FurtherAI Raises $5M To Advance Its Specialized AI For Insurance Read More
A specialty insurer with over three consecutive years of >20% premium growth and an expansion from five to ten insurance programs faced a critical operational bottleneck - claims workflows.
The insurer partnered with FurtherAI to deploy AI-enabled Claim Intake, resulting in >90% automation of the intake process, >$360k (>568% ROI) savings and >10x faster processing.
Before working with FurtherAI, workflows and processes within its claims organization were almost entirely manual, end-to-end, and threatened to impede further scaling.
Although the insurer processed over 3,000 claims annually, 98% of all claim workflows were executed manually, from initial notice intake through closing payment authorization.
In particular, Initial Claim Intake was a high-volume, repetitive data heavy and fully manual workflow, alone consuming approximately 2.5 hours of human time per claim, or roughly 7,500 labor hours for the >3000 claims noticed to the insurer annually.
Mishandled Claims → High incidence of errors due to manual data entry and document matching.
Repetitive → Initial claim notice intake demanded intensive, low-complexity effort, yet consumed nearly two hours per claim.
Inconsistent Input → To open a new claim, required documentation arrived in diverse layouts, requiring manual normalization of fields for accurate processing
Growth Bottleneck → The labor-reliant model risked throttling the insurer’s rapid growth & expansion while increasing audit risk & delaying claim settlement.
After mutual collaboration, the Insurer and FurtherAI decided to focus specifically on initial claim intake, and for good reason.
FurtherAI designed and deployed a specialized Claim Intake AI-Enabled Workflow tailored to high-volume claim intake and the insurers unique workflow, requirements and schema(s).
The Insurer’s IInitial Claim Intake Goal → to validate that incoming notice-of-claim documentation included all required documents and field level data, such that the claim could be successfully opened and taken up by a human adjust thereafter.
The insurer’s claim intake workflow was characterized by heavy data extraction and entry, minimal need for specialized claim expertise, high repetition, and a requirement checklist schema (documents and field level data) that was objectively considered.
A collaborative and phased approach ensured that the AI met rigorous performance thresholds before production deployment, while minimizing disruption to ongoing operations.
Design → Collaborated with the insurer’s claims team to map out process steps, define data requirements, and identify document variants.
Integration → Trained natural language processing (NLP) models and document & field level data schema logic from historical claim notices and logic templates
Testing → Deployed user-testing environment and provided the insurer user-testing credentials to incept an iterative feedback loop to refine configurations.
Go-Live → Transitioned to production, continually monitoring performance metrics (automation rate, error rate, processing time) and fine-tuning models
The engagement yielded both quantitative and qualitative benefits:
>$360k Saved
Annual Claims Processed by AI → >3,000
Time Saved per Claim → 2.5 hours
~568% ROI
Total Hours Saved Annually → 7,500 hours
Annual ROI → 568%
By integrating the new AI workflow, the insurer increased the automation of its intake of new claims from almost 0 to >90%, for the targeted workflow.
The success of the solution underscores the strategic value of AI-driven workflow automation in specialty insurance claims and, for this insurer, paves the way for broader enterprise deployment.
FurtherAI’s Claim Processing AI solution transformed the insurer’s originally manual claims intake workflow into a scalable & automated operation, delivering an immediate ROI and preserving the company’s rapid growth trajectory. The insurer can now absorb higher claim volumes, improve processing accuracy, and reallocate human resources to higher-value tasks.
Today, the claims organization is no longer considered a bottleneck to growth and the insurer has continued along its high growth trajectory.
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