Accelerating Insurance Claims Processing with IBM Automation and Cloud Services
A leading insurance provider transformed its claims management operations using IBM Cloud Pak® for Business Automation and IBM Cloud Services, achieving faster response times, improved accuracy, and enhanced agility in a highly regulated environment. The solution enabled the insurer to process claims in hours instead of weeks, strengthening competitiveness and customer satisfaction.
Business challenge
The company managed millions of insurance claims across multiple products but relied heavily on manual verification, data entry, and outdated workflows. These inefficiencies slowed claims resolution, increased operational costs, and limited scalability.
The insurer needed to:
- Automate manual workflows to improve turnaround time.
- Integrate core systems for seamless data exchange and reporting.
- Improve customer experience through faster, transparent claim handling.
- Build a scalable digital foundation to support future product launches.
Solution
Partnering with Nexright, the insurer implemented IBM Cloud Pak® for Business Automation and IBM Cloud Services to automate workflows, digitize claims processing, and integrate back-office systems into a single platform.
Using AI-driven decision automation, the platform rapidly categorized claims, verified data, and routed cases to the right teams in real time. With cloud-native microservices, the insurer could scale operations on demand and adapt quickly to new regulatory or business requirements.
Solution Highlights:
- Automated claims verification using AI and workflow orchestration.
- Integrated policy, billing, and customer data across platforms.
- Enabled cloud scalability for high-volume transactions.
- Delivered faster deployment of new insurance products.
Solution components
- IBM Cloud Pak® for Business Automation
- IBM Cloud Services
- IBM Business Automation Workflow
- IBM Robotic Process Automation (RPA)
Smart Workflow Automation
Integrated claims and policy systems, allowing rapid validation and processing through automated decisioning.
Real-Time Claims Routing
Used AI-powered classification to direct claims to the correct handler instantly, reducing manual errors and bottlenecks.
Scalable Cloud Infrastructure
Leveraged IBM Cloud to scale operations dynamically, ensuring high availability and business continuity during claim surges.
Result
- 85% faster response time for claim submissions.
- 50% reduction in manual processing effort.
- Claims resolution time improved from weeks to hours.
- Enabled addition of new insurance products within hours.
- Strengthened customer satisfaction and compliance reporting.
We can now launch new products and process insurance claims in a matter of hours — what used to take weeks. IBM’s automation and cloud solutions have completely transformed how we serve our customers.
— Chief Information Officer, Leading Insurance Provider