Insurance · Business Process Automation
Cutting Claims Processing Time by 60% With Pega Automation
Overview
A leading insurance carrier operating across multiple product lines was struggling with a claims processing operation built on fragmented legacy systems and manual handoffs. SLA breaches were mounting, error rates were climbing, and the operations team was stretched thin. They needed a modern, scalable solution - and they needed it without disrupting live operations.
The Challenge
The carrier's existing claims workflow spanned five disconnected systems, with adjusters manually re-entering data at multiple stages. There was no real-time visibility into claim status, no automated routing logic, and no consistent audit trail for compliance purposes. Every exception required manual escalation, creating bottlenecks that rippled across the entire operation.
Our Solution
Codeless IQ designed and delivered a Pega-powered end-to-end claims processing solution that unified the carrier's fragmented systems into a single intelligent workflow engine. We implemented automated triage and routing logic, integrated real-time SLA tracking and alerting, and built a compliance-ready audit trail into every case. The solution was delivered in phased releases to maintain operational continuity throughout.
Technologies Used
The Results
Measurable, Lasting Impact
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60% reduction in average claims processing time
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40% decrease in manual touchpoints across the claims lifecycle
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99.2% SLA compliance rate within 90 days of go-live
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Full compliance audit trail implemented across all claim types
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Operations team redeployed from manual processing to exception handling and customer service
The Codeless IQ team didn't just build what we asked for - they challenged our assumptions and delivered something better than we imagined. The results speak for themselves.
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