Partners

Industry challenge

The global (re)insurance industry is exchanging placing, accounting, and claims data through many different approaches, often requiring intensive manual intervention, hindering data speed and accuracy. Stakeholders are hampered by the need to establish many bespoke peer-to-peer connections with counterparties who may be at a very different level of digital maturity.

The solution

ADEPT (ACORD Data Exchange Platform & Translator) enables global, interoperable data exchange by connecting all insurance partners, regardless of their existing technology, processes, and data formats. ADEPT connects insurers, reinsurers, cedents, brokers, and others to ensure that they are able to send and receive consistent, easily consumable data in real time. ADEPT is fully integrated with the full suite of ACORD Digital Solutions, enabling the digitization, translation, and delivery of a wide variety of documents and messages.

Business benefits

• Provides a secure, decentralized data platform for placing, accounting & claims
• Dramatically reduces cost of data exchange and improves cash flow
• Enables straight-through process automation and ecosystem integration
• Improves compliance and data integrity, reducing errors compared to manual administrative processes
• Maximizes the effectiveness of data by making it easily available at the moment of value

Industry challenge

One of the greatest challenges facing organisations is working to embed regulatory compliance within insurance supply chains. This is a highly complex environment that can absorb teams as they wade through repetitive and time-consuming tasks. While a significant resource burden, failure threatens cost, efficiency and reputational impacts.

The solution

The joint Sapiens and Albany Group solution brings the ability to channel complex workflows and supplier management into a single, simple to implement and easy to use platform. Suppliers include third party admin (TPA), claims adjusters and experts, lawyers, underwriting brokers and even IT contractors. They also include contractors such as plumbers, builders, car mechanics and repair shops. Conect™ automates, streamlines and makes sense of supply chain complexity — to embed oversight, confidence and compliance. Integration of Conect™ with Sapiens core systems provides end-to-end performance, regulatory and operational control of supply chains, so that third party providers access to the insurer systems is according to their status in the Albany Group system. Code-free, Conect™ is rapidly deployable, customisable and scalable within departments, throughout companies and across markets.

Business benefits

•  CONTROL – Risk intelligence technology that puts you in control — to save time, reduce costs and automate regulatory compliance
•  INSIGHT- Harness trusted data, cross-sector expertise and intelligent analysis for complete oversight, performance management and audit of your supply chain
• SIMPLICITY – Code-free configuration and intuitive screens ensure that Conect™ simplifies the most complex processes

Industry challenge

Insurers face increasing pressure to control and optimise their profit margins (direct insurers, price comparison websites, low interest rates). Pricing sophistication has become a key differentiator, but pricing processes remain long, manual and iterative. While AI could significantly improve this process, standard machine learning algorithms generate models that cannot be put in production because of regulatory constraints and risk of adverse selection. Akur8 is the only technology on the market that reconciles machine learning and actuarial science to automate the generation of transparent, production-ready GAM/GLMs.

The solution

Akur8 leverages the power of Machine Learning & predictive analytics to inject game-changing speed and accuracy to insurers’ pricing process. The solution supports pricing experts at every step of the pricing process, generating significant efficiency. From data processing and visualisation to exporting final models, Akur8 provides a comprehensive modular approach to pricing built around three main modules:
1. Risk – to build technical models and pure premiums
2. Demand – to build behavioural conversion and retention models and measure price elasticity
3. Rate – to iterate on rate plans (commercial premiums) and run portfolio analyses

Business benefits

• Speed – Make your pricing process 10x faster
• Performance: Improve the predictive power of your models
• Transparency: Ensure full compliance with local regulation

Industry challenge

Remaining competitive in an evolving marketplace requires carriers to meet modern consumer expectations, such as accelerated claim lifecycles and digital self-service. There is a need to streamline the paperwork process and greatly reduce the turn-around time with Policy and Claim documents requiring authorized signatures.

The solution

The solutions streamline existing insurance workflows that require single or multiple signatures, reducing operational costs by significantly speeding the previously unwieldy document completion process (using mobile device, tablet, or computer). Close business 95% faster with eSignature. Create a 100% customizable experience to highlight your brand and seamlessly generate & send documents for signature via SMS or email.

Business benefits

• Rapid personalization of both claims and policy correspondence reduce cycle times by utilizing previously generated templates
• Easy access to a central repository of templates, plus automated data and content prefill document templates, save agents time
• Built-in document preview capability during authoring facilitates a quick turn-around from edit to production

Industry challenge

The likelihood of potential customers qualify or lapse at the online application stage is difficult for life insurers to predict. If insurers improve their placement ratio it would have a significant impact on profitability and internal resources. Using AI, machine learning and analytics can provide potential policyholders with a better match based on “peers like you” and will improve insurers’ profitability and customer satisfaction. Atidot offers growth opportunity for life insurance – empowers insurers to evaluate opportunities in an existing portfolio or a book of business with big data and predictive analytics.

