The Customer

A leading insurance carrier and Fortune 500 company approached the Roots' team regarding a potential partnership, with the aim of introducing automation into their claims department. This property & casualty carrier is U.S. based, focusing on auto insurance and workers compensation, with approximately $3 billion in revenue. They have roughly 1,000 employees, many of whom work remotely.

The Situation

The Customer is a growing insurance business with a small mailroom that accepts all of the physical documents related to claims. As the Customer continued to grow, their mailroom and their employees were inundated with claims documents.

Our Customer is required by law to acknowledge policyholder claims within a timely manner – a standard the company takes very seriously. The Customer anticipated an increase in claims, but the increased workload within the mailroom was too much – and too monotonous – for the current employees to manage.

The Challenge

Federal regulations demand insurance carriers to acknowledge a new claim within a certain period of time. Failure to acknowledge the claim within the designated timeframe can result in penalties, fines, and dissatisfied policyholders. The claims team struggled to acknowledge all of the incoming claims.

Employees couldn’t keep up with demand, and as such, couldn’t respond to consumers within the expected timeframe. Leveraging temporary workers to mitigate the workload incurred further cost and created took experienced, efficient team members ‘off-the-floor’, further exacerbating the problem. Additionally, the company was finding it difficult to scale and the executive team did not want to bring on any additional employees into the mailroom.

The Solution

This customer had a well-defined process, and Roots eventually delivered a AI Agent to be a digital coworker that customer employees affectionately dubbed Roxy. To build Roxy, our team mapped certain claims letters based on the insurance state. Roxy then forwarded the state-appropriate acknowledgements, ensuring each claimant received the correct communications.

After COVID-19 hit in 2020, the customer relied heavily on the bot to mitigate the employees’ exposure to the virus. Though Roxy wasn’t built for full autonomy, we simply changed the AI Agent's trigger, and then the acknowledgement letters continued. The end result for our Customer was a staggering 99% straight-through processing rate, meaning 99% of cases were handled entirely by Roxy.

The Customer was extremely pleased with their AI Agent's impact on their business. They quickly saw a 60% increase in throughput volume, coupled with their 99% straight-through processing rate. This improved the claimant’s experience, as well as the employee’s work experience.

The AI Agent reduced the lifecycle of a claim, thereby helping the customer to pay less to manage and process claims. According to the customer, it would normally take 2 or 3 FTE an entire day to process these letters, but Roxy is able to complete all of the work in the mornings.

Overall, the Customer saw a 246% return-on-investment, delivered within only 6 months. The results were so impactful for the organization that the Customer used their cost savings to invest in another AI Agent that their employees voted to name Rex. Rex is a document-indexing AI Agent and digital coworker, and it saves their team of adjusters several hours every day by indexing incoming documents and attaching associated files to the correct claim account.

Today, the Customer is exploring additional AI Agents within their organization, to be stationed in multiple departments.