AgentHack submission type
Enterprise Agents
Name
Rishi Jangid
Team name
ClaimCraft
Team members
Ayush Aswal, Tejaskumar Darji
How many agents do you use
Multiple agents
Industry category in which use case would best fit in (Select up to 2 industries)
Insurance
Complexity level
Advanced
Summary (abstract)
The insurance industry’s claim processing is often hindered by slow, error-prone workflows due to document complexity, disconnected systems, and lack of real-time customer support. These issues cause delays, higher costs, and poor customer experiences. The proposed solution leverages the UiPath Suite to automate and enhance the process through:
Document Understanding for accurate, automated data extraction.
AI-Powered Fraud Detection to identify suspicious claims.
Agent Builder interfaces for adjuster reviews.
UiPath Action Center for human oversight on critical decisions.
The solution aims to reduce claim resolution time by 70%, improve fraud detection by 30%, and enhance customer satisfaction with 24/7 virtual assistance.
Detailed problem statement
Claim processing in the insurance industry is often slow, error-prone, and inefficient. This is largely due to the complexity involved in managing diverse sets of documents and the lack of integration across fragmented back-office systems. These challenges result in delayed settlements, increased operational costs, and a poor customer experience. Moreover, there is often no 24/7 support system to assist customers with their queries during the claims journey. The absence of intelligent virtual assistants or chatbots further hampers user experience, leaving customers without timely guidance or updates.
Detailed solution
- Automated data extraction using Document Understanding
Utilize UiPath Document Understanding to intelligently extract, classify, and validate data from various claim-related documents (e.g., forms, invoices, reports). This reduces manual data entry and ensures accuracy from the start of the process. - AI-Powered Fraud Detection
Leverage UiPath AI Center to analyze historical claim data and identify suspicious patterns. Machine learning models will flag potentially fraudulent claims for further review, helping to reduce financial losses and improve compliance. - Adjuster Review with Agent Builder
Build a user-friendly interface with UiPath Apps and Agent Builder for insurance adjusters to easily view and assess flagged claims. This improves collaboration between automation and human decision-makers. - Human-in-the-Loop via Action Center
Route specific decisions or exceptions to UiPath Action Center, enabling timely human intervention where necessary. This ensures that critical cases receive proper attention without halting the overall process.
Demo Video
Expected impact of this automation
The implementation of the solution is expected to lead to significant operational improvements, including a 70% reduction in claim resolution time and a 30% increase in fraud detection accuracy. Additionally, the adoption of virtual agents will enhance the overall customer experience and enable faster query resolution, resulting in improved service efficiency and customer experience.
UiPath products used (select up to 4 items)
UiPath AI Center
Integration with external technologies
None
Agentic solution architecture (file size up to 4 MB)
Sample inputs and outputs for solution execution
User has to Provide Insurance Details to AI Agent like Please file my insurance claim, Policy Number - 14235232, Email address - rishi.jangid@wonderbotz.com, customer id - 13234, claim amount - 5000 , total amount - 10000