The solution

The joint solution provided by Sapiens and Atidot combines real-time AI, machine learning, and analytics capabilities with Sapiens ApplicationPro, a web-based insurance application software. The solution enables insurers to better predict their placement ratio, understand their customers profile, and recommend better policies based on ‘lookalike’ strategy. Companies can gain insights into their customer base and see the bottom-line impact of their product and marketing strategy. Atidot’s insights help you make smarter business decisions at just the right time.

Business benefits

• Improve top-line growth by up to 30%
• Gain up to 4x increase in your book of business value
• Improve predictability by 15X and increase lifetime value

Industry challenge

With more than 71% of the global deaths (according to WHO.org) caused by preventable disease, the Insurance industry wishes to move from being a claims payer to a lifetime wellbeing partner, helping people achieve and maintain better health and wellness levels, while better assessing risk and providing preventive, personalized services, at lower costs.

The solution

As a B2B company, Binah.ai provides the Insurance industry with an AI-powered, 100% software solution (SDK) they can easily integrate into their app or workflows to allow clients monitor health parameters, just by looking at the camera of a smartphone, tablet or laptop camera – anytime they need, anywhere they are, in only one minute. End-users are able to extract a wide range of health parameters such as blood pressure, heart rate, heart rate variability, oxygen saturation, respiration rate, mental stress, relaxing ability and more, and share this important health data with their insurers so they can better support their care, wellness and health improvement efforts.

Business benefits

• Enhance wellness programs success using members’ objective health data
• Streamline and empower underwriting and STP with remote, real-time health and wellness monitoring
• Better assess risk and increase prevention
• Lower operational costs (no need for wearables, less human time spent on health assessments)

Industry challenge

Consistent, timely communications is key when it comes to building lasting relationships with customers that help build your brand and grow your business. But maintaining a customer communications system that isn’t built with the user in mind can be expensive and time-consuming. The result can mean long turn-around times that limit your team’s responsiveness, and a technical burden to your IT staff that is costly and inefficient.

The solution

Cincom Eloquence is a customer communications management (CCM) solution that gives you the tools to design, deploy and deliver documents in a way that is flexible and user-centric. With Eloquence, you can say goodbye to manual data entry and tedious management processes—and say hello to cost savings and compliance with confidence.
Cincom Eloquence’s user-friendly design helps streamline customer communications processes across your entire enterprise—minimizing compliance risks, reducing operating costs, increasing speed to market and protecting your brand image.

Business benefits

• Deliver a consistent brand image to customers and partners
• Accelerate productivity: cut document production time by 90%
• Ensure communication compliance to address internal policies and external requirements
• Optimize legacy investments by integrating with existing business platforms and applications
• Deliver an enterprise-wide solution to meet the needs of the entire organization

Industry challenge

Litigation and Severity costs are eating into Insurers’ profits and ability to grow. Annually more than 20% of premiums are lost to litigation, fraud and compliance related claims handling. Lack of risk insights also blinds risk selection. Prioritizing claims with high propensity of litigation and severity to reduce claims cycle time and costs while efficiently managing reserves is much needed. Predictive analytics and Insights driven decision are the need of the hour.

The solution

Charlee.ai is an artificial intelligence based predictive analytics patented solution that helps reduce litigation and severity expenses while efficiently reserving claims. Charlee helps prioritize claims with high risks such as litigation, suspected fraud and non-compliance along with deep claim insights to help operational team streamline their workflows. Charlee is a secure, cloud-based and SOC 2 compliant web-application with custom dashboards and KPIs providing easy upload of data via SFTP or APIs.

Business benefits

• Charlee leverages our patented and proprietary natural language processing (NLP) and machine learning models to extract deep insights from structured and unstructured data and predict litigation and severity
• Charlee predicts litigation and attorney involvement starting at first notice of loss (FNOL) and 90-120 days prior, enabling workflow prioritization
• Charlee predicts severity in various ranges (low, medium and high with dollar amounts dependent on machine learning) allowing for fast tracking and insights-based assignments
• Charlee provides claim level alerts and red flags based on deep learning of unstructured and structured claims and policy data for developing investigation action plans
• Charlee provides claims and risk portfolio including operational metrics, reserving patterns and high-risk trends correlating to NLP based tagged topics

Industry challenge

Claim departments are challenged with managing large claim loads per claim professional, along with inflate medical, administrative, and legal costs associated to claim handling.

The solution

Through AI and Machine Learning tools an insurance carriers claim department will improve their processes and have access to in-depth analysis for proactive risk mitigation. Our Clara Claims solution now consists of:

CLARA Triage
CLARA Treatment
CLARA Litigation

Industry challenge

Manually reviewing medical records at scale is a huge drain on resources. The U.S. industry spends $3.5B on labor reviewing medical records per year.

The solution

DigitalOwl’s Digital Underwriting Abstract (DUA) automatically analyzes medical documents, including unstructured data and imaged records, creating a completely digital, interactive document.

