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Claude-powered Insurance Policy and Claims settlement automation

goML Team

May 31, 2024
Table of Content

Business Problem

  • The client is a $4B IT Services provider & had an insurance product powering the Insurance lifecycle, including Policy Querying, FNoL & Claims Settlement.
  • Using traditional ML models for document text extraction & workflow-based automation, made the process slow & less accurate, with Claims STP less than 12%, quite below the industry standards.
  • Application built on legacy technology hosted in their DCs, with nonnative components, resulted in high hosting & application maintenance costs.

About Procurement

Solution

Team GoML designed a new application, leveraging LangChain & Claude-v2 for intelligent document extraction, built on native AWS services, including Bedrock & Textract

The new application gave users capability to query policy documents with higher accuracy & have NLP powered interaction with Insurance documents, including intelligent analytics on insurance data, such as the highest no of premium filed within a region etc.

The application also automated downstream workflows, like Claims Settlement & FNoL, post data extraction, increasing the STP Claims significantly

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Architecture

  • Document Upload and Ingestion: Users upload documents, which are ingested into the system for processing.
  • AI-Powered Attribute Extraction: Amazon Bedrock and Anthropic Claude-v2 models process documents, extracting key attributes using natural language understanding.
  • Data Storage: AWS S3 provides scalable storage for ingested documents and extracted data, ensuring secure and easy retrieval.
  • Search and Retrieval: A search module enables efficient search and retrieval of documents and data using indexed attributes.
  • Data Analytics and Dashboard: A dashboard visualizes data analytics, monitors system performance, and provides access to processed documents and attributes.
  • API Integration: API Gateway manages requests between the frontend and backend, with FastAPI handling document processing and data retrieval.
  • Security and Monitoring: AWS Cloud Security ensures data protection, while SNS and CloudWatch provide notifications and monitor system performance.

Outcomes

28%
STP claims, up from 12% in 3 months
6%
Increased CSAT for post-sales support with policy query automation
4%
Reduction in post-sales call center team in 3 months