Connected Claims
A comprehensive solution for streamlining and automating the insurance claims process, providing a 360-degree view of each claim.
Appian Connected Claims is a comprehensive solution designed to optimize the insurance claims process. It provides insurers with tools to streamline and automate claims handling, increasing straight-through processing rates. The platform offers a 360-degree view of each claim through an actionable dashboard, unifying data from various sources including claim systems, policy systems, and third-party applications. This holistic approach enables more efficient claims management and improved decision-making. The solution includes modules for customer service, claim operations and settlement, and fraud case management, providing a complete toolkit for modern claims handling.
Feature List
- End-to-end claims lifecycle management
- Automated claims triage and routing
- Real-time claims status tracking
- Fraud detection and prevention
- Document management and storage
- Integration with third-party data providers
- Analytics and reporting dashboard
Use Case Scenarios
- An insurer can automate first notice of loss intake, reducing claim processing time by up to 60%.
- A claims adjuster can leverage AI-powered triage to prioritize high-value claims for immediate attention.
- A TPA can provide real-time claim status updates to policyholders through a self-service portal.
Functionality Overview
Appian Connected Claims functions as a comprehensive claims management system. It begins by ingesting claim data from various sources, creating a unified view of each claim. The system then applies predefined rules to automate straightforward claims and route complex ones to appropriate handlers. Throughout the claims lifecycle, it provides real-time updates, facilitates communication between all parties, and maintains a complete audit trail. The fraud detection module continuously analyzes claims data to flag suspicious activities. The platform's analytics capabilities provide insights into claims trends and operational efficiency, enabling ongoing process improvement.