MEDGULF Insurance KSA – Insurer Innovation Award 2023

1. MEDGULF
The World’s Digital
Insurance Awards 2023
Project: Automation of renewed Motor
Claims process
30-Jun-2023

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About MedGulf
In a rapidly growing and changing sector,
MedGulf contributes to providing you the best
customer service and acquiring your needs.
We offer various insurance solutions that suit
most industries from engineering, aviation and
industrials to motor, property insurance and
health care for groups.
Medgulf is aggressively seeking a competitive
edge in the market and considers Customer
Experience as one of the key differentiating
factors.

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Business Problem: Lack of Automation in Motor Claims Processing
Multi third party manual
integrations and checks
Delayed claims processing
leading to a diminished
customer experience
Paper-oriented processes
Manual Fraud detection
Amalgamated manual and
system based providers
management
Multi system modules
involved
Manual Surveyor journey
consuming time
Broken processes and lack of
automation

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About the Project: Automation of renewed Motor Claims
process
• In line with our “customer first” as part of digital strategy, we will launch a state-of-the-art, fully digitalized motor
claims system that will reduce the time taken for claims processing by 50%.
• The renewed Claims journey will transform the process, people and experience along,
• The claims process will integrate with third parties at relevant information required minimizing the Customer effort
by auto filling of forms as well as the processing staff moving to Omni digital experience.
• Customer will be engaged throughout the journey through SMS and/ emails from FNOL – Settlement.
• A segment of claims is planned to go for “Straight Through Processing (STP)” – i.e. no manual intervention and
claim settlement within minutes.
• The new digitized process will also reduce the probability of manual errors and enable accumulation of fine data for
future Data analytics and AI application.
• The technology used is a Low Code Platform on which the process is established enabling quicker amendments by
business themselves and reducing the dependency on IT.
We partnered with Newgen, to automate the entire claims journey, increase
process efficiency and standardization by empowering your users to perform
manual tasks digitally and reduce human intervention. Key criterion for digital
partner selection is the distinct value the entity is able to bring to the
customer journey in terms of innovation, automation and simplification and
project is in testing phase and expected to go live by Q4 2023 beginning.

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Key Solution Features – Transforming the Motor claims
process
Process
Management
Dynamic business process
management based on
defined characteristics and
process exceptions
Business Rules
Management Engine
Dynamic rules facilitate
straight-through checking
of various policy breach
conditions and fraud
management support
through rules engine
Flexibility and
Management of
Workflow
Workflow flexibility
ensures that a carrier can
perform to its promised
levels of customer
responsiveness at all times
Efficient Data
Capture
Configurable user
interface to define data
elements as per specific
requirements
Increased
Collaboration
A secure shared
workspace on the
corporate intranet or an
external web
Communication
Platform
System based triggering
of text and mails to
customers
Dashboards
Sophisticated data
analysis that goes far
beyond canned standard
reports
API Based
Integrations
Third party and internal
systems integration
through APIs setting foot
in ecosystem initiation in
the region
A B C D
E F G H

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Key Highlights – MedGulf Motor Claims
 Faster Claim Initiation via Customer Portal with the help of NAJM/ Basher and Taqdeer Integration.
 Straight Through Processing (STP) of Cash Claims: Third Party claims initiated through Customer Portal and
Front Desk are sent for settlement removing manual intervention for a defined claim amount.
 Enhanced Claim tracking and Customer actionable via Customer Portal
 All documents related to the claim and policy information available with reduced clicks
 Auto Repairer Allocation for the Vehicle Damage cases
 Anytime Anywhere Surveying capabilities
 Straight through Processing – eliminating back-office user actions
 Auto Fraud and Duplicity detections for the incoming claims
 Auto Email and SMS triggers - Reduced manual interaction with the customer
 Provider onboarding Documents and Listing by the Provider Affairs team
 Reduced Turn-around-time
 Enhanced Application Monitoring

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Benefits Achieved
Enhanced and responsive
customer communication
Improved risk management
process
Reduced manual errors and
increased staff productivity
through automation of manual
activities
Easy Integration with external
and internal systems
Increase in repeat business
due to higher CSAT
Reduction in effort required
for physical file handling
Reduced operational costs
and faster processing of a
motor claim

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Implementation Impact
• 100% Digitisation of documents leveraging cloud technology and enterprise content management.
• Automated end to end workflow with built in productivity metrics –, prevention of fraud and
increased efficiency.
• Registration of First Notification of Loss (FNOL) by Customer.
• Signification APIfication (23 API’s built) - enabling integration of our core system with Government
and other third-party providers apart from internal systems.
• Future-ready for enabling online motor claims registration (Electronic Notification of Loss) by policy
holder.
Targeting a segment of claims for
30% - 40% Straight Through
Processing

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Features & Business Benefits
Feature Before Implementation Post Implementation Benefit
Claim Initiation via
Customer Portal
Newgen’s Customer Portal
implementation for Claim Initiation
reduce Back office user’s effort for
Data entry
Integration with IMS, NAJM & Basher
reduces the data entry by the Claimant
Clean UI and less
switching between
screens
In the Legacy System of MedGulf –
IMS has multiple screen/windows
view
Newgen BPM system has more
efficient UI with no window popups
Less effort in manoeuvre between the
screen to access the claim data.
Fraud and Duplicity
detection
Manual Fraud flagging
Auto Flagging of Fraud and
Duplicate cases from System
Workstep
Auto Detection of Fraud cases and
Duplicity Detection based on the previous
claims data and NAJM fraud Indicators
STP processing
business rules
Manual Intervention for Straight
through cases
Claims will be initiated and then
system will automatically route the
case for settlement for Third Party
Cash
Auto Processing of Third-Party Claims to
settlement
Paperless
Transactions
Current Process involves the physical
document for accident reports,
approval document, expenses
Integration with IMS, NAJM, Basher,
Taqdeer, SADAD removes
dependency over physical
documents.
Cost saving in handling of physical
documents and also consolidated
overview of all the claim documents in
one place.

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Future study and vision
System Captures Claims Data much earlier – lot of data getting accumulated – more data points.
Data Provided to Datawarehouse and then used to improve claims analytics used by Operations,
Actuarial and Underwriting. Support dynamic premium
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Digitally engaging Customer in personalized manner and opportunities to cross sell other products
by further extending into the ecosystem in the region
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Improvising Reserving process to avoid fluctuating Motor Reserves, also extending the journey
from Claims to end-end new process.
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