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Automate Claim Handling

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Challenge

As a legal protection insurance company for individuals as well as private companies, DAS receives a large number of invoices from bailiffs, lawyers, experts, etc.s. These independents, who generally do not have fixed fees, work for a mission, and send their invoices to the DAS. DAS knows that some of these experts have a tendency to bill too much for the work that has been executed. However, the volume of these interventions means that an in-depth analysis of these invoices costs more than the amount that can be disputed. 

This is why DAS asked Sagacify to develop an automated solution which determines whether the invoice amounts are abnormally high for the task, and whether an invoice dispute is necessary.

Solution

Automate & optimize

The challenges were:

  • Use of highly sensitive data. 
  • Need to understand the business process to know which features are relevant. 
  • Need for close collaboration between Sagacify’s technology staff and DAS’ business staff to assess whether the predictions of invoice dispute are justified.

Results

The solution we developed collects information about the claim such as the beneficiary, the parties involved as well as the content of the invoice. On this basis, the model is able to make a decision on whether or not the invoice should be disputed.
Eventually, only 5% of the volume of invoices need to be analyzed to find most of the abnormal invoices. 

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