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Insurance Automation
A Comprehensive Guide
ScienceSoft applies 12 years of experience in insurance software development and 35-year expertise in digital transformation to help insurance companies automate their business processes.
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The Essence of Insurance Automation
Insurance automation aims to eliminate manual workflows across underwriting, billing, claim processing, policy updating, and other insurance-related processes.
Automated insurance systems rely on advanced techs (cloud, AI, big data, blockchain, etc.) to help insurers make their business operations more efficient and ensure the company’s sustainable growth.
- Key integrations: a CRM, payment gateways, accounting software, a BI solution, etc.
- Implementation time: 10–18+ months for a custom insurance automation system.
- Development costs: $200,000–$4,000,000+, depending on the automation scope and complexity. Use our free calculator to understand the cost for your case.
- A payback period: 6–12 months on average.
Main Use Cases of Insurance Automation
Underwriting
Automate up to 80% of tasks and enjoy a 2–5x faster cycle with >99% accuracy of underwriting operations.
Policy management
Drive >50% increase in the productivity of your insurance team and benefit from 3x faster policy creation, updating, and renewal.
Billing
Eliminate ~90% of manual tasks and decrease costs by up to 80% while getting a 2–3x faster billing process.
Claim management
Employ cognitive techs to accept, verify, process securely and error-free, and settle claims in minutes rather than days.
Regulatory compliance
Be 100% sure of your compliance with all insurance-specific legal requirements and data protection standards with real-time compliance checks and automated compliance reporting.
Customer support
Rely on intelligent virtual assistants to process >50% of omnichannel customer inquiries and improve the SLA performance for key metrics by >20%.
Key Features of an Insurance Automation System
ScienceSoft creates automated insurance systems with functionality bound to each customer’s unique needs. Below, we share a comprehensive list of the features commonly requested by our clients:
Customer onboarding and pre-qualification
- Configurable self-registration forms for individual and corporate customers.
- Automated capture and validation of customer personal and business documents using OCR, RPA, and AI technologies.
- Instant routing of suspicious and contradictory customer data pieces for manual check.
- Geography-based KYC/AML verification for new insurance customers.
- Automated customer pre-qualification against the pre-set internal requirements: age, location, income sustainability, owned asset value, etc.
- Data-driven customer segmentation by user-defined criteria: age, gender, lifestyle (for individuals), industry, location (for businesses), and more.
- Automated processing of insurance applications.
- Rule- and AI-based assessment of customer risks based on the analysis of:
- Data provided by customers.
- Data available from third-party sources (local credit rating bureaus, medical information bureaus, business registries, title registries, environmental databases, GIS and telematics platforms, etc.).
- The customer’s past insurance coverage and claims history, if any.
- Risk scenario modeling and risk impact assessment based on custom actuarial models.
- Automated calculation of individual insurance premiums based on:
- The type of insurance policy.
- Requested coverage terms.
- Customer creditworthiness, health risks, location, claim history, and more.
- AI-supported recommendations on the optimal personalized premium amounts, coverage limits, and reinsurance options for particular customers.
- Template-based generation of insurance quotes and automated quote submission to prospects.
- Customizable templates for various types of insurance policies: life insurance, health insurance, auto insurance, etc.
- Automated policy generation and submission to customers (via email, messaging apps, or a customer portal).
- Automated policy endorsement (updating customer data, coverage and premium terms).
- Rule-based policy renewal and termination.
- Instant communication of policy updates to the policyholders.
- Template-based creation of customer invoices, including multi-currency and multi-language ones.
- Calculating a customer-specific premium and applying it to the invoice.
- Signing invoices using an e-signature.
- Support of multiple payment methods, including bank transfers, credit cards, checks, e-wallets, etc.
- Automated payment processing via the connected payment gateways.
- Real-time invoice tracking by status (sent, paid, due, etc.).
- Automated aggregation and processing of claims from a customer portal, emails, phone calls, etc.
- AI-based validation of claim-supporting documents: medical images and reports, accident reports, photos or videos of damaged property, etc.
- Automated identification of fraudulent insurance claims.
- Remote damage inspection using AIoT and computer vision technologies.
- Rule-based damage estimation and claims triaging.
- Automated assignment of claim management tasks based on employees’ qualification, availability, location, etc.
- User-defined rules for claim approval or rejection.
- Calculating the due claim payment amount based on custom formulas.
- Instantly communicating claim-related decisions to customers.
- Automated payment of approved claims.
- Automated submission of claims under the reinsured policies for settlement to the relevant reinsurers.
- Calculating and monitoring the essential metrics: underwriting, claim management, financial performance, workforce, etc.
- Configurable analytical dashboards for various user roles: sales agents, underwriting specialists, claim managers, financial analysts, etc.
- Automated generation of insurance reports.
- Scheduled and ad hoc submission of the approved reports to the required legal regulators (e.g., FIO, NAIC, local insurance authorities).
- Predictive analytics to forecast insurance demand, revenue and expenses.
- AI-powered analysis of customer behavior and web sentiment.
Customer self-service portal
- Customer self-registration, managing and updating personal or business information.
- Template-based creation of insurance applications.
- Paying premium by a preferred payment method.
- Filing and submitting claims.
- Notifications to customers about the application and claim status changes, expiring documents, etc.
- Instant messaging.
