Customer story
Handling claims for one of the biggest pension funds in Switzerland
Follow one matter through the way it used to work, and the way it works now.
01 — The company
One of the biggest pension funds in Switzerland
The fund is an established multi-employer pension scheme that provides occupational pension solutions primarily to small and medium-sized businesses across a broad range of industries in Switzerland.
02 — The challenge
USD 562 million costs
That is the amount paid out in invalidity claims every year. The fund is able to properly handle no more than 7.5% of all claims, resulting in 95% of claims being paid out.
03 — How they worked before
Stacking up claims in expensive software
The fund used transaction-based software to process claims supported by more than 1,000 pages of documentation. Even with this technology, time constraints prevented most claims from being investigated in sufficient detail. Engaging external counsel was an unsatisfying alternative, as each claim required dozens of hours of work and cost thousands of dollars to review.
The result: USD 562 million in costs every year.
04 — How we handle it
Handling claims AI-native and end-to-end
An invalidity claim arrives
An insuree of the fund files an invalidity claim, and it lands with the fund's team to investigate.
Thousands of pages
Each claim arrives with more than 1,000 pages of medical records, correspondence and documentation.
Into Omnilex's legal analysis engine
The file is split back into its original documents, and every one of them is categorised.
Analysed in parallel
Many documents are analysed at once and checked against the law and the fund's policies.
Structured findings
A structured picture takes shape: timeline of events, causality of invalidity, coverage of insurance and more. Contradictions are flagged, and Omnilex lawyers are brought in when needed.
Signed off & delivered
A recommendation on how to proceed is written, signed off by an Omnilex expert lawyer, and returned to the fund through the portal.
05 — The impact
Saving millions each year
Omnilex case handling investigates each of the claims immediately and works out a recommendation on how to proceed that is first signed off by the Omnilex expert lawyer and then gets back to the fund. Already today, 2% of the claims that got paid out before are rightfully rejected, resulting in USD 11.24M of saved costs each year.
