Accurate and Errorless Reports – Claim Processing

Claims are processed on the completion of the said event for which the policy was initially bought such as death or illness. Claims are tagged as pending, closed, rejected, or approved based on their status and claim request reason. Only approved claims are taken forward for processing and the claim amount is decided by a set of predetermined rules set by the IRDAI. These rules differ based on the type of ownership, industry, age, and other demographics. IRDAI guidelines require insurance companies to settle the claims within 30 days of claim approval. 

Challenge 

• Manual processing of claims within a fixed period (generally 3 days) for insurance companies is tough.
• As rule sets differ for policies, the accurate calculation of the claim amount is prone to errors.

Before SheetKraft

Data dumps containing the list of claimed policies, claim amounts, and claim reason are used for the creation of the report. After creation, the same is sent to IRDAI to check for any probable errors. Any errors highlighted by IRDAI are to be corrected within 3 days. Manual processing of policies is error-prone and this often leads to multiple to and fro between IRDAI and the insurance company.

SK Methodology

• The data dumps containing the list of claims requested are fetched by the system. Policies are tagged as pending, approved, closed, and rejected based on their status and request reasons.
• Predefined sets of logic for each policy category are fetched and calculations regarding claim amount, Industry type, and  MFI Non-MFI tag is performed.
• Policies are then collated to create a consolidated report ready to be used by the stakeholders.

After Sheetkraft Automation 

SheetKraft automated reports are accurate, thus reducing the multiple to and fro between IRDAI and the insurance company to correct any probable errors.

Impact of SheetKraft 

Sheetkraft has been able to successfully create the application to generate accurate Monthly Reports in a scheduled, hassle-free manner.

Total Effort Savings: From 24 man-hours monthly to 15 min per month.