound handling of the situation.

How Cogitate can Help

‘Cogitate Intelligent Claims for Insurance’ suite includes three innovative, technology-led insurance software solutions for improving claims operations. These three solutions integrate easily with the existing claims management systems of the insurance carrier. Cogitate Demand Management makes use of ML and AI to make attorney demand letter processing as seamless as possible. Cogitate Claims Fraud Network Analysis - the CFNA - uses neural networks and advanced, futuristic technology to identify and act upon potential frauds with precision available only through use of such technology. The First Notice of Loss - FNOL - is a digital claims reporting tool which can be accessed through web portals or mobile apps, making the experience for customers much better. Talk to us today to learn how Cogitate’s solutions can be integrated with your systems to modernize claims processing

Top 7 Benefits of Investing in Claim Management Software System

 In insurance solutions, claims are a critical part. Even if your company is not a big player, it is prudent to invest in efficient claim management software due to its various benefits. The customer’s mindset and expectations are not the same as what they were 15 years ago.

As per a recent survey, 71% of customers did online research before investing in an insurance product. 67% of customers were ready to download and make use of an app from their insurer in order to access services in a hassle-free manner.

In short, these days, insurance industry is moving quickly to become more consumer-centric. And, to improve customer experience and streamline the communication process, your team members and consumers need to have access to intuitive claims management software.

This article speaks about the top 7 benefits of investing in the claim management software system. But, before diving deep into its advantages let us first understand what claims management software system is.

What is the CMSS?

The claim management software system makes it uncomplicated to administer various insurance products from application processing to dealing with clients and settling insurance claims. Using this software, users can manage insurance products by examining and judging the quality of the claim process.

Benefits of Claim Management Software

1) Consumer Satisfaction

These days, there is a lot of competition in the market, and because of it service quality has become a decisive factor in ensuring consumer’s loyalty to the insurer. When you invest in a claim management software system it makes sure that all data gets processed fast and in an accurate manner. So, it will lead to improved service and better customer satisfaction. Hence, this system helps you survive and thrive in an extremely competitive market.

2) Save Time

Usually, the manual process is quite time-consuming and sometimes leads to errors. This software eliminates the need for manual processes and avoids duplication of work. In short, data accuracy saves time and boosts up employee productivity.

3) Cost-Effective

Without investing in the claim management system, managing the claim process at an optimal cost is quite challenging for any insurance carrier or agency. This kind of software system streamlines the claim processing and lets the personnel work efficiently. As a result, it improves productivity and helps in reducing the cost of operations.

4) Authorized Access

The claim management software system integrates an architecture that lets each user access data only by using their individual set of credentials. This system never grants any unauthorized access to the data. Therefore, it ensures the security of all confidential data.

5) Fraud Detection

This software system lets you rapidly find fraud and speed up the investigation procedure in case of alleged fraud in a claim. The system utilizes proactive analysis based on historical data in order to find fraud associated with any case.

6) Data Integration

In such kind of system, you can integrate advanced data that offers the following benefits.

• It provides you with optimized work-flow.

• It enables data access in a definite format.

• It offers access to real-time information.

7) Process Standardization

The claim management software standardizes the claim settlement procedure. It combines various claim functions performed by multiple systems.

Wrapping Up

In nutshell, claim processing, settlement, and fraud detection are the common factors that facilitate in measuring the insurer’s ability to convert prospects into consumers. The claim management software could be an excellent tool and a great helping hand for insurers to perk up consumer satisfaction without ignoring the aspect of doing more business. In short, you can accelerate your business by investing in such digital insurance solutions.

Do you want to accelerate your business with digital insurance system then connect with Cogitate - https://www.cogitate.us/. We are expert in developing up to date and component-based software for your insurance business. Our ready to integrate solutions covers the entire insurance value chain from Rate, Quote, Bins and Issue, to Distribution to Claims solutions.

Top 6 Must-Have Features of Insurance Solutions

 There is no universal definition of insurance solution but, according to a general idea, it is software or a set of technological solutions given for economical management of insurance business. It contains some independent parts like fund management or offers presentations. Mainly, insurance solutions aim to resolve issues like product defining, settlements, or underwriting. The prime issue insurers face are problems with policy operations and claim processing, along with reporting. A reliable insurance solution must be of help with the above-mentioned problems.

Insurance solutions must also provide support for the various options including insightful products for mobile without a doubt.

Depending on the software’s target audience, there might be a vast difference in features. However, when talking about insurance solutions, the following features are a must-have.

