Transforming a Lengthy RFI Process with a Case Study-Led Strategy to Address Complex Claims Automation Challenges

A leading Lloyd’s & London Market insurer recently asked us to help them explore how claims automation technologies could improve and automate their insurance claims process including intake and triage .

Like many, they receive First Notice of Loss (FNOL) and insurance claims updates  via multiple, fragmented channels (including ECF and several dedicated email inboxes) requiring manual processes and intervention for data entry & triage, a time-consuming admin burden, even  before being able to review the claim for coverage and assessment.

Rather than using the traditional and often protracted RFI process, we took a different route.

Understanding requirements for claims process automation

We worked closely with the insurer to understand their challenges, reviewing the entire claims lifecycle from an end-to-end process point of view, documenting their claims management processes, high -level claim validation and triage rules, and internal handoffs. Based on our experience across claims operations, claims  automation and vendor capabilities, we created a case study that detailed the core requirements:

1. automatically extract and classify relevant data from incoming documents

2. route the claim to the right adjuster within the claims team

3. trigger the next step in their internal claims management platform

This case study formed the basis of an early-stage market scan. We shared it with 17 carefully selected technology vendors, asking for a short, light-touch response outlining their integration capabilities, and how  their solution could support automated claims processing and address the specific use case.

We then applied our independent evaluation process to assess each response where we looked at technical fit, claims domain expertise (particularly related to the Lloyd’s and London Market Central Services process needs), implementation feasibility, and clarity of approach. Six vendors were shortlisted and presented back to the insurer, with commentary on strengths and differentiators.

The insurer then selected their top 3 for a 30-minute targeted demo, showcasing the claims process automation solution and how each solution could meet the case study requirements.

The Benefits: Time, Process Efficiency, and Cost Savings

•  A structured, case-led process that saved time

•  Early visibility of technologies already solving similar challenges

•  Access to vendors they may not have found alone

•  A credible shortlist shaped by market knowledge and practical understanding

  
  

The insurance company  also gained an understanding of the current developments & capabilities of technology in the claims domain, going beyond the use case data extraction and triage use case. 

A number of the solutions also encompassed coverage determination ready for human review. The coverage determination was based on a review of the policy wording and substantiating the decision with clause evidence as well as an initial assessment of the value of the claim (based on a history of similar claims outcomes).  

This approach is faster than a traditional RFI and builds confidence and contributes to customer satisfaction by anchoring  discussions in real-world scenarios, not just lengthy RFI/ RFP. 

Plus, the same approach can be applied to all their historic data, giving them the ability to extract more granular data over a longer period of time and assess trends of their portfolio of claims.