Despite its scale and experience, the insurer faced persistent inefficiencies in claims processing. Claims intake, assessment, and approval depended on manual data entry, email-based document exchanges, and adjuster-driven decision-making, resulting in resolution times of up to 15 days even for low-complexity cases. Customers lacked real-time visibility into claim status, driving frequent support calls and dissatisfaction. Adjusters were overloaded with routine claims, leaving less time for complex investigations.

Fraud detection was largely reactive and rule-based, often identifying suspicious activity late in the process. Compounding these issues, claims data was fragmented across multiple systems, limiting analytics and consistency, while strict regulatory requirements demanded auditability, explainability, and secure handling of automated decisions.

Zymr helped the insurer transform claims processing from a slow, manual operation into a strategic differentiator. By leveraging AI-driven automation through Zymr FinHub, the company delivered faster, fairer, and more transparent claims experiences while reducing costs and fraud exposure.

This case demonstrates how an AI-powered claims platform can turn claims from a cost center into a driver of customer loyalty, operational efficiency, and long-term competitive advantage.

• Claims Processing Time Reduced from 15 Days to 3 Days
  Automation and intelligent triage significantly accelerated claim resolution.
  
• 45% Improvement in Fraud Detection Effectiveness
  Suspicious claims were identified earlier, reducing financial leakage.
  
• 30% Increase in Customer Satisfaction
  Faster settlements and transparent communication improved customer trust.
  
• Higher Adjuster Productivity
  Adjusters focused on complex cases while routine claims flowed automatically.‍
• More Consistent Claims Decisions
  AI-driven scoring reduced variability and improved fairness across outcomes.