How to Decrease Claim Handling Time From 45 to 15 Minutes

El Roble success story
El Roble success story
El Roble success story
El Roble success story

Customer
Seguros El Roble

Challenge
Move from manual claim handling to automated, structured, efficient, and organized claim processes.

Solution
FRISS Claims Analytics

Results

  • Claim handling went down from 45 to 15 minutes

  • GO-LIVE within 6 months

  • Enabled fast-track claims

Customer

Seguros El Roble is part of El Roble Seguros y Finanzas in Guatamala. Seguros El Roble is the largest private insurance company in Central America and is the first insurer in Latin America to use FRISS for automated fraud detection in the claims process.

They have a premium volume of 225 million dollar. In motor insurance, a market share of 34.5% has given Seguros el Roble the economies of scale that allows business solutions to be effective. More than 15 years ago Seguros El Roble established their strategic objective of developing the insurance market in Guatemala by offering insurance policies to meet the needs of the insured in segments that the country’s insurance sector had not previously covered.

Innovation in creating insurance and services for insured parties in the Motor, Health, Life and Personal Accident fields combined with the use of diverse marketing methods has led to insuring almost one million Guatemalans.

Challenge

Seguros El Roble has a strong progressive mindset and is ready to embrace digital transformation in the industry, supported by innovative technological solutions. They are aiming to have greater control of processes from prospecting to clients through efficient ways of subscription and handling claims. Hermann Girón Délery (General Manager, Seguros el Roble): ‘’We are aware of the impact fraud and risk evaluation has on the lifetime value of customers as well as future fraudulent claims."

The goal for this project, therefore, was to implement a strategic solution that would allow the processes for claims review and analysis to move from manual tasks to be automated, structured, efficient and organised to be certain that the claims processed are not doubtful in any way.

“They are aiming to have greater control of processes from prospecting to clients through efficient ways of subscription and handling claims.”

Seguros El Roble made this a showcase project, as they had unfortunate experiences with IT projects. Therefore the solution needed to be delivered within time and within budget. The automated fraud detection solution needed to be online 24/7, filtering assigned cases, as well as being able to search external databases.

Solution

The FRISS solution for automated fraud detection was recommended by Munich Re. Frank Buchsteiner (Munich Re’s Head of Client Management for the Caribbean, Mexico and Central America): “Within the Munich Re Group we have experience with FRISS as provider for automated fraud detection. Their solution has convinced us to enter a partnership with them for Latin America, Spain and Portugal in order to support our clients in reducing their combined ratio and in increasing the efficiency of their internal claims handling processes. We believe that El Roble is an ideal client to implement FRISS because of its openness towards innovative technologies and because El Roble recognizes the importance and advantages of an automated fraud detection tool. We are glad to accompany El Roble and FRISS on its way to reduce the amount of fraud in claims.’’

“Munich Re recommended the solution.”

Seguros El Roble believes the implementation of the FRISS solution adds an important element in the evolution of their efforts to reduce fraud and increase client satisfaction by fast track service of genuine and trustworthy customers.

"Munich Re’s selection of FRISS as a strategic partner for automated fraud detection and prevention was an important factor in our consideration of the FRISS solution. We are convinced that the use of FRISS technology in addition to smart underwriting will present significant benefits for our company results."

Girón Délery General Manager, Seguros el Roble

El Roble live with FRISS Claims Analytics
El Roble live with FRISS Claims Analytics

Result

Being the first to start with the FRISS solution for automated fraud detection in Central & South America proved important. It shows that technological innovation is part of Seguros El Roble’s culture, as demonstrated by the implementation of this project.

“The most important contribution made by the tool is the efficiencies that arise from the use and the contribution to reducing the administrative costs when considering the economies of scale, we’ve had within El Roble."

Technology is an integral part of the competitiveness that our value proposition offers the insured.” The solution has changed the flows of emergency processes, claims administration and workshop authorisation. Restrictive actions are implemented in them when filtered targets are yellow or red and they are cleared when they are green or dark green.

The work group was very responsible and diligent in the implementation. In a fun but focused way, the project group managed to take the project from Kick Off to Go Live in exactly 6 months. Thanks to the smooth cooperation, Seguros El Roble realized efficiency both in service and in costs. Claim handling went down from 45 minutes in the manual process to only 15 minutes to do in the digitalized and automated process. “It would have been impossible to achieve the success we have without the great support and collaboration with FRISS.”

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