EXL Smart Data Signals

Use Case Details

EXL Smart Data Signals aims to solve for the industry problem of proactive claim leakage management. As per industry estimates, there is around US $6B+ leakage in total claim payouts, at least 50% of which is addressable and preventable. This is due to:

  • Reliance on point-in-time and episodic analysis versus dynamic and continuous monitoring to detect real-time anomalies
  • Siloed approach to data & decisions across operational teams

EXL Smart Data Signals helps to drive better claim and customer outcomes through:

  • Decreasing Combined Loss Ratio: Proactive claim management enabled by near real-time insights for leakage detection and prevention to ensure accurate settlement to combat eroding Loss Ratio and achieve target cost savings
  • Improving Customer & Agent Experience: Proactive customer experience management during claim journeys enabled by near real-time insights for sentiments, potential escalations / complaints, and compliance.
  • Driving improved operational efficiency for Claim Leaders: Proactive claim management enabled by near real-time insights to augment Leaders for management of their claim pending to ensure time is spent on value-added activities

Key Features & Functionality

  • Predict and enable proactive leakage and customer management
  • Automate alerts based on a summarization of anomalies detected (powered by generative AI)
  • Enable claim leaders to provide the right support to the right claim at the right time
  • Augment existing claim quality programs with improved controls for customer experience, loss cost management controls, insights and performance prediction

Benefits & Business Impact

Increased revenue and customer satisfaction with:

  • Continuous monitoring of near 100% of claims
  • 10 times higher detection of potential anomalies across CX opportunities, leakage and compliance
  • 10% to 15% reduction from baseline leakage rate
  • 50%+ improvement from baseline CX management and process compliance satisfaction
  • Improved operational efficiency