Business benefits

• Faster review time with our abstract returned in hours versus days
• Improved productivity and scalability by speeding up tasks, freeing up resources, and empowering your underwriters
• Save money by reducing expensive hours manually reviewing medical records
• Focus on the elements pertaining to the case versus sifting through hundreds – or possibly thousands – of pages
• Make decisions more efficiently, effectively, and with greater confidence

Industry challenge

When it comes to customer communications management, building and managing document templates can be challenging, technical and expensive. Document templates are often built and maintained on syntax-based (mail merge) platforms by technical staff and the dependency on the IT team often results in slow turn-around times. Templates are not always managed and organized centrally which makes it difficult for an organization to have a clear view of their environment and follow a compliant document strategy.

The solution

DocFusion® enables you to turn regularly used documents and forms into intelligent templates for customer communications management
DocFusion’s drag-and-drop template designer makes template authoring easy and maintainable with drag-and-drop mapping, visual rule-building dialogues, offline template preview capabilities with test data, native connectors to multiple data sources, digital signature support and much more.
DocFusion also features an enterprise-grade central template repository with role-based access, version control and full auditing capability. Documents can be generated on-demand or in batch with the option to connect to our high availability and highly scalable cloud environment.

Business benefits

• Document composition, automation and governance
• Hyper personalized claims and policy correspondence
• Compliance and risk management
• Preservation of corporate identity
• Template libraries for re-usable content
• Pre-build connectors (data push or retrieve strategy)
• On-premise, cloud or hybrid

Industry challenge

Insurance companies try to sell the same product, at the same price, to customers who have unique needs, risk characteristics and price sensitivities. This commodity based selling, may cause the loss of customers who are willing to pay more for increased comprehensive coverage, as well as customers who cannot afford the product and are willing to give up some coverage to pay less.

The solution

The joint Earnix and Sapiens solutions uses Earnix for the quoting process on Sapiens’ system. It provides an end-to-end pricing and product personalization software suite, driven by world-class data science, analytical modeling tools, and integrated machine learning. The Earnix suite replaces fixed pricing tables with dynamic pricing API. With the dynamic pricing and product personalization solution, insurers ensure they are offering the right product, at the right price to the right person.

Business benefits

• Rapid personalization of both claims and policy correspondence reduce cycle times by utilizing previously generated templates
• Easy access to a central repository of templates, plus automated data and content prefill document templates, save agents time
• Built-in document preview capability during authoring facilitates a quick turn-around from edit to production

Industry challenge

Insurers struggled with justifying the financial and human capital that goes into processing payments. The demand in managing multiple portals, banking relationships, payment modalities and reconciliation.

The solution

Allow both workers’ compensation and property & casualty insurers to reconcile payments across multiple modalities with minimal IT requirements. All financial data will be streamlined into a single access point. Empower insurers to achieve immediate total electronic adoption, ensuring payment efficiency.

Industry challenge

As the insurance industry continues shifting online and carriers adopt instant decisioning, there is a lack of real-time data available to help carriers make instant decisions with confidence and accuracy. There is a need for more data, in real-time, that helps carriers understand the intent of their digital users so they can drive desired outcomes

The solution

ForMotiv’s behavioral data science platform runs real-time machine learning models on tens of thousands of digital behavioral data points captured during the digital application process to instantly and accurately predict the intent of the end-user. ForMotiv identifies high-risk users, potential cases of fraud / non-disclosure, window shoppers, high intent buyers, frustrated/confused users and more during the application process, meaning carriers can take action during the user journey to drive a desired outcome. ForMotiv has a suite of products including Data, Analytics/Reporting, Behavioral Signaling, and Real-Time Models

Business benefits

• Identify bottlenecks, dropoff points, high abandonment questions/fields and more to improve the user journey
• Reduce risk exposure without decreasing conversions
• Create smarter Accelerated Underwriting & reduce 3rd party data costs – instantly determine who should be accelerated and who should be further qualified via medical review/fluid test
• After a simple integration, behavioral data can be leveraged across the enterprise and incorporated into existing predictive models

Industry challenge

Because speed and convenience have altogether redefined what it means to serve consumers, it is time to start building the relationships your customers demand and deserve. However, you cannot simply accept all policy requests or pay out each and every claim. At least not right away. You have to do your research and you have to do it instantaneously. What would your processes look like if you could instantly trust your customers?

The solution

Knowing when to trust keeps you in control of your processes – automating as much as possible, while engaging staff in case a further assessment is required. In claims processes, FRISS’s Trust Automation Platform automatically notifies your adjusters which claims to trust and which ones require a deeper expert review to scout for fraud. This improves the experience for the sincere customer, while at the same time fraud risks are identified. This all happens in real-time within IDITSuite using a combination of real-time internal and external data, powerful AI models, network analytics, expert knowledge, text mining, and more.

