Cognitive View insurance claims

Supervision in the claims decision-making process reduces unsubstantiated claim rejections and discrimination. To support an efficient claims process that is fair, transparent, and compliant, Cognitive View AI & Big data analytics can help.

Cognitive View provides the proper foundation necessary to establish a systemic approach to develop compliance and conduct risk monitoring.

Resolve claim-related disputes in a compliant manner, learning from good industry practices and AFCA’s historical disputes.

Download the white paper to know more about Cognitive View’s Claims Handling assessment

Cognitive View Claims handling

Supporting your compliance objectives

Cognitive View dispute resolution

RG 271 Internal dispute resolution

Cognitive View claims management

Claims as a Financial service

Risk Supervision

RG 78 Breach reporting

Key features

Cognitive View vect claims policy

Policies & Obligations

A complete suite of customized policies and obligations for you to meet your compliance obligations and company policies.

Cognitive View vect claims automation

Control Automation

Communication monitoring to support risk-based supervision.

Cognitive View vect claims analytics

Reporting

Analytics and reporting to support operational risks.

How the technology will help

LEGAL OBLIGATION

Policies and guidelines to drive an efficient, fair, and compliant claims process

Cognitive View customer experience

Police governance & change management

Cognitive View customer velnerability

Supervise & monitor the communication channels for control automation

Cognitive View incident breach

Audit & reporting to address problems before they escalate

Cognitive View vect communication

Call recording & archiving for audit

DECEPTIVE CONDUCT ANALYSIS

Risk-based supervision & predictive analytics

PROCESS ADHERANCE

Incident & breach management

Cognitive View customer care

Support customer vulnerability

Claims related dispute trends from AFCA Insights

Cognitive View Claims dispute

Claim dispute is the top reason for complaints in the general insurance category

Top issues for claims related disputes

AFCA has made more decisions in favour of financial firms for the discloser

AFCA has made more decisions in favour of Financial firms for disclosure related disputes

Cognitive View Insurance contracts

Insurance contracts act is the top regulation for compliance failure

Cognitive View AFCA's decision outcome

What is AFCA’s decision outcome looks for fraudulent claims

Cognitive View trends COVID-19

Emerging trends because of COVID-19

How AFCA Insights will help

Cognitive View learn

Learn

from historical disputes & risk insights

Cognitive View Review

Review

operational model & compliance gaps

Cognitive View Enhance

Enhance

automate process & control monitoring

Cognitive View predict

Predict

customer concerns and complaints

How can we help

  • Policies & guidelines to drive an efficient, fair, and compliant claims process
  • Police governance & change management
  • Supervise & monitor the communication channels for compliance & conduct risk automation
  • Call recording & archiving for audit
  • Risk-based supervision & predictive analytics
  • Incident & breach management
  • Resolve claim-related disputes & support complex claims by learning from disputes lodged at AFCA’s historical data
AFCA Insights Cognitive View logo

Are you ready to transform & streamline your complaints management process in tune with the AFCA regulations? Try our automated insights to give you the guidance you need.

Insights from our blog

CV Blog Claims afca insights
CV Blog Claims Supervision
CV Blog Claims as a Financial Service
Cognitive View Regtech 100 2021
Award Logo Landscape V2.3 - Cognitive View

SEE HOW
IT WORKS!

Interested in learning about how conduct risk analytics work on the Cognitive View platform?

Cognitive View Scheduled demo