Automating claims for better experiences
Claims automation
Turn Challenges Into Lasting Impact
Improve one of your most critical customer touchpoints
Claims are the most critical customer touchpoint, yet they are often slow, manual, and inconsistent. Insurers are facing rising expectations, increasing claim complexity, and pressure to enhance both cost efficiency and compliance. Many insurers are also grappling with the challenge of integrating digital tools into complex, legacy environments that are difficult to scale or standardize. The demand for speed, transparency, and governance is growing every day.
With digital solutions
Realise an accelerated digital claims journey
VClaims is a versatile automation platform that revolutionizes the end-to-end claims process. Designed for life, critical illness, and disability claims, it offers a modular approach that empowers insurers to automate with precision and clarity. VClaims seamlessly combines an intuitive claimant experience with robust decision support — helping insurers deliver faster, more consistent outcomes while reducing operational complexity.
Realise lasting impact
Experience seamless claims processing with exceptional efficiency
Product Modules
The central hub for intelligent claims management
Enhance your claims efficiency with our comprehensive and flexible suite of components and end-to-end solutions. VClaims provides insurers with optimal customization, seamlessly integrating components to deliver 360° solutions. Our offerings integrate smoothly with your existing systems and workflows, significantly enhancing claims processing.
Claims Rules Solution
The claims rules solution centralizes decision-making, streamlining operations and ensuring consistency. It supports all core Life claim types and allows insurers to configure rules for exclusions, approvals, eligibility, and escalation. The system integrates with external services via APIs for extended functionality.
Questionnaire & Flow System
The out-of-box Questionnaire & Flow system collects information from claimants and stakeholders efficiently. It uses an adaptive question flow that responds to answers, ensuring relevant questions are asked at each stage. The system can be customized to meet the specific needs of each insurer, claim type, and product.
Claims Triage & Risk Flags
The out-of-box Claims Triage & Risk Flags capabilities categorize claims based on risk level and complexity. The solution flags claims needing additional scrutiny for manual review, while processing straightforward claims automatically. Predefined business rules evaluate each claim’s risk profile enabling the right touch, on the right claim at the right time.
Claims Catalogue
The Claims Catalogue drives condition-specific rules for claims, including diagnoses, exclusions, occupations, and risk factors. It is configurable to meet the needs of different insurers, products, geographies, and policies.
Claims Portal
The Portal enables agents, advisers, bank partners, brokers, and direct-to-consumer channels to operate efficiently. It features an intuitive dashboard for creating and monitoring cases, enhanced security with multi-factor authentication and e-signature capabilities, and email reminders with quick evidence upload for smooth processes. The system streamlines operations and expands reach, ensuring it meets the specific needs of each user and use case.
Claims Analytics & Reporting
The Analytics & Reporting of VClaims offers valuable insights into claims processes, identifying trends, bottlenecks, and areas for improvement. By leveraging powerful business intelligence tools, insurers can make data-driven decisions to optimize the claims process and enhance operational efficiency.
Designed for Your Environment
VClaims is built to address the real-world challenges insurers face – across people, process, and performance.
Reduces rising costs and workloads
Automates triage and decisions to reduce manual processing and streamline handoffs.
Prevents Inconsistent outcomes
Applies consistent, auditable rules and risk flags across claim types and regions.
Improves customer expectations
Provides a smoother, digital-first experience with timely responses and reduced friction.
Solves integration complexity
Offers flexible, API-driven integration with internal systems or third-party tools.
Transparent Governance and compliance
Enables transparency and traceability across decisions, rules, triggers, and workflows.
Benefits of automated claims processing
Improved Cost Efficiency
- Reduce manual effort and staffing costs by automating tasks.
- Redirect funds and leverage skilled expertise by optimizing resource allocation.
- Lower operational overhead with automation and streamlined processes
Enhanced Claims Efficiency
- Reduce manual handling and errors by automating claims processing.
- Enhance satisfaction and cut costs by reducing decision times by over 50%.
- Simplify claims submission with digital capabilities and omnichannel access.
- Handle increasing claim volumes with seamless system integration.
Optimized Risk & Decisioning
- Improve leakage prevention by identifying high-risk claims early.
- Improve in-force claims costs with more effective claims handling.
- Support claims with automated evidence management.
- Tailor decision frameworks with configurable business rules.
Superior Customer Satisfaction
- Provide faster claim resolutions, reducing customer wait times.
- Ensure accurate claim handling, increasing trust and reliability.
- Enhance overall customer experience, fostering loyalty and retention.
- Match customer needs with claim services for differentiated customer experiences.
Empowered Self-Service & Automation
- Offer user-friendly self-service portals for customers.
- Automate routine inquiries, freeing up human agents for complex issues.
- Balance digital tools with personalized human support.
Data-Driven Insights & Compliance
- Connect effortlessly with various electronic services.
- Integrate smoothly with data analytics platforms.
- Support a complete digital purchase pathway.
- Scalable integration with OCR, Chatbot, and scoring.
TRUST AND SECURITY – OUR PROMISE TO YOU
At SCOR Digital Solutions, your trust is paramount. In today’s digital world, we integrate top-tier security into every aspect of our operations. Using advanced encryption, conducting regular audits, maintaining 24/7 monitoring, and implementing real-time threat detection, we ensure your data’s safety with the highest level of protection and transparency.
Vclaims ensures life insurance claims are handled quickly and accurately when it really counts. By automating key processes and reducing complexity, we help insurers make faster, more consistent decisions. The result? Less stress, fewer delays, and better outcomes – because when it matters, the claims experience should be simple, transparent and reliable.
Ryan Gailey
Head of Automated Claims Strategy
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