Business benefits

• Direct bottom line savings
• Real-time claims segmentation enables a frictionless customer experience
• Actionable claim insights
• Instant value, reducing the total cost of ownership

Industry challenge

Glia allows companies to forge and maintain deeper relationships with their customers by providing real-time online “face-to-face” access to account managers, advisors, and agents. With 2-way video communication, your customers can put a face to a name – building greater customer satisfaction and loyalty in the process.

The solution

Glia enables companies to acquire more leads and increase online conversions. Companies are able to identify high-value website visitors, react to inbound communication requests, or proactively reach out via live chat, video, or audio. With our powerful Observation and Co-Browsing features, companies can arm their agents with visual context and offer personalized browsing to better aid customers. Intelligently Target Customers – Leverage business logic to reach out to customers who are ready to buy using Overseer, Glia’s proprietary business logic engine. Glia enables companies to better support their customers by injecting more context into the conversation. Through live observation and CoBrowsing, agents are able to see the issues customers are dealing with in real-time – allowing them to provide more personalized service and efficient resolution.

Business benefits

• Provide Superior Support with Digital Customer Service
• Increase Sales with Digital Customer Service
• Leverage co-browse to resolve issues faster

Industry challenge

Many insurance carriers prioritize speed to market to meet changing customer needs but struggle to develop, file, and implement new products and product changes. While Customer Communications Management (CCM) platforms can help manage communications for these products, few have capabilities to specifically manage the documents required during the product development process.

The solution

With GhostDraft, insurers can automate the forms and document lifecycle, from inception to delivery, in one powerful and easy-to-use suite designed for insurance. Now, you get everything you need to get new or updated products to market quickly and streamline all your communication needs in a centralized CCM system that offers research, design, filing, specification, development, review, test, deployment, and implementation tools for the whole organization.
GhostDraft offers a modern, cloud-native suite that is seamlessly integrated with Sapiens to simplify managing communications.

Business benefits

• Drive digital transformation and end-to-end process automation
• Accelerate speed to market
• Deliver superior customer experiences with modern forms
• Get an insurance-designed solution with ISO prebuilt libraries
• Reduce costs with a cloud-native SaaS-priced solution

Industry challenge

Insurers relying on traditional approaches for underwriting and claims management lack full visibility into risk, which limits their ability to win more business while maintaining their loss ratios.
On the underwriting side, they are challenged with pricing accurately to reflect the risk, limiting their ability to price competitively, quote business quickly, and expand into new markets profitably.
In claims management, insurers lack visibility into claims risks, leading to potentially long-duration claims which can become catastrophic and costly.

With a more complete, in-depth picture of risk, underwriters can make pricing decisions more accurately and more competitively, enabling them to win more business, grow with new clients, and enter new markets profitably. Claims managers gain an “early warning” of the most expensive claims, to focus proactively where needed while reducing the cost of claims. By using Gradient AI’s solutions, insurers of all types achieve a better return on risk.

The solution

Gradient AI is the leading provider of proven artificial intelligence (AI) solutions for the insurance industry. Its solutions improve loss ratios and profitability by predicting underwriting and claims risks with greater accuracy, as well as reducing quote turnaround times and claims expenses through intelligent automation. Unlike other solutions that use a limited claims and underwriting dataset, Gradient’s software-as-a-service (SaaS) platform leverages a vast dataset comprised of tens of millions of policies and claims. It also incorporates numerous other features including economic, health, geographic, and demographic information, as well as modeling expertise and deep insurance industry experience. Customers include some of the most recognized insurance carriers, MGAs, MGUs, TPAs, risk pools, PEOs, and large self-insureds across all major lines of insurance.

Business benefits

• Augmented intelligence to make your organization and people even more effective
• Cutting edge artificial intelligence and machine learning solutions
• Designed specifically for the insurance industry and risk management professionals
• Predictive and prescriptive analytics
• Enable automation and provide decision support

Industry challenge

Car insurance companies are facing high competition and low margins. To reduce claim losses, insurers must promote safe driving. They also need a better way to price risk, to retain safe drivers and charge higher premiums for ‘risky’ drivers. Usage based insurance is one possible strategy to reduce costs. However, being able to accurately predict the level of risk per driver, provides an additional layer of information for the insurer to set premiums better.

The solution

The joint Sapiens and GreenRoad solution enables automotive insurance carriers to secure a new level of risk assessment data about their drivers on a dynamic basis, making it possible for them to provide more competitive, personalized driver insurance premiums, customer-centric services and proactive risk-prevention programs.

Business benefits

• Rapid personalization of both claims and policy correspondence reduce cycle times by utilizing previously generated templates
• Easy access to a central repository of templates, plus automated data and content prefill document templates, save agents time
• Built-in document preview capability during authoring facilitates a quick turn-around from edit to production

Industry challenge

Insurance is complicated. This complexity results in policyholder and claim rep frustrations, higher costs and risks for all parties.

