Case Studies

To empanel hospitals on their cashless network, insurers negotiate treatment rates with the hospitals, which are made available to the insurer in the form of tariff plans. These tariff plans are provided in the form of scanned PDF documents and are specific to every hospital. Additionally, in countries like India, where no medical standards are followed, these documents contain non-standard data. This makes the process cumbersome, non-scalable, inefficient and prone to leakages. With i3systems’ Tariff Standardization tool, these tariff plans can be digitized and converted into structured data. Using algorithms built on top of this tool, an insurer can adjudicate a claim in seconds, with 100% accuracy and transparency.

The claim settlement mechanism, for cashless as well as reimbursement claims, involves capturing data from paper / PDF scans, and feeding the data into the insurer’s core system. This is typically done in a 5-step manual process, resulting in long waiting times for claim documents and multiple errors in data capture. This leads to losses through leakages and frustration for customers. Using i3systems’ claim automation solution, i3claim, insurers are able to capture data directly from paper scans / PDF documents in a structured, machine-readable form. This helps our partners convert claim settlements into a single-step process, which reduces the manual processing by over 80% and significantly reduces the claim settlement TAT.

Cashless claims enable insurance customers to take treatment without paying out of their pockets. However, before a patient is discharged, the insurance company must authorize the claim. A long turnaround time for authorization leads to a long waiting time for the patient before they get discharged, leading to bad customer experience. To ensure customer satisfaction at this crucial stage, insurers are increasingly looking to reduce claim authorization TAT in a scalable manner, without deploying additional manpower. i3systems’ claim automation solution, i3claim, enables insurers to reduce cashless claim authorization time to under 30 minutes without compromising on process integrity, in a highly scalable manner.

In Health and Life insurance underwriting, insurers request many of their customers to undertake a pre-policy medical check-up. The insurer then underwrites the medical risk on the basis of these reports, which are received either physically or in the form of scans. This forces the underwriter to manually browse a 15-20 page document with more than 100 relevant data points before arriving at an underwriting decision, which is completely subjective. DataMD is designed to digitize and analyze the medical data in diagnostic reports, irrespective of its format or medical nomenclature. The system performs standardization of reported results creating a unified dataset. The quality control checks like inconsistent data points are built into the system to ensure high process accuracy.

Insurers using DataMD, our medical underwriting product, often use clinical ranges on medical parameters. While this is possible, it isn’t directly applicable for underwriting. It is possible for parameters to be clinically above/below normal, but have no impact on the final underwriting decision. This leads to cases which should go into straight-through processing being rejected. Such an approach also looks at medical parameters in isolation. Thus, combinations of parameters which suggest abnormalities get overlooked. i3systems’ Rule Discovery solution analyses past data to build a set of medical rules specific to the insurer, enabling higher straight through processing, while ensuring accuracy and alignment with the insurer’s underwriting philosophy and risk appetite.

Vendor management at large organizations can be a cumbersome task as they receive invoices from multiple suppliers in various formats. A great deal of time and effort goes into entering data from different types of invoices into the system. Moreover, errors in data capture through manual entry can lead to mistakes such as paying the wrong amount. i3systems enables extraction of data from invoices through the BillBot. The BillBot can validate 10,000 invoices per day from 500+ different suppliers and categorise key items from an invoice such as invoice number, GSTINs, place of supply, invoice line items and other information within seconds. Financial services companies can automate processes like vendor financing and bill discounting through the BillBot.

Companies can receive thousands of documents for obtaining personal information to process policy requests, KYC, etc. Even when these documents have a common template, there can be issues that make data extraction difficult such as tilted images or documents not held against a contrasting background. With smartphones being used to capture and send documents, there is a need to make data extraction from mobile images plain sailing. i3systems provides AI solutions that enable businesses to identify and extract data from structured documents such as document scans and images. From identification documents, such as Aadhar card, passports, driving licenses to income tax documents such as Form 16, structured data extraction has many useful applications.