Manual claims processing
A claim arrives with a form, photos, an invoice and a medical letter, each in a different format. An adjuster reads them all, retypes key facts into the claims system and checks them against the policy.
- Why it happens
- Claims evidence is unstructured, and the system of record expects structured fields.
- What it costs
- Slow settlements, transcription errors and adjusters spending skilled time on clerical work.
- How we approach it
- We classify each page, extract the fields the claim needs with a confidence per field, validate against the policy record and rules, and route low confidence or rule breaking claims to review.
- What to measure
- Straight through processing rate, extraction accuracy per field and time to first decision.