RightIndem - AI Insurance Claims CoPilot.

RightIndem是全球领先的保险科技公司。我们迫切需要先进的技术来自动处理大批量、低价值的索赔，以实现直通式处理（STP），并支持复杂案件的人工索赔流程。这一需求是由战略需求驱动的，即降低运营成本、加快客户联系/索赔流程并减少联系/索赔次数、新的客户责任法规;以及前所未有的索赔处理技能差距。这些挑战因索赔不断增加而变得更加复杂，并且流程变得越来越技术化/细致入微，并在2022年实施了严格的新FCA法规。在索赔处理中产生的错误可能会产生影响，DirectLine因不公平对待客户而被罚款3000万英镑。汽车保险面临的挑战尤其严峻，2022/23年度表现最差，每1英镑保费支付1.10英镑的索赔/运营成本（安永，2023年）。我们目前为汽车保险公司（esure）提供平台，事故援助组织（AA）和外包索赔处理公司（纳斯达克上市的WNS）作为其以客户为中心的数字化转型的一部分。基于我们现有的平台，该项目将利用人工智能的快速发展来提供下一代索赔处理，实现超自动化，消除目前阻碍STP处理大批量、低价值索赔的障碍，并为索赔处理人员提供实时帮助，以最大限度地减少复杂案件中的错误/固有偏见。我们创新的核心成果将是“联合试点”：实时支持索赔处理人员，实现索赔和决策的可靠自动验证，最大限度地减少偏差。联合试点将根据保单措辞/条件详细分析适用的索赔情况。它将增加客户提供的信息，使用ML访问编排的数据以验证索赔的有效性，例如，WeatherNet数据用于验证有关恶劣天气的声明，或IVI用于上传照片，以确定车辆是否可修复/无法修复。当需要更多信息/背景或上传的证据（图像/视频元数据;涉嫌欺诈）存在不一致时，副驾驶将动态提示处理人员提出进一步的问题。TRL 6副驾驶和协调层将成为我们下一代平台的核心，通过提供第一个上市工具来提高我们的竞争力，为我们现有和潜在的客户提供他们迫切需要的实时支持。这将使Rightindem成为第一个在整个流程中实时支持索赔处理人员的解决方案，同时还可以通过不断变化的客户动机/客户行为来实现平台的敏捷变化。

RightIndem is a globally-leading InsurTech company. We are experiencing urgent demand for sophisticated technologies to automate high-volume, low-value claims towards straight-through-processing (STP), and to support manual claims processes for complex cases. Need is driven by strategic imperatives to reduce operational costs, speed-up customer contact/claims processes and reduce number of touches/claim, new Customer Duty regulations; and an unprecedented claims handling skills gap,. These challenges are compounded by spiralling claims, and processes becoming increasingly technical/nuanced, with stringent new FCA regulations imposed in 2022\. Impacts of resulting errors in claims handling can be existential, with DirectLine fined £30m for treating customers unfairly .The challenge is particularly acute within motor insurance, which experienced its worst performing year in 2022/23, with £1.10 paid in claims/operating costs for every £1 of premiums (EY,2023).We currently provide a platform to motor insurers (esure), accident assistance organisations (AA) and outsourced claims handling companies (NASDAQ-listed WNS) as part of their customer-centric digital transformation..Building on our existing platform to answer the urgent identified industry need, this project will use rapid advancements in AI to deliver next generation claims handling, with hyper-automation and elimination of obstacles currently impeding STP for high-volume, low-value claims, and real-time assistance for claims handlers to minimise errors/inherent biases in complex cases.The core outcome from our innovation will be a "Co-Pilot": supporting claims handlers in real-time, enabling reliable automated validation of claims and decisions, with minimised bias. The Co-Pilot will present detailed analyses of claim circumstances applied against policy wording/conditionality. It will augment information presented by the customer, using ML to access orchestrated data to verify validity of claims, e.g., WeatherNet data to verify claims about adverse weather or IVI for photo uploads to determine if a vehicle is repairable/beyond repair. The Co-pilot will dynamically prompt handlers to ask further questions where more information/context is needed or where there are inconsistencies in uploaded evidence (images/video metadata; suspected fraud). It will also support fulfilment, with integrations with auto-repair shops, etc.The TRL6 co-pilot and orchestration layer will be the core of our next generation platform, increasing our competitiveness by delivering the first-to-market tool providing the real-time support our existing and prospective clients are urgently demanding for their handlers. This will make Rightindem the first solution to support claims handlers in real-time through the process, whilst also enabling agile changes to the platform, driven by changing client motivations/customer behaviours.