Automating Claims Processing

Delivering smart, efficient claims processing improving customer satisfaction through faster case resolution

Crucial to any insurance organisation is its claims handling processes. This process is fundamental to achieving high levels of customer satisfaction and business success. Yet many insurers still rely on time-consuming, labour-intensive, and manual tasks to process claims, leading to delays and sometimes errors.

With Celaton’s Intelligent Process Automation (IPA) platform, inSTREAM™, these tasks can be streamlined through AI, Machine Learning, OCR and RPA, delivering simpler more efficient claims handling, improving processing time and case resolution, compliance, customer experience and operational expenditure.


Key Solution Features

  • Intelligent automatic data extraction, validation, and enrichment

  • Identification and extraction of key dates, claim numbers, claim content, claimant details

  • Verification of claims numbers with case management systems

  • Continual process automation with self-learning AI algorithms and analytics

  • Bespoke email and approval workflows and multi-step process approvals





  • Seamless integration and automatic export to CRM and Case Resolution platforms including Agresso, Oracle, Microsoft Dynamics and many more

  • Exceptions, fraudulent and duplicate claims sent for human verification and action

  • Secure document archive for easy access, claims tracking and compliance

  • User-friendly and easy to install application for multi-site and remote working

"inSTREAM helps us to reduce claim cost and speed up the claims process, a win-win for insurer and policyholder alike"

Managing Director DMS, Davies Group

Customers who have applied inSTREAM to their Claims Processing have achieved:

Improved customer satisfaction with faster processing and case resolution

Scalability with business growth or surge periods

Significant Reduction in manual effort

Errors eliminated

Full visibility of process to ensure compliance and easy claims tracking

Intelligent Automation in Action

inSTREAM is able to process all claims regardless of how they are received including web forms, EDI, emails and attachments, paper (post and fax. It is able to read and process all formats,unstructured, semi-structured and structured ensuring all claims you receive follow a single process through inSTREAM.

inSTREAM reads and categorises the claim, whilst extracting key data and carrying out further tasks such as validation and verification of case details, identification of suspicious claims and other business checks.

Human in the Loop

As an AI platform inSTREAM requires human interaction to learn.  Through an easy to use Graphical User Interface (GUI) inSTREAM collaborates with the Claims Handlers who teach it where to find key information. inSTREAM learns from every document it processes, therefore as the volume of documents processed increases, its confidence and accuracy improve and the amount of interaction needed with humans decreases, enabling employees to focus on the complex, value-based tasks. 

Reporting

inSTREAM’s dashboards and reports provide organisations with visibility of processes and people enabling monitoring of costs, quality, capacity and productivity leading to greater control. inSTREAM provides analytics and insights into:

  • Data audit trails

  • Process insights

  • Performance analytics

All information is kept within a secure environment, with appropriate access granted. InSTREAM provides organisations with a simple and powerful way to bring together documents into a secure repository and create reports for management information.

Data Security

Celaton is an ISO27001 certified organisation which ensures your data is protected and GDPR compliant. Find out more about how Celaton protects organisation’s data.

Integration

inSTREAM has a wide variety of integration capabilities to ensure that all information is validated, verified and delivered to business compliant systems. Some examples include:

Celaton also delivers trusted Intelligent Process Automation solutions for Accounts Payable, Sales Order Processing, Customer Correspondence handling and Delay Repay for train operators.

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