DECEMBER 2021CIOAPPLICATIONS.COM8DAVID MATHES, VP, UNDERWRITING SYSTEMS, RYAN SPECIALTY GROUP (RSG)Trends and Challenges in the Claims Processing and Management spaceIn terms of trends, I see key adjudication methodologies that were more or less ideational years back, now, bearing fruit. Two key areas where I have seen this manifest are in parametric claim payments and the use of AI in fraud detection.Parametric claim payment is one of the more fascinating trends I have recently observed in claims processing and management. Under this workflow, claim payments are automatically triggered in the event of a covered loss. This is an emerging concept in lines such as earthquake and cyber products. It is not an entirely new concept, but we are seeing the concept being realized today far more materially than in the past. The best example of this is the earthquake driven parametric claim process. Should an earthquake occur in a covered territory, the insurer automatically notifies all covered insured that they are aware of the incident and are promptly paying the agreed-upon amount to each insured. Automated payments follow shortly thereafter.Use of AI in fraud detection: More and more companies are now easily able to employ AI software and models to data-mine internal and external data sources to detect CLAIMS PROCESSING AND MANAGEMENT: OPTIMIZING THE COMPLEX COMMERCIAL INSURANCE PURCHASING IN MY ViewDavid Mathes
< Page 7 | Page 9 >