Introduction

Rising customer expectations, complex regulatory requirements, and strict cost targets. But behind every claim is a process - one that holds the key to unlocking faster settlements, fewer overpayments, and reduced rework. With Intellifold, you can move beyond reports and dashboards and into the actual process flow, pinpointing where time, money, and effort are being wasted.

The Problem

Common challenges in claims handling include:

• Slow claims processing due to wasted efforts and rework creating dissatisfied customers and extra costs
• Lack of visivbility about who does what in the process and what can be improved to lower key person risks.
• Automation challenges due to data quality issues and limited insight into what's working and what not.
• Policy and approval misalignment increasing the risk over leakage and overpayment.
• Late intervention when claims don't seem right or resolution times are in jeopardy.
• Reopening and adjustment of claims causing extra delays and effort.

Over time, these inefficiencies complicate compliance, erode profit margins, and limit your ability to grow.

Traditional BI tools only scratch the surface, failing to reveal the root causes of inefficiencies and non-compliance, and they do not support improvement actions and continuous monitoring.

Fragmented and complex data across systems creates blind spots, making it impossible to track cross-departmental processes effectively, or to clearly measure the impact of improvement initiatives.

Unaddressed process bottlenecks and control failures lead to significant operational risks, rework, unnecessary costs, and lost revenue.

The Solution

Intellifold’s Claims Manmagement solution acts as an X-ray across your claims handling processes, revealing exactly where the unwanted behaviour and inefficiencies hide. Visualise the true claim journey across functions and systems, with live data insights to streamline and automate. Our solution helps:

• Identify delays in settlement, bottlenecks in approvals, or handoffs between teams slowing down claims handling.
• Detect control gaps, incorrect policy interpretations, data quality issues, or processing errors.
• Trace the root causes behind claim adjustments and reopen rates, documentation gaps, and inconsistent deviations.
• Understand the cost of rework, incomplete submissions, and additional verification.
• Quantify the benefit of process automation with detailed process execution times and volumes.
• Trigger alerts based on key process and risk indicators through continuous monitoring.

With these powerful insights, process owners can proactively fix inefficiencies, ensure that claims are handled appropriately, and your customers will love your resolution times. Make the right decisions backed by data and drive improvement across risk and performance.

Key capabilities:

• Full Process Transparency: Visualise every handoff, missed step, and rework step in real-time.
• KPI Tracking & Dashboards: Monitor essential metrics like first time settlement, reassignment rates, disputes, automatic handling.
• Root-Cause Detection: Identify why issues keep occurring and isolate the teams or activities involved. Monitor bottlenecks and rework loops to stop repetitive issues at their source.
• Advanced Analytics: Implement automated fraud indicators and through predictive insights spot issues before they arise.
• Alerts: Configure alerts via sms or email to intervene timely in case steps are missed or claims and policies don't align.
• Automation: Integrate with RPA and AI to automate claims intake and handling with the right human oversight.

Why Intellifold

• Beyond Dashboards: We dig deeper than Power BI or other reporting tools to expose root-cause inefficiencies that traditional dashboards miss.
• Product Flexibility: Fully customisable dashboards, analytics, and deployment options. Analytics can be executed directly within the solution or pushed back to the underlying database. Deployment in Intellifold cloud or private cloud environment.
• End-to-End Service: Unlike point-solution vendors, we provide the software, consultancy, training, and ongoing support in a single integrated package. This ensures a quick return on investment and the best use of advanced technology.
• Expert Guidance & Training: Your team quickly gains confidence through hands-on training and continuous improvement support.
• Security & Compliance: We’re SOC2-aligned and have rigorous data governance and security protocols. See our Trust Center for details.
• 90-Day Transformation: Achieve full transparency, start tackling key bottlenecks, and improve compliance within 90 days—or we’ll work with you for free until you do.

Results you can expect

With Intellifold’s Process Mining & AI platform, claims teams, compliance officers and transformation leaders get a clear, data-driven view of how claims are really handled—backed by process mining, AI, and tailored visualisations.

✅ Faster claim resolution ✅ Fewer touchpoints ✅ Smarter automation ✅ Lower risk exposure

Common concerns

“We already have reporting and BI tools—why add Process Mining?”
Process Mining goes beyond visualisation to uncover root causes of inefficiencies that dashboards simply can’t.

“Is this compatible with our existing ERP/CRM/Workflow?”
Yes! We seamlessly integrate with common systems like SAP, Oracle, MS Dynamics, data warehouses and many more.

“Will our team struggle to adopt this?”
Our hands-on training and continuous support ensure quick, confident adoption. This is a priority for us.

“What about data security?”
We partner with leading cloud providers, offer on-prem or private cloud deployment, and follow strict compliance controls (SOC2).

When This May Not Be Right for You

While Intellifold solutions bring extraordinary value to organisations with complex, high-volume, and data-rich processes, there are times when our technology might not be the perfect fit:

• No Digital Footprint: If your process isn’t supported by systems that capture event data, we won’t be able to mine or analyze workflows effectively.
• Insufficient Volume: Our insights rely on patterns in enough transactions or complex steps to identify significant inefficiencies.
• Limited Buy-In for Change: Real transformation requires stakeholder support and organisational readiness to act on the insights we provide.

If these conditions apply, you may not see the full benefits of Process Mining & AI.

For everyone else and with the right commitments, we guarantee improvements within 90 days.

A 3-Step plan to Your Transformation

1. Discover & Assess: We tailor a solution and roadmap around your unique processes, compliance needs, and technical environment.
2. Seamless Setup & Integration: Our experts connect Intellifold to your ERP, CRM, workflow source systems, offering real-time insights.
3. Ongoing Support & Improvement: Expect continuous monitoring, consultancy, and training so you see and sustain real results.

Our Commitment to You

1. Our Guarantee: Full process transparency, and the first elimination of bottlenecks or improvements in compliance —or we keep working at no additional cost. We want to make this work for you!
2. Hands-On Partnership: From strategy workshops to tailored training, we’re with you every step of the way.
3. Security Assurance: We meet rigorous data protection standards, and if any issue arises, we resolve it fast at no cost.

Ready to Transform Your Processes?

Whether you're in health, life, or car insurance, our Claims Management solution helps you find the facts, fix the friction, and focus your efforts where it counts. Book a 30-Minute Call to discover how Intellifold can help you improve efficiency, reduce costs, and ensure compliance across your entire process.

Intellifold — Your partner in Process Mining & AI for better processes, empowered teams, and an improved efficiency.