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Client Success Story

Medical & Insurance 
Fraud Detection
Strategy
Client type:
Large insurance company
Industry:
Insurance
Goal:
Enhance fraud detection and prevention
Metric:
Enhance fraud detection and prevention
Execution

Connect the fraud detection system with the out-of-the-box connector for transaction monitoring systems. Configure relevant KPIs, including fraud detection rate and false positive rate.

Process Mining uncovers patterns in fraudulent transactions and identifies the steps where fraudulent activities bypass detection.

Enhance fraud detection algorithms by incorporating machine learning models that analyze transaction patterns in real-time.

Monitor the metric fraud detection rate to continually improve the effectiveness of fraud prevention measures.

Result
A large insurance company used process mining to increase fraud detection accuracy by 15%, reducing financial losses due to fraudulent activities.
Policy Renewal Optimization
Strategy
Client type:
Large insurance company
Industry:
Insurance
Goal:
Improve policy renewal rates and customer retention
Metric:
Improve policy renewal rates and customer retention
Execution

Connect the policy management system with the out-of-the-box connector for insurance policy administration. Configure relevant KPIs, including policy renewal rate and customer retention rate.

Process Mining identifies bottlenecks and delays in the policy renewal process. Further analysis shows specific stages where customers are most likely to drop off or delay renewal.

Automate renewal notifications, streamline the renewal process with online portals, and offer personalized renewal options and discounts to incentivize timely renewals.

Monitor the metrics policy renewal rate and customer retention rate to ensure continuous improvement in the renewal process and customer experience.

Result
A large insurance company used process mining to increase policy renewal rates by 18%, leading to improved customer retention and higher overall customer satisfaction.
Claims Processing
Strategy
Client type:
Large insurance company
Industry:
Insurance
Goal:
Reduce claims processing time
Metric:
Reduce claims processing time
Execution

Connect the claims processing system with the out-of-the-box connector for insurance claims. Configure relevant KPIs, including average processing time and claim settlement rate.

Process Mining identifies delays in the claims verification stage. Further analysis shows specific claim types and customer segments experiencing the most delays.

Implement automated claims verification for low-risk claims and prioritize high-impact claims for faster processing.

Monitor the metric average claims processing time to ensure continuous improvement in the claims settlement process.

Result
A large insurance company used process mining to reduce claims processing time by 25%, enhancing customer trust and satisfaction.

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