A mid-sized regional property & casualty insurer, ~1.2M active policies
Financial Services / Insurance
شكل هذه المشكلة
The same judgment, made differently every time
المشكلة
Claims arrived as unstructured attachments - PDFs, phone-photo scans, handwritten forms - into a shared inbox, where 14 clerks read, classified, and keyed each one by hand. First-touch to adjuster assignment averaged 4.3 business days, and roughly 9% of claims were misrouted at least once.
ما بنيناه
We began with a two-week audit rather than a model, sampling 1,800 submissions to map where time actually went. Two findings reshaped the scope: 60% of volume came from four claim types, and most misrouting traced to a data-entry step, not a reading problem. We redesigned the routing workflow first, then built NLP extraction against the four high-volume types, running it in shadow mode until accuracy held above 94% on a live holdout.
ما تغيّر
| المقياس | قبل | بعد |
|---|---|---|
| First-touch to adjuster assignment | 4.3 days | 7 hours on 72% of volume |
| Classification accuracy | غير مقيس | 96.8%, versus a 91% human baseline |
| Misrouting | 9% | 1.4% |
Misrouting
الأرقام مأخوذة من سجلات التنفيذ الخاصة بالممارسة للمشروع المذكور، ومقيسة مقابل العملية التي سبقته. ولم تخضع لتدقيق طرف ثالث، ولا يُعرض أي منها كمتوسط بين عملاء.
We expected an AI tool. What we got first was an honest map of why our intake was slow - and fixing that before the model went in is why the numbers held.Head of Claims Operations
- خط الخدمة
- Document & Request Triage
Partial, and say so in these words - the classification and routing machinery is in production; this specific application would be new. That sentence has never once cost a deal, and asserting otherwise would.
ابدأ من هنا
أيّ الأربعة هو مشكلتكم؟
أخبرونا بالمستندات والحجم الشهري وسنرسل أقرب سجلّين، مع الدليل وراء كل منهما والملاحظة الصريحة حيث تكون المطابقة جزئية.
يصلك الرد في غضون يوم عمل واحد، من المهندس الذي سينفّذ العمل - لا من سلسلة رسائل تسويقية.