Solution Design for Insurance Underwriting and Risk Assessment

[pradeep-shukla]

Solution Design for Insurance Underwriting and Risk Assessment

Use Case Description

Introduction:
This use case outlines the solution design for expediting the underwriting process and risk assessment for employee health insurance in a medium-sized business. The goal is to streamline the manual tasks, increase efficiency, and improve accuracy in the underwriting process.

Business Process Analysis:
The current underwriting process involves manual data entry, verification, and risk analysis, which is time-consuming and prone to human error. The proposed solution will automate the following tasks:
• Data Extraction: Extract employee data from payroll systems, HR databases, and other relevant sources.
• Data Validation: Verify data accuracy and completeness, including missing information and inconsistencies.
• Pre-qualification: Perform a preliminary risk assessment based on pre-defined criteria such as age, health history, and job type.
• Risk Scoring: Generate a risk score based on various factors, including pre-qualification results, medical history, and insurance claims data.
• Underwriting Decision: Recommend an appropriate insurance plan based on the risk score and business rules.

Technology Stack:
The proposed solution will utilize the following technologies:
• UiPath Studio: For building the automation workflows.
• UiPath Robots: For executing the automated tasks.
• UiPath Orchestrator: For managing and monitoring the robots.
• API integration: For integrating with existing systems.
• UiPath AI Center: to host & execute the risk assessment model

Benefits:
• Increased Efficiency: Automating manual tasks will significantly reduce processing time and improve overall efficiency.
• Improved Accuracy: Automating data entry and validation will minimize errors and improve data quality.
• Enhanced Risk Assessment: The automated risk scoring model will provide a more objective and consistent assessment of employee risks.
• Reduced Costs: Automation will reduce labor costs and improve resource allocation.
• Scalability: The solution can be easily scaled to accommodate a growing workforce.

Implementation Plan:
• Phase 1: Design and development of the RPA solution.
• Phase 2: Pilot testing with a small group of employees.
• Phase 3: Rollout of the solution to the entire workforce.
• Phase 4: Ongoing monitoring, maintenance, and improvement.

Success Metrics:
• Processing time reduction.
• Error rate reduction.
• Underwriting cycle time reduction.
• Employee satisfaction.
• Cost savings.

Conclusion:
The proposed solution has the potential to significantly improve the efficiency and accuracy of the underwriting process, allowing the insurance company to better manage risks and serve its customers more effectively. By automating manual tasks and leveraging data intelligence, the solution will provide a valuable tool for the insurance company to remain competitive in the market.

AS-IS WORKFLOW, TO-BE WORKFLOW

Other information about the use case

Industry categories for this use case: Compliance, Insurance

Skill level required: Advanced

UiPath Products that were used: UiPath Studio, UiPath AI Center, UiPath Orchestrator

Other applications that were used: HR systems (Workday, Bamboo etc.), Health Insurance Platforms (Plan details, Claims history etc.)

Other resources: -

What is the top ROI driver for this use case?: Accelerate growth and operational efficiency