The solution

Hi Marley helps carriers achieve success across the most important dimensions in insurance, streamlining complexity and easing customer and employee churn.

Business benefits

• An Elevated Policyholder Experience – Policyholders are delighted to communicate in the ways that work best for them. The continual stream of timely communication manages
  expectations and builds trust and loyalty to improve customer satisfaction and retention.
• A Better Employee Experience – Claims adjusters’ jobs become easier, allowing them to focus on the most important tasks, while building better policyholder relationships. Hi
  Marley’s Coaching capabilities reward and encourage positive behavior and best practices, improving job satisfaction.
• Improved Financial Results – Streamlined communication and enhanced collaboration allow carriers to see financial savings with reduced cycle times, improved productivity and
  increased customer retention. Results are measurable with analytics and expert reporting features.

Industry challenge

Insurance customers largely aren’t engaged with their providers. Meanwhile, increasing competition threatens retention. Insurers need to communicate with customers in a way that won’t be ignored but is also scalable and easy to implement.

The solution

Idomoo’s Personalized Video platform lets you build and launch campaigns fast, whether you need 500 videos or 5 million. With real-time rendering, interactivity and cinematic quality, it’s the superior CX your customers deserve. Personalized Video combines the impact of video with the relevance of personalization to create an effective communications medium. It’s proven to increase sales by as much as 8x and cut churn by 37%, all while adding a human touch to the insurer-customer relationship. From acquisition to onboarding to loyalty and more, launch campaigns and get results fast. Modern consumers expect personalized experiences. Why should video be any different?

Business benefits

• Increase retention by reaching out personally and visually at key moments in the customer journey, such as
  before a policy renewal

• Reduce call center volume with videos that answer questions clearly and personally before your customer picks
  up the phone

• Put your data to work with personalized offers that drive ROI, and add interactivity to your video to further
  boost conversions

• Increase customer satisfaction from the start with personalized onboarding videos that increase brand loyalty
  long-term

• Idomoo’s open platform, which easily scales to millions of videos, saves you time with built-in automation
  tools and customizable templates.

Industry challenge

Insurers struggle to access multiple payment providers and technologies to cover their complex needs. Their legacy IT systems make these integrations a long, expensive, and resource-draining process. On top of that, insurers lack the payment know-how and specialist resources needed to optimise their payments system in-house.

The solution

Through one single connection to us, Imburse connects any organisation, regardless of its existing IT infrastructure, to the entire global payments ecosystem. We do all the heavy lifting of connecting to payment providers and technologies around the globe, making it easy, fast and inexpensive to deploy new technologies, for both collections and pay-outs.

Business benefits

• Improve speed-to-market
• Maximise payment options
• Improve customer experience
• Reduce costs
• Access unified reporting and payment analytics
• Traditional integrations are complex, expensive and time consuming. The Imburse solution looks to remove this obstacle of by offering enterprises a single, convenient entry point to the entire global ecosystems of payments.

Industry challenge

The Insurance industry continues to suffer from connectivity gaps. Brokers are submitting quotes to carriers through email. Carriers have invested millions in digital transformation, but still require point to point integrations for leveraging the latest Distribution network and Insurtech capabilities. Insurtech’s market is limited to carriers willing to build connections to them. These inefficiencies lead to manual processes, technological debt, slower speed to market and missed revenue growth opportunities.

The solution

Intellagents Ecosystem Connectors is a tech agnostic platform enabling seamless, secure connections between the variety of technologies used by participants in the insurance value chain. With access to an open, collaborative ecosystem, Insurers now have the flexibility to adapt and compete in rapidly changing risk landscapes.
CARRIERS: Your digitization process may be complete internally, but easily and rapidly creating connections with the larger market lags
INSURTECH: Without a way to connect across all players in the ecosystem, your advanced capabilities do not achieve their full potential
BROKERTECH: Submissions and client engagement platforms are ready for digital business, but are unable to achieve their full reach without frictionless connections

Business benefits

• Choose from our library of best in class Insurtechs or use your own
• In seconds, add custom rules for when each service should be utilized for more control over your costs
• Sequence the Insurtech services in a way that best fits your needs
• Deploy the newly created API with a single click
• Start Innovating

Industry challenge

Insurance organizations face many payment processing challenges from improving reconciliation efficiencies, reducing policyholder churn and keeping costs low. Add to that the burden of compliance liability, the pressure of ever-changing customer expectations and the need to reduce policyholder churn. The challenges may well seem insurmountable.

The solution

The joint Sapiens and Invoice Cloud solution delivers a streamlined omni-channel payment experience that improves operational efficiencies by simplifying the payment process and increasing self-service adoption. Invoice Cloud’s tight, real-time integration with Sapiens’ industry leading software solutions accelerates reconciliations, while providing a seamless payment process for policyholders. Invoice Cloud provides a simple, secure online billing and payment solution for insurers.

