Automated Processing Solution for Insurances
Efficient automation solution for insurance
Digital processing of objection or claim letters
Insurance companies spend a large part of their resources on customer correspondence. An example of this is the time-consuming processing of objection or demand letters related to premium increases in private health insurance. According to current legal rulings, premium increases must meet specific justification requirements. Otherwise, policyholders have the right to object to the increases and claim refunds. Some lawyers even advertise to policyholders and generate partially automated objections and demand letters. Consequently, many insurance companies receive a large number of objection letters regarding premium adjustments (over 2,000 per year, depending on the insurance company).
Benefits
Relief for your employees
Automated claims processing reduces the workload for your employees. They can be efficiently deployed where they are urgently needed.
Cost savings
With our customisable automated claims handling software, you can keep settlement costs of claims and litigation low.
Support from our experts
Our PwC experts are available at any time to provide you with their many years of experience for advisory support in automating your insurance processes.
Modular Approach: The building blocks of our insurance automation software
The Automated Processing Solution for Insurances organises individual processes, creates digital files, manages deadlines and automatically generates corresponding responses with consistent high quality. Individually configurable dashboards provide you with a current overview of all key metrics at any time.
01Analysis
- Screening incoming correspondence using Natural Language Processing (NLP) and enhanced Optical Character Recognition (OCR)
- Extraction of important information (such as date of receipt or deadline) and capturing individual parameters (including information about policyholders and incidents, as well as legal arguments) through artificial intelligence
In the Spotlight
Ensuring clarity with intelligent automation in the insurance sector
Choose between two options:
Pricing
Managed Service
Place the process in our hands and reduce the workload of your employees.
from € 9
per process
For representation in court matters, the statutory fees provided for this activity according to the German Lawyers' Fees Act (RVG) are owed.
Software Licensing – 3-year contract
Utilise the Automated Processing Solution for Insurances as an integrated part of your process structure. We provide advisory support throughout.
from € 7.90
per process
Software Licensing – 5-year contract
from € 6.90
per process
FAQ
What does the current case law on premium increases mean for your company?
The rulings of the Federal Court of Justice (Bundesgerichtshof) on December 16, 2020, case numbers IV ZR 294/19 and IV ZR 314/19, establish the standards that must be followed when justifying a premium increase by a private health insurance company. According to these rulings, health insurance companies must communicate the basis on which the premiums have changed. Failure to do so renders the increase ineffective. Additionally, if the justification for the premium increase is insufficient, policyholders have the right to claim refunds until the next valid justification for adjusting the premiums. As a result, many policyholders attempt to file objections and potentially make refund claims. This leads to significant administrative effort for insurance companies, which can be simplified and expedited using the Automated Processing Solution.
In which areas can the Automated Processing Solution be used in my company?
In addition to handling objection letters regarding premium increases, the Automated Processing Solution for Insurances can be used for all matters that essentially involve similar circumstances. For example, it can be applied in digital claim management to swiftly process termination waves and effectively implement changes to terms and conditions in a digital and time-saving manner.
What are the differences between traditional and digital legal consulting?
Digital legal consulting differs from traditional legal consulting in terms of faster processing speed and lower costs. You upload the objection letters or inquiries you receive to the PwC Engagement Center using drag-and-drop. Alternatively, you can send inquiries via email to our PwC experts. Additionally, with our dashboards, you always have an overview and don't need to request status updates via email.
How is my data protected in the Automated Processing Solution for Insurances?
All data transfers and storage in the automation software for insurance processes are encrypted using the latest security standards, ensuring end-to-end encryption. The data is stored on servers located in Europe. All data centres are ISO 27001 certified. Do you need more information? Please use the contact form.
From what size are my issues suitable for the automation solution for insurances?
For straightforward scenarios like objection letters, we already achieve significant efficiency gains and quality improvements compared to traditional manual processing with as few as 50 cases. The more cases that are processed, the greater the efficiency gains, and the more precise the AI-based and learning Automated Processing Solution can operate.
How error-prone is the Automated Processing Solution for Insurances?
By utilising rule-based processing with the Automated Processing Solution, errors due to carelessness or "copy-paste" mistakes are eliminated. This significantly increases reliability compared to traditional manual processing. Additionally, PwC Legal's lawyers optionally review all drafts before they are sent, further ensuring accuracy.
How do I know if my circumstances are a use case for the Automated Processing Solution?
Given the broad scope of the Automated Processing Solution, extending beyond the handling of objection letters, there is a high likelihood that the Automated Processing Solution can also be used in the scenario you have in mind. We are available for a discussion and can assess whether the specific circumstances in your company are suitable for implementing the Automated Processing Solution for Insurances.