Solutions for claims management

Process support for the primary insurer

Drawing on our expertise in the implementation of the flexible claims processing systems that are often made available to the primary insurer by the reinsurer, we also support our customers in expanding these systems to add automatic claims processing. At this time, data and analytics methods can be used to categorise claims and assess accumulation losses.

Process support for the reinsurer

The extraction of data from continuous text, such as multi-page reports, is also an area with great potential. Depending on the application and the customer’s needs, adesso offers projects that incorporate different tools to achieve the desired goal.

Claims and claims settlement are core activities of an insurance company. Every claim needs to be assessed and evaluated.

Software that makes it possible to quickly and precisely assess the amount of claims – and thus the amount of the reserves – provides a comparative advantage because capital is not tied up unnecessarily. Particularly in the case of long-tail claims, in other words, claims that are settled over a long period of time, it is extremely difficult to determine the exact reserve requirements. This is in no small measure due to the many variables at play, which also includes future variables, such as the cost of care or medical treatment. In addition, claims can be automatically outsourced for review and/or bills can be generated electronically.

Beyond that, professional analytics software can assist in the evaluation of claims reports by semantically evaluating and ‘understanding’ the texts. Either the case worker in charge of the claim is offered a summary or the claim is categorised immediately and made available for further automatic processing.