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HCL's ADvantage™ Pega D.I.C.E. Solution

D.I.C.E. - Digital Insurance Claims Experience platform - insurance claims risks & raffles to circumvent

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Overview

Insurance fraud is any act committed to defraud an insurance process. This occurs when a claimant attempts to obtain some benefit or advantage they are not entitled to, or when an insurer knowingly denies some benefit that is due. Insurance Fraud is no longer a victim-less crime, instead it has a cascading impact on all the stakeholders bearing the fraud-loss. Hence there is a great urge & demand to develop a system that can identify potential frauds with accuracy and arrest it at the very initial stage for detailed scrutinization. Some of the key problems faced by Insurance Organizations:

  • Paper-forms that are manual & error-prone
  • Multiple Handoffs with limited transparency
  • Limited Input Channel Support
  • Data stored in pockets across various legacy systems
  • Reactive Detection of Fraudulent claims
  • Speed of Settlement is slow, impacting customer experience
  • Limited personalization or 1:1 engagement
  • Increased Operational Expenditure / Cost

Key Features

A solution for NextGen Insurance Platform, built leveraging Robotic Process Automation, Pega Case Management, AWS Machine Learning & HCL's ADvantageTM Azure Intelligent Assistant. It helps customers embarking on a digital journey and how the seamless interlock across the products can be achieved.

The bootstrap solution is for an Auto Accident Claim Insurance scenario. Following are some of the components leveraged:

  • HCL's ADvantageTM Azure Intelligent Assistant (Chatbot, Multilingual, OCR, Virtual Assistant - Alexa/Google Assistant)
  • Robotic Process Automation (Automated email parsing & processing of claims - leveraging UiPath)
  • AWS Machine Learning / Sagemaker Integration for Fraud Detection / Prediction
  • Google Map APIs integration for Street View
  • Pega 8.x for Case Management Implementation
  • WhatsApp Integration for fetching claim status info (leveraging Twilio Integration)
  • Workato for iPaaS layer and defining a loosely coupled architecture

Why build a solution with Pega + other Ecosystem Partners, when Pega Infinity Platform can address them all?

Pega Infinity Platform's enterprise blueprint and cutting edge offering it can put a tick in a box for many areas (CRM, Case Management, Decisioning, AI/ML, Marketing, RPA, IVA to name a few). With this offering we want to create a pathway for ensuring how malleable & flexible Pega can be in a heterogeneous ecosystem. It also helps in creating a "better-together" strategy for addressing a customer landscape with diversified investment & complementing ecosystem products.

Business Benefits:

  • Improve Productivity & faster time to market
  • Reduce Manual hand-offs & overheads with STPs
  • Reduce Operational Cost (OpEx)
  • Multi-lingual conversation and voice enabled assistants
  • Eliminate mundane & monotonous tasks with OCR & RPA
  • Personalized Customer Experience
  • Providing a human-face to your brand
  • Elevation of the Nature of Work
  • Improve Speed & Scale
  • Proactive detection of Fraudulent Claims with AI/ML techniques

Other Offerings

HCL's ADvantage™ Assess for Pega

HCL’s ADvantage™ Design Assessment Tool (DAT) for Pega

HCL ADvantage™ Pega Case Migration Kit

HCL’s ADvantage™ Pega Code Impact Analyzer

HCL's ADvantage™ Pega Code Scanner

HCL's ADvantage™ Pega Environment 360 Portal

HCL's ADvantage™ Pega Experience Amplifier

HCL's ADvantage™ Pega Governance Dashboard

HCL's ADvantage™ Pega Immune Workplace Solution

HCL's ADvantage™ Pega Pre-Update Assessment Tool (PAT)

HCL's ADvantage Pega Process Fabric Connector for ServiceNow

HCL's ADvantage™ Pega - ROAR

HCL ADvantage™ Pega Tamper Proof Audit Trail

HCL ADvantage™ Pega UI Kit to Theme Cosmos (U2C)

HCL's ADvantage™ Pega Workato Connector

HCL’s ADvantage™ Rapid Deployment Framework for Pega

HCL's ADvantage™ RPA 3D-Process Value Discovery & Prioritization Framework

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Compatible with

Pega Platform 8.1 8.2 8.3 8.4 8.5 8.6

Last updated

October 17, 2022

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