RightIndem - AI Insurance Claims CoPilot.

RightIndem是一家全球领先的保险科技公司。我们正面临着对尖端技术的迫切需求，以实现大批量、低价值索赔的自动化，实现直通处理(STP)，并支持复杂案件的人工索赔流程。需求的驱动因素是降低运营成本、加快客户联系/索赔流程并减少接触/索赔次数的战略要务、新的客户责任法规；以及前所未有的索赔处理技能差距。随着2022年实施严格的FCA新法规，索赔螺旋式上升和流程变得越来越技术性/微妙，使这些挑战变得更加复杂。索赔处理中产生的错误的影响可能是存在的，DirectLine因不公平对待客户而被罚款3000万GB。汽车保险领域的挑战尤其严峻，该公司在2022/23年经历了表现最差的一年，每GB保费支付1.10 GB的索赔/运营成本(安永，2023年)。我们目前为汽车保险公司(Esure)、事故援助组织(AA)和外包索赔处理公司(NASDAQ上市的WN)提供一个平台，作为其以客户为中心的数字化转型的一部分。该项目将在我们现有平台的基础上，满足迫切确定的行业需求，利用人工智能的快速进步来提供下一代索赔处理。随着高度自动化和消除目前阻碍STP处理大容量、低价值索赔的障碍，并为索赔处理人员提供实时帮助，以将复杂案件中的错误/固有偏差降至最低。我们的创新的核心成果将是“联合试点”：实时支持索赔处理人员，实现可靠的自动化索赔和裁决验证，并将偏见降至最低。副驾驶将详细分析针对政策措辞/条件性适用的索赔情况。它将补充客户提供的信息，使用ML访问协调的数据以验证索赔的有效性，例如，Weathernet数据用于验证关于不利天气的索赔，或IVI用于照片上传以确定车辆是否可修复/不可修复。副驾驶将动态地提示操作者进一步询问哪里需要更多信息/背景，或者在上传的证据(图像/视频元数据；涉嫌欺诈)中存在不一致之处。它还将支持实现，并与汽车维修车间等集成。TRL6副驾驶和协调层将是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，提供我们现有和潜在客户对其处理程序迫切要求的实时支持。这将使Rightindem成为第一个在整个过程中实时支持索赔处理员的解决方案，同时还能够在客户动机/客户行为变化的推动下对平台进行灵活的更改。

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.