It is nothing new that insurance companies receive daily claims from their customers through a variety of channels and in a variety of formats, as well as the knowledge that it is a complex task that usually involves many manual processes, involving high level professionals, medium-high costs and the sub-contracting of external services, being a challenge in this operation the unification of criteria in the reports.
For a company it is essential to be able to manage them properly, to ensure customer satisfaction through an appropriate and correct response to their claim, but at the same time it is necessary to find the cause of the complaint in order to take appropriate action.
It is not enough to solve the incidence once it has occurred, since later it can happen again and the time that could be dedicated to other managements, is focused on investigating, analyzing and solving again a problem that, if its underlying cause is discovered, could be solved in a standardized way or at least follow a process already established for similar cases.
As can be seen, the Root Cause Analysis model applies natural language processing tools in order to determine the cause of each claim, group them together and calculate the accumulated value of the economic amounts being claimed for each of them. By identifying the origin or root cause of the claims, processes can be corrected to prevent the problem from recurring in the future and thus provide transparency, confidence and thus added value to the company as it improves customer satisfaction.
