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Claims Analytics Use Case

Auto Insights can help insurance teams automate claims performance analysis, drill into claims trends, and spot anomalous claim rates.

This article covers:

  • Example insights from this use case.

  • Recommended data structure for this use case.

What Sort of Insights Can Auto Insights Help Me Uncover?

We've outlined some example questions that Auto Insights can help answer through a combination of its proactive insights, Missions, and What caused this? analysis.

Automate claims performance analysis:

  • Number of Claims by Department

  • Average Time to Payment by Agent

  • Number of Claims by Policy Type

Drill into claims trends:

  • Trend of Claims by Claim Reason in Sydney

  • Seasonality of Claims

  • Compare Claim Amounts for Theft in Metropolitan and Regional areas

  • Average Time to Close Claims by Department and Claim Type

Spot anomalous claim rates:

  • Average Number of Claims per customer

  • Claim Amount by Claim Reason in Sydney

  • Top 20 Claims by Claim Amount and Claim Reason last quarter

How Do I Structure My Data?

  • Auto Insights requires structured, transactional data, with at least 1 measure (for example, Number of Claims) and 5 segments (for example, Claim Type). In addition, we recommend at least 7 months of data (at monthly or daily granularity) so you can take full advantage of Auto Insights' Unexpected Changes feature.

Example Data Structure

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Please refer to Dataset Requirements for more information about data structure.

Segments

Here are some of the typical segments we find in revenue data. A segment is a qualitative value, like names or categories:

  • Claim attributes: Claim reason, Claim type, Team, Department

  • Policy attributes: Policy type, Policy name, Months since last claim, Agent assigned, claim channel, coverage type

  • Claimant attributes: Age, Gender, Location, etc.

Measures

A measure is a quantitative, numeric value. Some of the typical measures include customer ID, number of claims, claim amount, time to close claims, and time to payment.