{"id":511,"date":"2023-08-10T17:53:40","date_gmt":"2023-08-10T17:53:40","guid":{"rendered":"https:\/\/clients.evostudio.ro\/encorsa\/?p=511"},"modified":"2025-01-13T13:12:12","modified_gmt":"2025-01-13T13:12:12","slug":"hiper-automatizarea-procesului-de-claims-in-asigurari","status":"publish","type":"post","link":"https:\/\/encorsa.ro\/?p=511","title":{"rendered":"Hiper-automatizarea procesului de claims \u00een asigur\u0103ri"},"content":{"rendered":"<p>Indiferent c\u0103 vorbim de asigur\u0103ri auto, de bunuri sau de via\u021b\u0103 atunci c\u00e2nd un eveniment nepl\u0103cut a avut loc posesorul poli\u021bei va solicita desp\u0103gubirea de la asigurator \u00een baza acesteia. Acest proces prin care asiguratul notific\u0103 asiguratorul \u0219i apoi asiguratorul face to\u021bi pa\u0219ii necesari p\u00e2n\u0103 c\u00e2nd beneficiarul poli\u021bei prime\u0219te desp\u0103gubirea se nume\u0219te \u201cInsurance Claim\u201d. Mul\u021bi dintre noi au trecut printr-un astfel de proces \u0219i au constatat c\u0103 dureaz\u0103 mult, asiguratorul solicit\u0103 tot felul de documente, nu \u0219tii c\u00e2t dureaz\u0103 \u0219i c\u00e2te drumuri trebuie s\u0103 faci la po\u0219t\u0103 sau la biroul asiguratorului. Haide\u021bi s\u0103 vedem cum ar trebui \u00eembun\u0103t\u0103\u021bit procesul prin noile tehnologii astfel \u00eenc\u00e2t clientul final s\u0103 beneficieze de o experien\u021b\u0103 de interac\u021biune c\u00e2t mai bun\u0103 cu firma de asigur\u0103ri.<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<h3>Hiper-automatizarea unui proces de Insurance Claim<\/h3>\n<p>Putem automatiza aproape complet un proces de claims folosind trei tipuri de tehnologii de automatizare \u00eenglobate \u00eentr-o solu\u021bie unic\u0103 de hiper-automatizare:<\/p>\n<p>&nbsp;<\/p>\n<ul>\n<li>un chatbot de ultim\u0103 genera\u021bie capabil s\u0103 poarte discu\u021bia cu clien\u021bii, s\u0103 colecteze informa\u021bii de la ei \u0219i s\u0103-i informeze \u00een leg\u0103tur\u0103 cu pa\u0219ii care trebuie urma\u021bi;<\/li>\n<li>o platform\u0103 BPM low-code care s\u0103 permit\u0103 definirea tuturor pa\u0219ilor din procesul de claims, a leg\u0103turilor dintre ace\u0219tia \u0219i a ac\u021biunilor derulate de c\u0103tre operatori;<\/li>\n<li>un robot RPA capabil s\u0103 opereze automat datele \u00een diversele aplica\u021bii software ale asiguratorului, degrev\u00e2nd operatorii umani de sarcini repetitive \u0219i consumatoare de timp.<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full wp-image-512\" src=\"https:\/\/encorsa.ro\/wp-content\/uploads\/2023\/08\/88.webp\" alt=\"\" width=\"1280\" height=\"720\" srcset=\"https:\/\/encorsa.ro\/wp-content\/uploads\/2023\/08\/88.webp 1280w, https:\/\/encorsa.ro\/wp-content\/uploads\/2023\/08\/88-300x169.webp 300w, https:\/\/encorsa.ro\/wp-content\/uploads\/2023\/08\/88-1024x576.webp 1024w, https:\/\/encorsa.ro\/wp-content\/uploads\/2023\/08\/88-768x432.webp 768w\" sizes=\"auto, (max-width: 1280px) 100vw, 1280px\" \/><\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<h3><b>Descrierea procesului de claims<\/b><\/h3>\n<p>&nbsp;<\/p>\n<p><b>Notificarea evenimentului\u00a0<\/b>\u2013 primul pas al procesului de claim este reprezentat de notificarea evenimentului de c\u0103tre asigurat. Asiguratul intr\u0103 pe site-ul asiguratorului, pe Facebook sau pe WhatsApp \u0219i ini\u021biaz\u0103 discu\u021bia cu un chatbot dotat cu inteligen\u021b\u0103 artificial\u0103 capabil s\u0103 r\u0103spund\u0103 la toate \u00eentreb\u0103rile acestuia \u0219i s\u0103 \u00eel ghideze \u00een preg\u0103tirea documentelor necesare deschiderii dosarului.