Imagine managing claims for over 700,000 insurance customers while relying on manual processes prone to delays, inconsistencies, and errors. This was the reality for AXA Indonesia, a leading branch of the global AXA Group offering medical insurance solutions.

Their post-authorization claim review process demanded extensive manual effort from 50+ medical officers who analyzed detailed PDFs containing treatment procedures, medications, and expenses. These officers assessed the claims against international medical guidelines to determine their legitimacy.

Key challenges we've observed were:

⌚ Time-consuming reviews

Lengthy approval timelines caused frustration among customers.

🤔 Inconsistent Decisions

Varied interpretations of medical guidelines led to potential errors.

❓ Fraudulent Claims

Significant costs incurred from overtreatment and fraudulent claims.

AXA needed a transformative solution to address these inefficiencies and improve their claim review process.