Claimshero turns around claims team

The challenge

An insurer’s claims audit program was not providing insightful information around quality or leakage

The solution

After implementing Claimshero the insurer was able to identify that 60% of claims had a quality issue and 26% of all claims processed had an issue that would likely lead to hard leakage. Claimshero’s deep dive capability enabled a total view of claims quality and leakage - identifying root causes, frequency and impact. This enabled the insurer to identify areas of a process failure, poor decision making and inappropriate decisions, gaps in training and awareness.

The business impact

Using Claimshero, the insurer was able to target their largest pain points, implement changes in process, training and resourcing and track the measurable improvement.