- AI-powered virtual assistant to help customers solve operational, technical, and security issues.
- (optional) A self-service insurance price calculator.
Security and compliance
- Compliance with KYC/AML and OFAC requirements, FIO, NAIC, NICB, IFRS17, CCPA, CPRA, GLBA, SOC1 and SOC2, SAMA and IA requirements (for the KSA), MCEV principles and GDPR (for the EU), NYDFS (for New York), HIPAA (for health insurance), other relevant global, local, and industry-specific regulations.
- Real-time compliance monitoring.
- Scheduled compliance reports.
- End-to-end audit trail of insurance activities.
- Permission-based access control.
- Multi-factor authentication.
- Insurance data encryption.
- (optional) Insurance data hashing, timestamping, and recording in the immutable blockchain ledger.
Important Integrations for an Automated Insurance System
Connecting the insurance solution with relevant internal and third-party systems helps drastically improve the efficiency of insurance operations. ScienceSoft recommends establishing the following key integrations:
- For calculating the expected demand and data-driven planning of distribution and marketing activities.
- For informing the insurance teams about the planned promotions of particular insurance products.
For instant processing and real-time tracking of premium payments.
For automated recording of insurance-related financial transactions in the general ledger.
For comprehensive insurance analytics and advanced visualization and intuitive reports.
Third-party data sources
For accurate risk assessment, insurance pricing, claim validation, and damage estimation.
Communication channels
For fast and convenient customer interaction.
Success Factors for Insurance Automation
ScienceSoft’s experience shows that an ROI for the insurance automation system can be achieved in 6–12 months on average. To maximize the solution’s value for the client’s internal processes and drive faster payback from insurance automation, we always cover the following important factors:
End-to-end automation
To eliminate manual workflows across the entire insurance cycle, from underwriting, through claim processing, to policy renewal.
AI-powered analytics
To get data-driven risk assessment and optimal, risk-based insurance pricing, promptly identify insurance fraud, and more.
Regulatory compliance
To process insurance-related data in accordance with up-to-date legal requirements.
Proper user training
To help insurance teams quickly learn how to apply automation to streamline their daily tasks.
Explore ScienceSoft’s Featured Success Stories
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Insurance Automation Costs
The costs and timelines of implementing custom insurance automation solution vary greatly depending on:
- The number and specifics of insurance processes (e.g., underwriting, billing, claim management, etc.) to automate.
- Functional complexity of the automation system, including the implementation of features powered with advanced techs (e.g., blockchain for insurance).
- Performance, availability, scalability, security, compliance requirements.
- The scope and complexity of integrations.
- The number of user roles.
- The sourcing model (full outsourcing, team augmentation, or all in-house) and team composition.
From ScienceSoft’s experience, an insurance automation project for an upper-midsize company may cost around $200,000–$1,500,000. Large enterprises with complex insurance processes should expect to invest $1,000,000–4,000,000+.
Want to know the cost of your insurance automation solution?
Financial Outcomes of Insurance Automation
When a Custom Insurance Automation Solution is Your Best Choice
ScienceSoft’s experience shows that a custom automated insurance system can drive a significant ROI for the range of insurance companies with particular business needs:
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Companies that need to automate complex or unique insurance operations. |
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Companies that want to get intelligent guidance on specific insurance-related decisions. |
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Companies that operate in multiple countries and need to comply with numerous local insurance regulations. |
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Companies that want smooth and cost-effective integration of insurance automation software with their legacy corporate tools. |
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Companies with large insurance teams that want to avoid a considerable subscription fee for off-the-shelf insurance tools, which scales as the number of users grows. |
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Companies that need advanced data security. |
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Companies that want to leverage smart contracts for insurance automation. |
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Companies that start their digital insurance journey and want to build their business software ecosystem around a comprehensive insurance automation system. |
Insurance Automation with ScienceSoft
In insurance software development since 2012, ScienceSoft provides a full scope of required services to help insurance companies plan and introduce robust business process automation.
Depending on your needs, we can build your insurance automation system from scratch or based on a low-code platform (e.g., Microsoft Power Apps). Although the latter option offers less flexibility in terms of UX and UI design, it proved to bring 70%+ reduction in development costs.
Insurance automation consulting
We design an insurance automation strategy tailored to your unique needs and accurately plan its implementation. You get optimal features, architecture, and tech stack for your insurance automation system.
Implementation of insurance automation
We plan and develop a new insurance automation solution or upgrade your existing insurance tool. You benefit from smooth software integration with all the required systems. You also get user training in a preferred format.
Our Customers Say
ScienceSoft demonstrated a deep understanding of our requirements, and their developers needed minimal supervision, keeping us updated on progress and potential hurdles along the way. What stood out was ScienceSoft's proactive suggestions for cost-saving architecture design and tech stack solutions. Their input ensured we stayed within budget without compromising on software quality. The value we derived from partnering with ScienceSoft is definitely worth the investment.
Jen Dalton, Chief Information Security Officer at Brush Claims
About ScienceSoft
ScienceSoft is a global IT consulting and software development company headquartered in McKinney, Texas. Since 2012, we design and build robust solutions to help insurance companies automate their business processes. Being ISO 9001- and ISO 27001-certified, we apply a mature quality management system and guarantee that cooperation with us does not pose any risks to our customers’ data security. Our mission is driving success for our insurance clients no matter what.
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