Connected Claims
A comprehensive solution for streamlining and automating the insurance claims process, providing a 360-degree view of each claim.
Appian Connected Claims is a comprehensive solution designed to optimize the insurance claims process. It provides insurers with tools to streamline and automate claims handling, increasing straight-through processing rates. The platform offers a 360-degree view of each claim through an actionable dashboard, unifying data from various sources including claim systems, policy systems, and third-party applications. This holistic approach enables more efficient claims management and improved decision-making. The solution includes modules for customer service, claim operations and settlement, and fraud case management, providing a complete toolkit for modern claims handling.
Feature List
- End-to-end claims lifecycle management
- Automated claims triage and routing
- Real-time claims status tracking
- Fraud detection and prevention
- Document management and storage
- Integration with third-party data providers
- Analytics and reporting dashboard
Use Case Scenarios
- An insurer can automate first notice of loss intake, reducing claim processing time by up to 60%.
- A claims adjuster can leverage AI-powered triage to prioritize high-value claims for immediate attention.
- A TPA can provide real-time claim status updates to policyholders through a self-service portal.
Functionality Overview
The Connected Claims platform provides a comprehensive solution that integrates seamlessly with existing insurance infrastructure. It manages the entire claims lifecycle from first notice of loss through investigation, adjudication, and settlement. The system uses configurable business rules and AI-powered analytics to automate routine decisions while routing complex cases to specialized adjusters. Built-in reporting provides real-time visibility into claims performance metrics.