1. Built-in Metrics

Insurance solution software includes profitability indicators like loss ratio, burning costs, risk cost per policy, net basis, and reinsurance. The built-in KPIs provide analysis capabilities and advanced reporting out of the box.

2. Claims Activity Monitoring

Software’s can capture entire claim information that includes claim payments, outstanding claim reserves, payment components, deductibles, perils and event codes, and relevant claim activity dates. It provides the claim manager in-depth information needed to manage and monitor claim activity resourcefully.

3. Lapse and Renewal Calculation

The premiums and policies that are up for renewal are grouped according to their renewal date. The system provides information on the analysis of lapses, renewal lists, and renewal rates comparison. The functionalities draw attention to the characteristics of insurance products, the behaviour of the distribution channel, and active marketing and sales support.

4. Insurance Exposure/ Views Of the Sum Insured

Insurance is not just about claims of cash flow and premiums. Companies must monitor the risk whether it is in sum insured base or the unit base. Insurance solution software provides insurers with methods of pre-built calculations and measurements to monitor and analyse the exposure to underwriting risk on a gross, retained basis, and reinsurance ceded.

5. Supports Changing Organization Structure

The insurance solution must support multiple chains of hierarchy and asymmetric organizational structures. It should provide various scenarios when the organizational structure changes. It ensures correct reporting of profitability performance and distribution of sales channels.

6. Time Bases

It must manage insurance time dependencies with the calculation method and data model. The insurance software must enable you to analyze insurance information from a various time perspective, reporting, and providing the framework of analysis to underwriters, marketing executives, reinsurance managers, claims managers, and accountants. The system should provide financial accounting analysis, operational reporting, snapshot reports, and policy inception. The time base perspective alters the way measurements are calculated, and the inter-dependencies on them are supported by the system.

In Conclusion

Like any other industry, insurance solution software development requires professionalism and excellent expertise. When hiring the best software solution, the insurance company must have a solid understanding of the industry’s best practices and regulations.

To get the best possible result of your initiative, choose Cogitate that has a proven track record of successful projects. Having worked with the industry leaders, Cogitate has the experience and skills to help build a user-friendly and modern mobile and web applications for your insurance business. Cogitate’s Artificial Intelligence and Machine Learning driven solutions for claims integrate seamlessly with your existing Claims Management Systems.

The best software solution for insurance must be a modern and intuitive platform to handle various functions of the insurance value chain. So, connect with Cogitate today on https://www.cogitate.us/ to enhance your existing claim management system capabilities and features and provide your clients first-class and hassle-free services

Tips to Choose Claims Management Software

 When you make errors while judging, it can become extremely exasperating in the insurance or any business world. Whether these errors you make due to lack of knowledge or your impatient nature, it can cost you high. However, if you want to ensure that you make no such errors and your business functions smoothly then you must consider investing in claims management software for your insurance business.

Of course, while choosing for claim management software you want to settle down for the right one. But, nowadays, there area plethora of systems available. In such a case, how do you know which one is the best fit for your business? Well, do not worry. We have the answer for it.

Let us check out the below tips that you should follow while selecting claims management software

1) Consider Vendor/Company Experience

While selecting the claim management system, the vendor or company’s experience is highly important. It makes sense to go for a company that has experience in developing software related to the insurance field. Therefore, while choosing the software, the first thing you should check for is how long the company has been in the business.

2) Ensure the SoftwareYou Choose is Easy and Intuitive to Use

You should always select the software that is user-friendly and simple. In your insurance business, you have to go through lots of tasks. So, you must pick the software that is easy to learn, normal to use, and captivating to be in. Ensure it is easy to review and operate upon the data.

3) Make Sure the Software is Compatible With Your Insurance Field

You should always select the software that is highly compatible with your specific insurance claims processing field. The company or vendor you are choosing to develop your software must be able to fulfill your entire requirement to handle claims and risks.

4) Choose Cloud-based Software

You should choose cloud-based software for better inter-department communication. It will help them in taking real-time decisions. So, go for SaaS architecture which offers browser-based and state-of-the-art access to your data.

5) Never Compromise on Security

When it comes to managing and processing the claims insurance data, you cannot take any chance. The software you optfor must provide the security you will need to avoid any attempt of a data breach.

6) Emphasize on Cost Efficiency

While choosing the software its reliability and efficiency play an important role but it should not break your bank account. The software you select must also lie within your budget. So, do proper research regarding software costs and ensure there is no hidden cost associated with it. Make yourself well-versed regarding any per-user cost, data storage cost, periodic cost, and much more.