<\/p>\n<p>&nbsp;<\/p>\n<p data-l-s=\"95286\"><b>Deschiderea dosarului<\/b>\u00a0\u2013 \u00een al doilea pas, informa\u021biile colectate \u0219i validate de chatbot sunt transmise automat prin API c\u0103tre platforma BPM. Aceasta ini\u021biaz\u0103 deschiderea dosarului de daun\u0103 \u0219i \u00een baza informa\u021biilor preluate verific\u0103 \u00een sistemele interne ale asiguratorului dac\u0103 exist\u0103 poli\u021be aferente asiguratorului, dac\u0103 acestea sunt active \u0219i acoper\u0103 evenimentul notificat.<\/p>\n<p data-l-s=\"95286\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full wp-image-513\" src=\"https:\/\/encorsa.ro\/wp-content\/uploads\/2023\/08\/99.webp\" alt=\"\" width=\"1600\" height=\"462\" srcset=\"https:\/\/encorsa.ro\/wp-content\/uploads\/2023\/08\/99.webp 1600w, https:\/\/encorsa.ro\/wp-content\/uploads\/2023\/08\/99-300x87.webp 300w, https:\/\/encorsa.ro\/wp-content\/uploads\/2023\/08\/99-1024x296.webp 1024w, https:\/\/encorsa.ro\/wp-content\/uploads\/2023\/08\/99-768x222.webp 768w, https:\/\/encorsa.ro\/wp-content\/uploads\/2023\/08\/99-1536x444.webp 1536w\" sizes=\"auto, (max-width: 1600px) 100vw, 1600px\" \/><\/p>\n<p><b>Verificarea documentelor<\/b>\u00a0\u2013 \u00een acest pas sistemul BPM notific\u0103 un specialist din departamentul de daune c\u0103 un nou dosar i-a fost atribuit. Specialistul verific\u0103 informa\u021biile \u0219i intervine acolo unde este cazul, solicit\u00e2nd noi documente sau informa\u021bii de la asigurat.<\/p>\n<p>&nbsp;<\/p>\n<p><b>Completarea dosarului<\/b>\u00a0\u2013 Chatbot-ul \u00eel contacteaz\u0103 pe asigurat prin WhatsApp sau Facebook Messenger \u0219i \u00eel informeaz\u0103 \u00een leg\u0103tur\u0103 cu documentele suplimentare necesare \u0219i \u00eei ofer\u0103 toate detaliile pentru ob\u021binerea acestora. C\u00e2nd asiguratul ob\u021bine documentele le \u00eencarc\u0103 de pe telefon sau calculator \u00een fereastra de dialog a chatbot-ului iar acesta\u00a0 le transmite mai departe c\u0103tre BPM.<\/p>\n<p>&nbsp;<\/p>\n<p><b>Aprobarea dosarului<\/b>\u00a0\u2013 specialistul de daune valideaz\u0103 documentele \u0219i le transmite spre aprobare unui superior. Acesta le poate vizualiza \u0219i aproba de pe laptop sau telefonul mobil. \u00cen urma aprob\u0103rii sistemul BPM genereaz\u0103 referatul de plat\u0103.<\/p>\n<p>&nbsp;<\/p>\n<p><b>Darea la plat\u0103<\/b>\u00a0\u2013 un robot RPA opereaz\u0103 referatul de plat\u0103 \u00een sistemul de pl\u0103\u021bi \u0219i alte sisteme interne de baz\u0103. C\u00e2nd plata a fost operat\u0103 cu succes, sistemul BPM transmite c\u0103tre Chatbot informa\u021bia de plata, iar acesta notific\u0103 clientul \u00een leg\u0103tur\u0103 cu suma \u0219i contul \u00een care s-a f\u0103cut transferul \u0219i solicita feedback de la asigurat.<\/p>\n<p>&nbsp;<\/p>\n<p><b>\u00cenchiderea dosarului<\/b>\u00a0\u2013 \u00een ultimul pas al procesului, sistemul BPM \u00eenregistreaz\u0103 feedback-ul colectat de chatbot, \u00eenchide dosarul \u0219i transfer\u0103 datele necesare \u00een alte sisteme interne.