Case Study: Fortegra automates claims adjudication with InRule

Fortegra Financial Uses Inrule® to Automate Decisions for Claims Adjudication

Fortegra Financial, a leading insurance services company, needed to automate a complex claims adjudication process that had been handled manually by business analysts on its AS/400-based legacy system. The challenge was to standardize decisions across multiple policy and insurer-specific rule sets while meeting a tight deadline and supporting both legacy and newer .NET/web applications. InRule provided the business rules technology Fortegra selected to address this need.

Using InRule’s .NET-based, embeddable rules engine and web service integration, Fortegra separated claims rules from the core system and automated the adjudication decisions previously made by hand. The solution improved consistency and accuracy, reduced processing cost, and eliminated human intervention that slowed claims handling. Fortegra reported specific evidence of better decisions and expected quantifiable results, while also noting that the rule separation simplified testing and positioned the company for future BPM integration.

Fortegra