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Facilitate employee / member disability claim processing

COVID-19 Challenge

Mandated lockdowns create spike in federal/state leave requests

Claims Group Benefits—Leave of Absence - Due to mandated school closings and federal/state quarantines, many employees of the Group Benefit business are asking for claims as per the FMLA (Family Medical Leave Act). The insurance group receiving these claims is expecting a surge of 300–400 claims per day.

Solution

The insurance group is deploying five bots that pick up a claim from a common queue and check eligibility. The bots help with claim creation, validation, approval/denial of requests including return to work notices, letter generation, and responses.