Business benefits

• Rapid personalization of both claims and policy correspondence reduce cycle times by utilizing previously generated templates
• Easy access to a central repository of templates, plus automated data and content prefill document templates, save agents time
• Built-in document preview capability during authoring facilitates a quick turn-around from edit to production

Industry challenge

Reinsurers face the challenge of identifying and financially quantifying cyber risk for a single business and accumulated exposures across their portfolios. Reinsurers lack access to the tools for calculating potential affirmative cyber exposures within cyber policies and silent cyber exposures within other P&C policies, leaving them exposed to unexpected cyber losses.

The solution

The joint Sapiens and Kovrr solution delivers transparent, real-time data- driven insights into affirmative and non-affirmative single, accumulated and catastrophic cyber risk exposures. The Kovrr platform is designed to help underwriters, exposure managers and catastrophe modelers better understand, quantify and manage cyber risk by utilizing AI-powered predictive risk models. Kovrr uses customer data from Sapiens and other sources and the underwriting insights can be integrated to the overall underwriting, according to the insurance product.

Industry challenge

The insurance industry is chock-full of routine and time-consuming tasks like manual data gathering and entry. At a time when the ability to handle data quickly and accurately is a matter of survival, many insurers still struggle to execute repetitive business processes at high volumes.How do we cut SLA from days to minutes? How do we enhance process accuracy by making sure there are no errors? How do we create a system that can work 24/7 for us?

The solution

The partnership between Kryon and Sapiens allows insurers to easily discover and map all processes with an AI based tool. It can identify which ones can be executed automatically by the Sapiens solution and which can be automated simply by taking the workflows generated by the discovery tool into a developing environment for fine-tuning (instead of having to create them from scratch). Bots will run these processes 24/7 to reduce CSR work, avoid human error, and increase productivity.

Business benefits

• Avoid costly errors while complying to regulations
• Streamline claims registration and processing
• Improve customer service

Industry challenge

The risk and the exposure to new forms of fraud is increasing. The innovation and digitalisation disrupting the insurance industry creates new opportunities for carriers but also for fraudsters. Insurance fraud undermines the capital needed to pay genuine claims and is an additional tax on every policyholder.

The solution

Fighting fraud is Kube Partners’ primary mission. We work for the greater good, and with our anti-fraud platform Detector, we will reinforce this fight at a global level.

Developed with the contribution of experienced claims handlers, Detector is an advanced cloud-based software platform to provide end-to-end fraud detection and to empower experts to make the right decisions. Our customers have enjoyed a 400% improvement in the number of cases successfully investigated and a 300% improvement in fraud detection efficiency. With our fast implementation path, insurers can go live in as little as 4 to 6 weeks and the initial investment is fully repaid in just a few months with a 10X return on investment.

Business benefits

• Accurate scoring, minimise false positives
• Acceleration of the settlement process for genuine claims
• Full automation: Detector claim scoring and investigation workflow ensures cost and productivity monitoring
• Easy-to-use SaaS platform: intuitive, self-explanatory and simple-to-use and integrates with company’s system, Detector provides real-time proof of fraud
• Multiple lines of business supported (motor, property, health, travel, general liability, personal accident, pets)

Industry challenge

Consumers expect instant experiences anywhere and everywhere but especially on their mobile phones. Sales processes that involve paper forms slow down sales and renewals cycles causing potential customers to drop out and turn to more digital-savvy competitors. Slow claim cycle-times also inflate claims costs, cause customer frustration and churn. You need to deliver the instant digital experiences consumers expect or risk losing business to the competition

The solution

The joint Sapiens and Lightico solution enables insurers to complete entire customer-facing processes in real time by streamlining, digitizing and automating interactions. With Lightico, businesses can instantly collect customer documents, eSignatures, eForms, payments and consent to disclosures, plus confirm policy terms and verify ID, even on their mobile phones

Business benefits

• Decrease the time and costs associated with the claims process
• Increase the speed of payment on overdue accounts
• Decrease inbound call volumes
• Improve the overall customer experience
• Offer choice and Opt-In and preference management
• Be up and running and see significant results within 90 days

Industry challenge

Millions of documents, in a myriad of formats, and to be retained for decades. The challenging reality for insurance companies anywhere.
Paper documents, PDFs, Emails, Word™ documents, Excel™ sheets, photos, videos, sound recordings, portal uploads, text messages, chat dialogs, and XML files – you name it.
You don’t want to mess up your core systems, but you still need the info. And you need to keep it safe and secure.

The solution

Next® Enterprise archive, lets you access all the relevant documents directly from the account, the policy, and the claim record in IDIT, other SAPIENS solutions, and your customer portal.
Next® automatically captures all your documents. Performs OCR. Classifies and index documents. Creates futureproof versions in PDF/A. And manages permissions. For decades.
Next® is a unified enterprise archive for all your documents. On premise or on the cloud.

