Better Decisions and Less Manual Work: Connecting Health Insurers via Data and AI

To improve third-party liability (TPL) accuracy and reduce friction in claims processing, a leading health insurer partnered with Launch to modernize its TPL data ingestion and curation process. The result: a cloud-native, AI-powered platform that reduced manual labor by 80% and incorrect decisions by 90%.

Results that matter:
90% Reduction in Decision Errors
Improved data accuracy helped eliminate costly TPL and coordination-of-benefits mistakes.
80% Less Manual Labor
Automation replaced inefficient manual processes, accelerating resolution and reducing rework.
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The Challenge

Our client—a major U.S. health insurer—was struggling with outdated systems and costly manual processes around Third-Party Liability (TPL) claims. They depended on third-party data feeds costing over $10 per record, but these feeds were error-prone and lacked consistency. Infrastructure limitations, service delays exceeding 15 days, and poor data visibility compounded the issue.

They saw the opportunity to apply AI and automation—but lacked the infrastructure, governance, and data readiness to move forward.

A major health insurer cut data errors by 90% and manual labor by 80%, transforming claims processing through cloud and AI innovation.

The Solution

Launch brought deep healthcare experience, AI expertise, and a human-centered approach to redesign the client’s TPL record process:

  • Conducted end-to-end process assessment with client SMEs
  • Built a cloud-based TPL platform on AWS
  • Integrated an AI Business Rules Engine (BRE) to automate ingestion and validation
  • Developed governance for data rules and quality management
  • Introduced data lineage capabilities to trace all decisions

The Results

With the new system in place, the client saw meaningful, measurable transformation across their TPL function:

  • Centralized, Scalable Infrastructure
    Supports 60 transactions per second and scales to 500M+ claims per year.
  • Proactive Data Quality Monitoring
    Automatically identifies and addresses errors—60% of feeds had existing issues.
  • Governance & Auditability
    Clear data lineage and formal rule governance support confidence and compliance.
  • Faster, More Accurate Decision-Making
    Fewer errors, less rework, and quicker response times mean improved provider and member satisfaction.

With streamlined processes, reduced labor, and better data visibility, the client is poised for stronger relationships and smarter decisions—all while preparing for future AI-driven capabilities.

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