Ambition
A leading general insurance provider in the UK covering more than 2 million customers and with gross written premium (GWP) of more than £700m, embarked on a digital transformation journey to achieve their mission of becoming the UK’s number #1 home insurer. The digital transformation was needed to unlock insights into customer needs and efficiently scale to growing business needs with intelligent automation, delivering touchless, frictionless digital customer journeys across channels.
The client faced several challenges, including a low digital customer rate of less than 5%, limited digital servicing capabilities, high costs associated with paper documentation, and limited self-service capabilities for policy changes. The client aimed to simplify and control the process and outcomes of the experiences through digital solutions, benefiting both customers and employees.
Action
Wipro collaborated with the client to define a strategic roadmap for the transformation journey, building a fully integrated digital solution for insurance claims processing leveraging Pega Customer Service for Insurance and Process AI, AI/ML models, and NLP model capabilities.
The salient features of the solution include
- Digital platform layer that integrates with Pega case management to orchestrate the workflow and automation across the claims journey from FNOL to Recoveries. Pega, in turn, integrates with client’s enterprise applications like SAP, Duckcreek, and others.
- Digital platform overlay powered by Pega Customer Service to provide frontline claims handlers and Protected Cell Companies (PCCs) a centralized 360-degree view of claims status with portfolio management capability.
- Pega ProcessAI powered Intelligent Decision Engine (IDE) with AI/ML models to aid efficient claims decisioning, fraud detection, segmentation & routing, workload & claims allocation, and settlement & fulfillment.
- Intelligent Document Processing (IDP) engine to allow document capture and provide automated document processing ability for all documents and Google image checks
- New/improved customer journeys (digital self-service FNOL, settlement, and fulfillment) with intelligent workflow orchestration and data auto-fetch capabilities to support Straight Through Processing (STP) automation for straightforward claims and better triaging (business rule and AI model-driven) for complex claims.
- Designed for growth and future with adaptable service components to engage customers proactively during surge events like floods, fires, or storms.
- Intuitive and self-guided workflow solution for ease of user adoption.
Ambitions realized
The fully integrated digital solution drives high efficiency in claims handling processes, elevating customer experience and helping employees focus on priority value-added tasks.
- Improved digital adoption of FNOL by 10x and other requests by 50x
- Increased digital document submission by 70% for new business, renewal, mid-term adjustment (MTA), and other documentation
- Automated straight-through processing for more than 35% claims
- Reduced call volumes for FNOL by 65% and for other requests by 50%
- Reducing paper document submission by 60%, providing substantial cost savings.
