Robotic Process Automation for end-to-end insurance claim processing

RPA or Robotic Process Automation has been a part of the global insurance industry for some time now. RPA has been a part of the industry’s goals to achieve operational efficiency through digital transformation. It has helped many to move out of their legacy systems and processes, but problems related to customer experience, legacy mindset, and lack of buy-in top-down has largely witnessed such fragmented efforts stall the adoption of automation largely. The problem identified relates largely to the industry’s eagerness to automate easy processes without planning to scale up and include all processes in an end-to-end chain.

Automating end-to-end claim processing

Even though end-to-end claim processing has been a part of the horizon for years now, it has largely been unrealized. There are reasons for this – most insurers wanted to deal with the burning issues and automate tasks as a piecemeal effort. But it only meant starting automated processes and stalling them midway because of the lack of vision and the right strategy to fit automation with the future of the business.

Issues that such siloed attempts gave rise to include:

  • Unable to match customer expectations.
  • Leaving more and more customers unsatisfied.
  • Dependence on manual completion of tasks leading to frustrations.
  • Inability to meet rising customer support requests.
  • Increasing risks of fraud and errors.

All of these typically result in operational efficiencies and increased costs. In the US alone, a one percent difference in accuracy can result in humongous costs to insurers each year.

Another important aspect of end-to-end claim automation is that most insurers spend half or more of their IT budget on legacy maintenance rather than cutting-edge technology and innovative initiatives. Thankfully, with AI and the latest automation technology like RPA, the industry can adopt scalable automation rather than ad-hoc automation. The key to success in this area is more integrated efforts from the top management and RPA initiative owners. So, what is the best way to go about automating end-to-end claim processing processes?

  1. Have a C-level automation sponsor come on board. The scope of work for the sponsor includes innovation and automation initiatives synced with the organizational goals.
  2. Include a pyramid structure that starts with task automation at the base where individual employees drive automation initiatives. The second phase is process automation that includes the entire department and organization. The third and the upper half include a digital strategy that takes into account the entire enterprise.
  3. Involve the operations team and the IT team to lead the automation process.
  4. If there is already RPA in place, it needs to be upgraded to be smarter. If not, the fine combination of ML, AI, and RPA can be deployed with intelligent elements.
  5. It is essential to study the workflows of the claim process meticulously so that inefficient tasks and sub-processes can be removed. When the entire process is streamlined, automation should be attempted.
  6. Integrate claim process RAP with other workflows like Customer relationship management, KYC process, underwriting, sanctions, fraud databases, and more.
  7. A necessary part of the process is identifying and mapping out the entire claim process, from the beginning to the end, especially from the customer’s perspective – what he wants and what he experiences.


Industry leaders should not simply focus on short-term ROI opportunities. They need to look at the bigger picture. End-to-end claim processing involves using RPA with chatbots, ML, and OCR to handle claim processing. It reduces manual error rates, operational overhead, customer wait times, and data leakage. It helps insurers work in compliance and also gives employees to contribute to high-value work. If you are planning to automate your end-to-end claim process, contact scalong – it is a premier software development company offering high-end automated solutions.