Neutrinos Connected Claims Solution

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Neutrinos Connected Claims solution creates a holistic claims process bringing convenience and transparency for the customer and agent, simplification and efficiency for branch/front-office staff, adjudicators and back office operations, and delivering improved productivity, faster turnaround and lower cost to serve overall. Multiple global insurers have utilized the Neutrinos solution to create powerful claims digitization outcomes and unique digital assets, successfully overcoming complexities such as legacy core systems, highly diverse orchestration needs and complex processing rules.

Neutrinos brings prebuilt claims experience and operations journey building blocks including FNOL, intelligent document processing, rules-driven straight-through processing, case management and workflow, claims workbench for adjudication, benefits management and many more. In addition, specialized capability blocks are available for health and life risklines.

The Neutrinos Connected Claims solution infuses each stage of the claims journey with rich, real-time data, automation, intuitive decisioning support, and deep business visibility.

The solution, built on Neutrinos Composable Innovation Platform, is fully digital and cloud native, yet can fit seamlessly into the insurer’s existing application and process landscape as well as provider and vendor networks. This provides a means of incremental, derisked and fail-fast claims transformation without disruptive core technology shifts.

Key Features

Neutrinos provides numerous capability building blocks that make it easy to compose digital journeys for claims systematically, with speed and customizability. These include:

  • Omni-Channel Claim Submission: Allows customers to submit claims through various channels, including phone, email, and web portals.

  • Eligibility Verification and Reflexive Questionnaire: Verify and record claimant details, check eligibility based on the event, and ask for additional information through reflexive questionnaires.

  • Auto Adjudication Rule Engine: The engine has eligibility rules and document requirement rules that enable claims to be automatically processed.

  • Adjudication Workbench: Offers easy management of claims, including a customizable worklist and 360-degree case details.

  • Workflow Engine: Process orchestration through the workflow engine provides an efficient way to manage claims and payment approvals.

  • Task Manager: Offers dynamic and equal distribution of tasks to claims operation users based on business logic.

  • Document Viewer: Provides ability to compare captured data against scanned document fields, with masking support.

  • Communication Module: Offers a built-in email correspondence manager for communication with internal and external stakeholders.

  • Additional Requirement Management: Specific list of documents can be requested as further information along with the option for manual description for other document types.

  • Referral Management: Internal referral workflow for cross-functional opinions/decisions.

  • Dashboards and Reports: Provides business process insights and governance on critical metrics, financials, comparison metrics, and user productivity reports.

  • System Integrations: Integrates with policy admin, claims portal, mobile app, chatbot, DMS, and enterprise rule engine.

Key Benefits

  • Faster claims processing and reduced turnaround time: For a P&C insurer, the Neutrinos solution increased straight-through processing cases by more than 20% even for complex cases. Average processing time reduced from 3+ days to one day.

  • Improved customer satisfaction: NPS improved by 80% for a South African insurer through simplified FNOL process, and speed of response and closure through claims processing transformation with Neutrinos.

  • Increased accuracy in claims processing and reduced errors: More than 25% reduction in claims leakage through consistency of rules application.

  • Increased efficiency and productivity of claims processing staff: Time spent by lead adjudicator on case assignments reduced to just minutes from 2+ hours per day.

  • Enhanced workflow transparency with real-time monitoring and reporting.

  • Improved decision-making with automated adjudication rules and recommendations.

  • Reduced costs and increased revenue due to improved efficiency and productivity.

  • Greater compliance with regulatory requirements.

  • Improved overall claims management with end-to-end automation and workflow orchestration.