Business benefits

• Improved customer service
• Reduced operational costs
• Faster response to customer needs
• Faster implementation of new and updated systems
• Easier retirement of old systems
• Easier compliance with GDPR and other regulations

Industry challenge

Used by claims and case managers, healthcare providers, employers, insurance carriers, third-party administrators, managed care organizations, and attorneys, and adopted by more state regulators for state workers’ compensation systems than any other guideline. ODG by MCG’s goal is to help provide you with the right care, return-to-work plans, and job modifications, with the right resources to the right patient at the right time – with minimal waste and streamlined automation where recovery and guidelines align.

The solution

ODG provides unbiased, evidence-based guidelines and technology solutions that support payers, providers, and employers in their efforts to effectively return people to health in workers’ compensation. The clinical guidelines and analytical tools within ODG help improve and benchmark return-to-work performance, set reserves, facilitate quality care (including auto-authorization by CPT-ICD), and assess the level of claim risk for interventional triage.

Business benefits

ODG for Workers’ Compensation solutions include:
• TAO Index (Treatment Analyzer on Outcomes): measures the correlation of each medical intervention with timely return-to-work
• Treatment Guidelines: ODG evidence-based treatment guidelines are designed for clinical practice as well as utilization review and medical management
• Return-to-Work Guidelines: ODG evidence-based return-to-work guidelines and predictive modeling are designed to impact as well as forecast time away from work for prospective
  case/claims management and retrospective benchmarking

Industry challenge

Most insurers today have a highly manual claims process which leads to substantial process costs, lengthy response times and disgruntled customers.
Customer expectations regarding communication are moving in a direction that requires digitization inside of the insurance companies.

The solution

The joint Sapiens and omni:us solution allows insurers either to automate the claims handling process or to suggest “Next Best Actions” to the claim’s processor.
Cognitive and deep data extraction of all incoming documents (structured, unstructured, continuous text, handwriting, etc.) is interpreted and translated into fully contextualized claims scenarios which prepares the ground for an AI-based decision framework for automation and decision support. Our solution minimizes the manual data processing and forms a basis for straight-through processing at scale.

Business benefits

• Process complexity reduction
• Claims decision support for claims adjuster
• Real-time claims status & updates
• Personalized claims experience
• Fast & transparent settlement

Industry challenge

To provide carriers a digital payment network allowing their consumers a fast, frictionless, and secure payment experience.

The solution

With One Inc’s proven PremiumPay® and ClaimsPay® digital payment networks, we provide insurers with the comprehensive insurance payments experience that customers require – fast, flexible, and future-focused.

Business benefits

• Customer Experience-Connect and engage policyholders through an exceptional, expedient, and seamless payment experience
• Digital Engagement-Proactively engage policyholders throughout the premium and claim payments experience.
• Reporting and reconciliation-Reconcile accounts, instantly find discrepancies, analyze and report payment activity.
• Security & Compliance-Remove sensitive payment data from your network and simplify your compliance burden

Industry challenge

Opterrix is a powerful risk intelligence platform that enables insurance carriers to proactively identify, quantify and mitigate avoidable losses. Designed by insurers for insurers, Opterrix leverages the latest advancements in meteorology, data science, AI, and cloud computing to help insurers make better decisions faster and implement proactive strategies throughout the insurance value chain. Insights are available via our single sign-on web application and API access.

The solution

Underwriting: Opterrix is a single source of knowledge that helps carriers measure and manage property-level accumulation and aggregate limits, real-time moratorium declaration and monitoring, and post-event claims management.
Claims: Opterrix monitors complex portfolios in real-time, provides advanced notifications of upcoming weather events, generates claims predictions before FNOL, and offers unparalleled street-level analysis for optimized claims workflows.
Customer Engagement: Opterrix enables insurance carriers to deliver real-time notifications that protect, inform, and interact with policyholders when and where risk mitigation is top-of-mind.

Business benefits

• Prevent binding of high-risk policies and reshape costly accumulations in real-time
• Create a holistic view of loss activity
• Reduce claims cycle times and loss adjustment expenses
• Improve combined and operating ratios
• Increase customer satisfaction and retention

Industry challenge

Need to quickly and easily create communication templates from a single design interface (ability for drag and drop design composition approach). Along with having a central version-controlled and compliant library of content.

The solution

Quadient provide a portfolio of technology that enables organizations to create better experiences for their customers through timely, optimized, contextual, highly individualized, and accurate communications for all channels. Extend your communications by using Inspire Flex’s secure delivery channels. Power interactive and compliant experiences at scale for web, mobile and digital. Inspire will allow insurers to easily design, modify, manage, and deliver claim and policy documents without the need for technical expertise. This will drive efficiency, reduce errors and enhance communication across all channels.

Business benefits

Rapid personalization of both claims and policy correspondence reduce cycle times by utilizing previously generated templates
Easy access to a central repository of templates, plus automated data and content prefill document templates, save agents time

Built-in document preview capability during authoring facilitates a quick turn-around from edit to production
Easily integrate multiple data sources to generate personalized digital and printed communications on demand or in high-volume batches.

