Insurers want incredibly efficient operations. But customers want easy filing, efficient processing, and prompt, accurate payouts.
Here’s how to get past complicated integrations, outdated systems, and other claims efficiency roadblocks that get in the way of both of those things.
A lot of data goes into processing every claim, from internal and external sources. If insurers lack proper data integrations to account for varying formats and dataset structures… redundancies, inaccuracies, and inconsistencies become more likely — and slow down claims.
These integration difficulties — and other common problems, like outdated anti-fraud tools — are often rooted in legacy and modern legacy core systems. These platforms simply weren’t built with today’s technologies in mind, and require claims teams to handle many processes manually or on slow-running systems. This ups the risk of inaccurate payouts, unfair claim denials, and other problems customers won’t tolerate.
Cloud-based ClaimCore® and ClaimSmart™ from EIS allow claims teams to set up automated workflows to mitigate or prevent common claims bottlenecks.
For example, auto claim submissions automatically trigger interactions with repair shops and rental agencies, while claims themselves are routed directly to the correct adjusters. Meanwhile, customers receive real-time updates on claim status, so they’re never out of the loop.
ClaimSmart helps simplify claim filing for customers so they can submit the most accurate information possible from the start, without having to re-enter crucial information later on.
Automated workflows in ClaimCore and ClaimSmart enable end-to-end lifecycle management, directing claims efficiently so routine filings are quickly resolved and complex claims receive proper scrutiny (e.g., for fraud detection or subrogation).
Upon claim resolution, accurate payments are made per policy terms via airtight integration with your policy administration systems.
A: EIS boosts claims efficiency with ClaimCore’s event-driven automation and ClaimSmart’s AI/ML to reduce manual work and improve fraud detection from FNOL to resolution.
A: EIS stands out by combining cloud-native, API-first core claims (ClaimCore) with embedded AI/ML (ClaimSmart) on an open, real-time, event-driven platform that gives customers the transparency they crave, and insurers the accuracy and efficiency they need.
A: Yes—ClaimCore workflows and rules are highly configurable, and ClaimSmart journeys can be tailored by line of business and use case.
A: EIS accelerates deployment with preconfigured templates, configuration tooling, and low-code workflow and rules management across the platform.
A: AI in EIS claims automation speeds decisions and reduces manual work by spotting risk early, guiding the next best action ,and automating routine steps — with human oversight where it matters.
A: EIS improves claims CX by combining digital-first intake, real-time status visibility, and personalized communications.
A: EIS claims automation supports multiple lines of business, including P&C, life, disability, and other types of insurance, with workflows designed to fit each claim type.
A: EIS supports compliance with built-in auditability, security controls, and configurable data handling aligned to regional requirements.
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