Life & Health Insurance

For insurance companies finding and building customer relationships and managing risks is the key to creating a growing, profitable business.

The healthcare industry has massive amounts of data available in health records, billing & claims processing systems. Health insurers face challenges in unlocking the value buried within this data to accelerate claim payments, reduce fraud, drive better patient outcomes, underwrite risk, price dynamically and maintain regulatory compliance.

Autonomous systems are able to learn complex features across multiple dimensional data sets and assist the life & health insurance business to not only optimize the performance within a process but also enable multiple processes to work more intelligently in unison.

01
Virtual attendance

Improve effectiveness of customer communication to build engagement, boost conversion rates, and decrease churn.

Personalize targeting and enhance customer experience

Automate customer targeting and retention strategy using autonomous AI systems, that learns granular features across dimension from data and evolves with new data

Boost conversion rates and overall ROI from the targeting channel

Nudge the sales team and agent channel into personalized service

Increase the ROI from channels by running optimized micro-strategies

Monitor Agent performance, and nudge them for improved deliverables

02
Virtual attendance

Go beyond rule engines and automate complex cases through autonomous AI systems with high accuracy

Improve quality and speed of underwriting

Reduce underwriter load by increasing STP proportion, flagging information requirements while monitoring financial and medical risks.

Goes beyond rules to classify cases STP eligible cases intelligently assessing required information checks and documentation needs

Reduces early claims and flags probable non-disclosures and high risk parameters

Ensures standardised implementation of underwriting policies and allows for rapid reconfiguration based on business needs

Beyond rigid grids, enables personalized pricing based on customer profile, product type and business risk appetite

03
Virtual attendance

Go beyond rule engines and automate complex cases through autonomous AI systems with high accuracy

Automate claims processing and control claims leakage

ACP module uses complex deep neural networks to learn from historical claims enabling near real time decisioning while controlling leakages.

Automate claims decisioning on complex cases with high precision and recall, thus decreasing costs

For complex cases augment assessors' expertise with insightful data driven inputs

Continually improve coverage, disruption-free, through feedback ingested during retraining

Deliver customer satisfaction through swift decisioning without compromising assessment quality

04
Virtual attendance

Go beyond rule engines and automate complex cases through autonomous AI systems with high accuracy

Track, monitor & control risk across functions – Fraud, Compliance & Regulatory

Obtain comprehensive, timely and actionable insights into potential transgressions of governance frameworks through autonomous and guided analysis

Flags risk at transaction level as well as portfolio level risks through detecting individual anomalies and trend predictions

Filter out frauds at each step of the customer journey from underwriting to claims ensuring multiple checkpoint based

Ensure compliance adherence through checks on third party decisions, product filed versus policy issued checks, validates

As an automated system , is configurable for mandated periodic audits, be activated on predetermined triggers or be on scan mode for high impact triggers

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