7) The Data Conversion Process Should Go Smoothly

While selecting and buying claim management software, ensure it provides you with the streamlined data conversion. If you face any issue then your vendor or company should be willing to help you in solving it. If you try to fix errors onyour own it will create more problems. So, it is better to involve your vendor or company in the process.

To Sum Up

In nutshell, picking the perfect insurance claims management software might be a daunting task. However, by considering the above tips you can make this task easy for you. It is always better to be safe than feeling sorry and so you should do all the necessary research to ensure you are selecting the right system.

You should go for a highly reputable company like Cogitate - https://www.cogitate.us/ that has extensive experience in easily integrating intelligent claims solutions in your existing CMS. At Cogitate, we help our clients in integrating Cogitate Intelligent Claims solutions seamlessly with their accessible CMS in such a way that it aligns with the demand of their organization. In short, if you want to give your clients the best service possible then ensure the claims management solution that you integrate into your CMS best fit your company needs, has the above-discussed features, and does not end up costing you!

How Insurers Are Using Technology to Deal with Insurance Claims Fraud

 This post details the growing menace of insurance claims fraud. It is a problem that nearly all insurers are battling, but with limited success. The fact that fraudsters are always a step ahead by misusing technology to achieve their nefarious deeds makes it even more difficult to manage the problem. Technology is the only way of mitigating the instances of claims fraud and empowering insurers to deliver their services more effectively.

Insurance claims fraud is an area of serious concern for insurance providers, as the instances of such scams are proliferating globally. Scammers indulge in inflating claims by manipulating facts and making a pile of cash illegally. It forces insurance companies to invest heavily in system upgrades, technology, and manpower to proactively detect such fraud attempts and mitigate potential losses.

The Challenges: 

Insurance providers have been relying primarily on the judgment of agents and industry experts to detect instances of frauds. While this was a reliable method in the past as there were limited number of cases, in the modern world it is impossible to keep a track on fraud using human resources.

• It is virtually impossible to scrutinize all claims manually.
• Fraudsters are using newer and more sophisticated ways of perpetrating such crimes.
• This has entailed the need to use technology to deal with this growing and serious crime.

 

The rise of technology such as data analytics has created a world of endless potential for organizations operating in the insurance sector. While cost concerns and regulations have been the reasons for slow adoption of data analytics by the insurance sector in the past, all that is rapidly changing because of the intense pressure on the industry to cut down the colossal losses caused by claims fraud.

There is a lot of regulatory importance placed on protection of personal information, with new layers of security being added regularly. This has made it extremely tough for insurance companies to access data from various sources for fraud predictions. Data analytics has proved to be a game-changer for the industry and is helping insurers manage claims fraud instances better.

Fraud Analytics Software

Insurers are incorporating insurance fraud analytics software into their business processes to detect fraudulent practices and detect such incidents early and proactively.

Fraud analytics software systems can reduce claims fraud by gathering data from various sources and collating it into meaningful and valuable information. Predictive capabilities of the software can help companies apply the process to a large area of business operations and improve fraud detection significantly. The software can be used for:

• Identifying optimal risk level
• Gaining qualitative insights from data
• Mitigate fraud risk at insurer’s end
• Eliminating fraud risk at the agent’s end
• Moving from manual to automated underwriting
• Establishing accepted limits of risks
• Automating procedures to identify risk assessment for determining various factors such as coverage, profitability and others

 

Understanding Legacy Systems

One of the biggest challenges of adopting analytics software is the need to upgrade systems to the latest versions. With technology evolving rapidly and continuously, this might entail a fairly substantial investment. Also, there are concerns around use of a third-party service or software because of privacy protection issues. Insurance companies might not have absolute control over data which can result in significant liability.

Insurance Fraud Detection Solutions:

Advanced claims fraud detection solutions are driven by technology. It works in the following ways:

Detection of Anomalies:

Multiple metrics are created to compare the behavior of various entities. The system makes use of statistical analysis to detect any anomalies that deviate from the normal behavior patterns of agents and customers.

Analysis of Claim Notes

Analytics can help in extracting information by going beyond structured data. In simple terms, it means that it can pull data about circumstances of a specific incident, the parties involved, the damage caused, treatment costs and other related data vital for claims settlement.

Investigation of Anomalies:

Agents and customers pointed out as anomalous on more than one count are singled out and detailed analysis carried out to find out the reasons for the anomalies. Business rules can be set up to prevent misuse and future frauds.

Conclusion

Insurance frauds are generally carried out in a very organized manner across the globe. In the modern world, it will be difficult to detect them without using sophisticated analysis methods. Insurers must leverage newer technologies to prevent, detect, and filter frauds. This will help improve claim adjustment expenses and improve the efficiency and performance of the industry.