<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<h3><b>Care sunt beneficiile unui sistem automatizat de claims?<\/b><\/h3>\n<p>&nbsp;<\/p>\n<ul>\n<li><b>Cre\u0219te satisfac\u021bia clientul<\/b> \u2013 clientul prime\u0219te toate informa\u021biile necesare, oric\u00e2nd \u0219i instantaneu prin intermediul chatbot-ului. \u00cen plus, chatbot-ul ajut\u0103 clientul s\u0103 completeze formularele;<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<ul>\n<li><b>Cre\u0219te satisfac\u021bia angaja\u021bilor<\/b> \u2013 angaja\u021bii nu mai trebuie s\u0103 proceseze documente pe h\u00e2rtie sau completate gre\u0219it \u0219i toate informa\u021biile necesare sunt aduse de BPM \u00eentr-un singur ecran;<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<ul>\n<li><b>Cre\u0219te conformitatea procesului\u00a0<\/b>\u2013 toate opera\u021biunile derulate de robo\u021bi sau de oameni sunt \u00eenregistrate automat pentru audit;<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<ul>\n<li><b>Cre\u0219te eficien\u021ba procesului<\/b> \u2013 procesul de claim este executat mai repede, cu mai pu\u021bine itera\u021bii \u00een care clientul trebuie s\u0103 transmit\u0103 documente, cu mai pu\u021bine erori \u0219i cu mai pu\u021bin\u0103 activitate manual\u0103;<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<ul>\n<li><b>\u00cembun\u0103t\u0103\u021bire continu\u0103<\/b>\u00a0\u2013 algoritmii de AI vor analiza miile de dosare de claims \u0219i vor recomanda \u00eembun\u0103t\u0103\u021birea pe mai departe a sistemului identific\u00e2nd punctele \u00een care acesta func\u021bioneaz\u0103 greoi, pa\u0219ii \u00een care se fac erori, elementele care sunt completate gre\u0219it \u00een mod frecvent de c\u0103tre client, cele mai dese \u00eentreb\u0103ri ale asigura\u021bilor.<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>Indiferent c\u0103 vorbim de asigur\u0103ri auto, de bunuri sau de via\u021b\u0103 atunci c\u00e2nd un eveniment nepl\u0103cut a avut loc posesorul poli\u021bei va solicita desp\u0103gubirea de la asigurator \u00een baza acesteia. Acest proces prin care asiguratul notific\u0103 asiguratorul \u0219i apoi asiguratorul face to\u021bi pa\u0219ii necesari p\u00e2n\u0103 c\u00e2nd beneficiarul poli\u021bei prime\u0219te desp\u0103gubirea se nume\u0219te \u201cInsurance Claim\u201d. Mul\u021bi [&hellip;]<\/p>\n","protected":false},"author":13,"featured_media":686,"parent":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"articol-tip2.php","format":"standard","meta":{"footnotes":""},"categories":[5],"tags":[397,392,395,387,394,393,386,390,396,388,385,389,391],"class_list":["post-511","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-articole","tag-ai-in-procesul-de-daune","tag-automatizarea-procesului-de-daune","tag-beneficiile-sistemelor-de-daune","tag-chatbot-asigurari","tag-experienta-clientilor-in-asigurari","tag-fluxuri-de-lucru-eficiente-in-asigurari","tag-hiperautomatizare-in-asigurari","tag-management-automatizat-al-daunelor","tag-optimizarea-proceselor-in-asigurari","tag-platforma-bpm-pentru-daune","tag-procesul-de-daune-in-asigurari","tag-rpa-in-asigurari","tag-transformare-digitala-in-asigurari"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v21.5 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Hiper-automatizarea procesului de claims \u00een asigur\u0103ri - 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