August 12, 2022

How to Validate Claims Processing Behavior?

Learn the various benefits of claims processing & how it can have a positive impact in the insurance industry.

Claims processing is a monotonous task that can be time-consuming and challenging. It involves identifying the details of an insurance claim, verifying its validity, and assigning it to the appropriate department for further analysis. If you’re reading this article, chances are you already know how tedious this task can be. In fact, if you’ve ever worked in insurance claims processing before, you know just how complicated it can get. The good news is that there are solutions available to make your life easier. However, if you’re not familiar with the concepts related to insurance claims processing, this article will serve as your guide. Here, we’ll discuss everything from risk prevention to automated claims processing using Intelligent Document Processing (IDP).

What is Claims Processing?

Before we dive into automated claims processing, let’s discuss what exactly claims processing is. Claims processing is the process in which a company reviews incoming insurance claims and determines the condition of the policyholder. You’ll need to check the type of coverage the policyholder has, the details of the incident, and any exclusions that might apply. If the policyholder is covered, you’ll need to review any applicable deductibles and then assign the claim to the appropriate department for further analysis.

Insurance Claim Processing Steps:

Any insurance claim starts with an event, such as a loss or damage, that requires investigation and documentation. When the event is reported, the business needs to understand the type of event, the terms of the policy, and the reason for the claim. The next step is to create a claim, which is a record of all the information about the event and the required actions. A typical insurance claim processing workflow can be divided into four steps:

1. The Broker should be Informed of any Damage

Whenever there is a loss, the broker acts as a mediator. The mediator provides all the relevant information, including images and videos of the damage. In order to follow up on the claim, an adjuster is hired. ‍

2. Investigative Phase Begins

An adjuster investigates a reported claim and determines whether the claim is covered by the policy.

3. Policy Review and Damage Assessment

As soon as the adjuster receives the inquiry, he analyzes the policy, seeks expert help, and determines the extent of the damage covered by the policy.

4. Payment

In addition to organizing money for the loss's repairs, the adjuster will keep the policyholder informed of the progress of the repairs.

A structured and error-free claims processing process is challenging due to the heavy reliance on manual inputs, inconsistent stages, outdated applications, costs associated with recovery, and changes in regulatory aspects between states. ‍

For proper claim processing, several administrative, managerial, and manual efforts must be made to gather the necessary information. It is necessary to have a comprehensive system that integrates manual labor, business forecasting, database management, and an efficient IT structure to support the processing.

The Main Problem in Claims Processing

Every insurance company handles various types of insurance claims, such as fire claims, car accidents, and medical claims. When a claim is reported, insurance companies need to understand the type of event, the terms of the policy, and the reason for the claim. A large number of documents are required to support the claims process, such as receipts, repair estimates, medical reports, and police reports. Manually processing insurance claims can be challenging. First, the number of documents and data is increasing, making it difficult to process claims quickly. Second, a large number of documents with varying formats and content can become very challenging and time-consuming to process. Finally, there is a need for experienced manual data entry and a lot of staff training to meet high accuracy expectations. If a company does not have the right tools and technologies in place, it might not be able to meet these expectations.

How does Automated Insurance Claim Processing Work?

When the documents are scanned and sent to the data center, they are automatically ingested and indexed. The Intelligent Document Processing for Insurance processes documents and extracts the required data, such as the customer’s name and policy number. In addition, it will also pull other data related to the condition of the item or the event that was reported. The next step is machine learning, which involves automatic identification and classification of counter slips and switches that are independent of bank formats. Following that, the OCR will then extract relevant fields from the detected documents. Afterward, the NLP method is employed, which involves triangulating the correct information to ensure that it is accurate and complete. The final step is integration, which includes automatic data export to business processes and workflow integration with all downstream applications, including cloud and local databases and document repositories.

A Comparison of Manual and Automated Insurance Claim Processing

For the most part, there are some similarities between manual and automated insurance claim processing. Both methods use a workflow, where data is extracted from documents and stored in a system. However, there are also significant differences between them. Manual processing is often less accurate as there is a high level of human error. It can also be quite time-consuming and require a lot of training for staff. In addition, there might be a risk of inconsistent data quality, since each person might enter data differently. Automated processing is more consistent, as the same rules are applied to every document. In addition, it can produce higher accuracy, since it doesn’t rely on people to make mistakes. When it comes to data quality, it is important that the system is able to recognize the content of the documents.

What is Intelligent Document Processing for Insurance?

Intelligent Document Processing, or IDP, is an automated system businesses can use to manage documents. It allows organizations to automate a range of different business processes, such as document scanning, document routing, and document indexing. While these tasks may sound simple, they can quickly become complicated if you are not using the right tools. For example, if you don’t use a well-designed document routing system, it can be challenging for employees to find the information they need. IDP is an important part of modern business operations. It allows organizations to process documents quicker and more accurately. This is good for the business since it can convert more documents into revenue.

Why do we need Automated Data Extraction through IDP?

The volume of data is increasing, and companies need to quickly process a large amount of documents. Manual processing is time-consuming and doesn’t meet the needs of businesses today who need to process documents quickly. Automated data extraction from documents, such as receipts and reports, is the solution for businesses today. It can process a high volume of documents quickly and accurately. In addition, it can help organizations to improve data quality. When choosing a solution for Intelligent Document Processing for Insurance, it’s important to look for a solution that meets your needs. It should have the ability to process a wide range of documents and data types. It should also be able to recognize different content types, such as names, account numbers, and dates, from different types of documents.

Why should you use VisionERA IDP to Automate Insurance Claim Processing?

Insurance claim automation is becoming increasingly important, and determining the right automation solution is one of the next critical concerns.

Unlike other IDP platforms, VisionERA IDP is built with cutting-edge proprietary technologies such as artificial intelligence, deep learning, computer vision, natural language processing, and so on. The use of these technologies increases productivity, scalability, and flexibility while speeding up the processing process. With the collaboration of human and artificial intelligence, enterprises can benefit from improved automation capabilities. If you're looking for a dependable document processing solution, look no further than VisionERA . Using a continuous feedback learning mechanism, the system is regularly updated for upcoming issues. It can also be completely customized to meet your business needs. Using VisionERA IDP reduces claim processing time and eliminates human errors associated with manual entry, resulting in operational precision and speed.


In the insurance claims processing industry, automation consists mostly of rule-based processes where data is read and processed in a systematic manner. Insurance companies invest in claims automation processing systems to simplify their work and enhance customer satisfaction rates, from omnichannel client engagement to revenue generation, business operations improvement, and service streamlining.

The correct technology can prevent data breaches, and various automation developments in the industry are aiding companies in this regard. In addition, software that automates the process of filing insurance claims is designed to make the filing process more efficient, as well as make the process of cleaning and mining data more convenient. Additionally, you may gather insights from customer data while claims are being processed, notice developing trends, undertake data mining for insights, and collect insights from customer data while claims are being processed.

VisionERA IDP solution can automate data extraction for the processing of insurance claims. To see it in action, sign up for a free demo. Also to send us a query, use our contact us page!

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