Claims 2.0

Groupama Asigurari (Roumanie)


Casco margin shrunk in 2019 due to the combined effect of a sharp inflation on the average cost of claims (both on spare-parts and manpower) and of the increase of provision on recoveries from MTPL.

– What the project proposes?

Restoring quickly the profitability in Casco and containing the inflation of unit costs of material claims in MTPL, while maintaining a right perception of quality at a correct price for end customers and improving employees’ engagement.

– How it works?

Complex transformation program launched starting end 2019,with an holistic approach including 9 project streams: Reduction of unit cost of claims, Reduction of claims handling cost, Prevention of fraud, Leakage prevention, Governance with 1.000 partner garages, Process redesign through innovative RPA & Machine Learning as well the introduction of a new claims management tool (Audatex), Performance and Change Management, People Engagement

– What is its added value?

All the developments delivered by the program proved to be of real support for the team and for the customers, by decreasing the non-value adding activities and embedding innovative artificial intelligence and machine learning technology. Some examples of program deliverables:

o Yoda- an AI application that detects at claim notification customers with specific patterns and redirects them to either our claims inspection center or to a contracted partner garage with a special customer retention script.

o Poirot: machine learning technology mainly focused on data analysis and pattern recognition to spot fraudulent behaviors.

o RPA development for payment automation

o Implementation of Audatex, a new claims evaluation platform, thus managing to reduce the operational time in the claims settlement process and focus more on capitalizing the team expertise.

o Dynamic Scoring for 1.000 Partner Garages allowing ranking of garages based on multiple criteria (e.g. average cost of claims) and proper focus in managing them.

o Performance Management using Visual boards with KPIs for activity and results, at individual and team level, with a weekly frequency

o Action Plan for people engagement and customer satisfaction, including thorough people assessment and introduction of a quarterly performance bonus.