Automatic claim processing through Appian in Insurance company

Hi All,

Can someone help in telling a workflow for an automatic claim processing without human intervention?

Requirement:

  • Significant delays in processing low value claims due to adjuster’s availability
  • Impact on profitability due to time spent by adjusters on low value claims against the revenue
  • Need for an application for the Adjuster for claims assignment and adjudication
  • Need for streamlining and expediting Claims settlement / payment process

Solution:

  • Developed an application for Adjusters to maintain entire claims lifecycle
  • Application handles processing of claims in the Claims Management System (CMS)
  • Automated approval & payment of claims based on defined business rules / workflows

Thanks

Faisal

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