GenAI-Empowered Underwriting & Claim Processing for Leading Insurance Provider

Executive Summary

Our partnership with a leading financial protection provider resulted in a functional Generative solution that turns clients’ pain points into strengths. Since manual document handling, underwriting, and claims review were leading to inefficiencies, delays, and errors, our team came up with a comprehensive, AI-driven solution. Subsequently, our ability to deliver a tailor-made AI solution within time and budget constraints has set new operational standards for the client, ensuring long-term value and operational efficiency.

About the Customer

Serving diversified clients across the United States and the United Kingdom, our client is a leading financial protection provider with over 20 years of experience in the industry. The company delivers a vast selection of Disability, Life, Accident, and Critical Illness insurance products. Specializing in disability insurance, life insurance, accident insurance, critical illness insurance, and other supplemental health and employee benefits, the team has earned the trust within the insurance domain. While their vision revolves around the combination of cutting-edge technology and a forward-thinking approach, the company sets new standards in the industry, providing efficient claims processes to ensure timely support when it matters most.

Customer Challenge

There is no doubt that insurance providers cope with multiple underlying challenges. In this regard, our client is no exception. Facing various issues with document processing and underwriting workflows, their team sought an efficient solution to overcome several challenges simultaneously.

Since hundreds of brokers submitted document packages in various formats, including PDF, Excel, Word, email, and scanned images, document heterogeneity was one of the key issues to be solved. On the flip side, a lack of standardization caused by the specific nature of the business led to problems with reducing source data to a finite number of document types with similar layouts or forms.

What is more, there was no system in place to extract, consolidate, and analyze data from the diverse document formats, while underwriting, claims review, and administration were predominantly performed manually by brokers, leading to potentially costly errors. This, in turn, also caused delayed underwriting, leaving clients on wait for 5 to 15 days.

Why Matoffo

With a proven track record of multiple successfully delivered Generative AI solutions, the Matoffo team easily meets the unique needs of each client, from small startups seeking custom solutions to large enterprises looking to streamline their diversified services. Thus, our commitment to innovation, coupled with a deep understanding of the financial protection landscape, has become a decisive factor for our incredible client. Summing up, our strong emphasis on customer-focused services and the ability to develop tailor-made solutions within time and budget limitations resulted in fruitful cooperation and mutual benefit.

Why AWS

Thanks to its scalability, flexibility, and comprehensive ecosystem for AI and machine learning, AWS is a perfect technology for building an AI-driven document processing and analysis solution. While AWS Elastic Container Service (ECS) efficiently handles unstable loads, AWS Lambda provides cost-effective, serverless computing for rule-based tasks and real-time document processing.

Over and above that, there is no better option than AWS when it comes to ensuring security compliance and data protection. With a vast selection of robust security features, its extensive toolset and pay-as-you-go pricing stand out from the crowd, making AWS the most cost-effective, scalable, and secure technology for various business needs.

Matoffo Solution

Striving to deliver a robust AI-driven document processing and analysis solution, our team utilized high-level context architecture, including the following:

  1. Data Ingestion & Integration:
    • AWS Transfer and AWS Glue for batch processing of unstructured data sources;
    • AWS Lambda for rule-based processing;
    • JSON configuration for flexible data mapping;
    • AWS ECS for hosting the service portal, ensuring scalability and easy management.
  2. Data Curation & Knowledge Management:
    • Amazon SageMaker for advanced data curation and model training;
    • AWS Bedrock Knowledge base for centralized information management;
    • Labeling Studio for accurate data labeling and annotation.
  3. Advanced Data Processing:
    • Amazon SageMaker for RAG Index Preparation and document processing;
    • AWS Lambda for metadata extraction and semantic search index pipeline;
    • Pinecone for vector store and long-term memory capabilities.
  4. AI and Decision Making:
    • AWS Bedrock for LLM integration (Anthropic models);
    • LLM Abstraction Layer with LLM Proxy, LLM Ops, and Workflows for flexible AI operations;
    • Automated decision-making pipeline with AI decision-maker for complex cases;
    • AWS Step Functions for orchestrating complex workflows and service portal logic.
  5. Enterprise Data Management:
    • Amazon RDS for metadata store;
    • Integration with existing ERP, CRM, and database systems via AWS Step Functions.

High-level context Architecture

Speaking of the development process, we started with implementing AI and OCR technologies to ensure automated data extraction from various document formats. Next, our developers created standardized templates for data extraction and consolidation while developing a centralized data storage, consolidation, and analysis system.

During the following development phase, the Matoffo team introduced automated workflows for underwriting, claims review, and administration.

We also enabled real-time processing and analysis to reduce underwriting time. Last but not least, it was time to implement context-aware GenAI analysis with LLM agentic workflow for near real-time, context-based analysis.

The development team included an ML consultant, Business analyst, MLOps/LLM engineer and DevOps engineer. In general, it took us about 6 weeks to deliver a ready-to-use AWS solution.

Business Value

This project required significant effort, and now it is finally time to reap the benefits. All in all, it is always a pleasure to measure the value of your work:

  • Next-Gen Efficiency

Document processing now takes hours instead of days, with a 78% success rate for automated processing.

  • Accuracy in Each Step

Thanks to AI and OCR technologies, we have significantly improved accuracy, eliminating the risk of manual errors.

  • Money Saved

With less manual effort in document processing and underwriting, the client can invest less, saving the budget for growing their business.

  • Faster Underwriting

There is no need to wait for weeks anymore since underwriting can be processed in real time or within several hours.

  • Scaling Without Risks

The solution successfully handles ups and downs in document volume without additional manual labor.

  • Better Decision Making

Enhanced underwriting decision accuracy with AI-powered analysis and consolidated data.

Client's Feedback

“Working with Matoffo has transformed our business. From day one, their team demonstrated a deep understanding of our challenges and delivered a feature-rich solution that has exceeded our expectations. We highly recommend Matoffo to any organization looking to modernize their workflow with AI-driven solutions. We look forward to continuing our partnership with them as we grow and evolve in the insurance industry.”

Head of Operations

OUR FOCUS IS
CLOUD SOLUTIONS

Our primary goal is to deliver value to our clients by resolving technical challenges and helping them achieve their objectives. We utilize cloud solutions as a powerful toolset to make this happen. With Matoffo expertise, companies can significantly reduce the time from idea to market and rapidly scale their digital business. Additionally, Matoffo enables seamless adoption of rapidly growing tech capabilities, transforming businesses to stay competitive in the market.

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