How to Decrease Claim Handling Time From 45 to 15 Minutes
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.
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."