Industry challenge

The existing market solutions suffer from manual inspection processes, long review times, and additional blocks to productivity. These problems cause delays while frustrating claims processors, repair shops, and customers who rely on their cars.

The solution

From Underwriting, through FNOL, to settlements, Ravin AI greatly reduces friction. Our AI-powered assessment of damage combined with Ravin’s seamless video capture experience, produces greater insight, ensures that standards are met from the start, and helps repair shops source the required parts. Saving effort, speeding up claims, and getting people back on the road.

Business benefits

• Cut down claim cycle time to minutes. A customer is guided by the Ravin Inspect app to capture damages with a
  mobile app.
• Empower and create transparency between insurer, customer, and repair shop.
• Advanced AI ensures high quality, multi-angle capture and limits fraud.
• Repairers receive full visibility and participate in the quote using Ravin’s remote intelligent dashboard.

Industry challenge

Automation has created efficiencies to medical bill processing that have had an opposing effect to the management of high dollar medical bills. Faster turn-around time, siloed adjudication tools, and minimal human touch have left a status quo where the market has accepted that casualty medical payments will have a high degree of overpayment.

The solution

S1 Medical’s bill review program & complex bill strategies brings the necessary balance of available tools, clinical competency, and communication to produce clinically reviewed, accurately coded, and competitively fair medical payment allowances.

Business benefits

• Every medical bill submitted to Complex Bill Strategies begins with an exhaustive review of every line of supporting medical notes
• Rather than a predetermined “pend queue” hierarchy, S1 takes all options into consideration and chooses the most effective strategy, bill by bill
• Real-time claims status & updates
• Our solution involves people, who are available and ready to speak in detail with complete familiarity on every bill
• This intense effort found in S1’s Complex Bill Strategies generates medical bill savings that far exceed the market-standard bill adjudication reductions

Industry challenge

Several industry reports estimate fraud to be around 10% of the entire insurance gross written premium for P&C. This represents total losses of more than $40 billion for P&C insurers in the US and more than $55 billion for P&C insurers in Europe. In addition, fraudsters are becoming more innovative, deploying complex fraud patterns. SIU teams find that rules-based solutions are less reliable and more labour-intensive when faced with novel fraud techniques.

The solution

Shift Claims Fraud Detection is an AI-native solution that lets investigators discover more fraud, faster, and throughout the entirety of the claims process. Our solution leverages the collective knowledge of over 200 data scientists and over 100 external data sources – including trusted fraud detection resources such as Lexis-Nexis and the NICB. G71By combining insurance-specific intelligence and data, Shift Technology creates a solution that lets investigators find and mitigate more fraud while encountering fewer false positives. This improves the customer experience and creates cost savings that P&C insurers can pass on to their policyholders.

Business benefits

• Powerful AI solution grows hit rate by 3x
• Reduce false positives to drive more efficient workflows
• Identify both simple and sophisticated fraud techniques
• Clear context for 60% faster resolutionShift Technology is enabling P&C insurers to see more, do more, and be more for their policyholders. Decisions shape the insurance industry. P&C insurers must make the correct decision, quickly, in every policyholder interaction, from underwriting to claims and beyond. Shift’s AI solutions effectively automate and optimize insurance decisions, liberating insurers to innovate and find new ways to be there for their customers.
• More accurate decisions about fraud and misrepresentation at the point of underwriting and policy
  activation to reduce leakage
• AI-native claims fraud detection that effectively identifies individual and network fraud schemes and
  provides contextual guidance for investigators
• More efficient and accurate decisions at the point of claims first notice of loss (FNOL), including AI
  document intake and analysis, and verification of claims details
• More efficient use of human expertise thanks to insurance-trained AI that can handle many routines and
  complex tasks
• Support for compliance efforts including Know Your Customer (KYC) and Anti-Money Laundering (AML)
  initiatives

Industry challenge

In today’s competitive environment, carriers, state funds, MGA’s, MGU’s, premium finance companies+ need to be able to offer Pay -As- You- Go solutions on lines of insurance with variable exposures such as payroll, sales, insurance values, etc. Building these capabilities and developing systems to gather the variable data necessary to calculate and collect premiums, is a daunting and time- consuming task that most carriers+ are not prepared to do on their own.

Business benefits

• Easy implementation within Sapiens’ platform based on a flexible, carefully developed approach to a PayGo solution that fits your processes and your needs
• Reductions in billing and collection expenses
• Various options of direct data collection of multiple exposures such as payrolls, sales, insured values, etc.
• Maximum transparency on exposure data during the policy period, helping to reduce audit and bad debt expenses, saving you time and money

Industry challenge

Digital disruption in today’s Insurance Industry has forced many companies to rethink traditional business models and processes. Due to the rise of mobile smartphones, tablets, apps, cloud computing capabilities, and privacy and security concerns, consumer expectations have shifted towards a need for communication, payment and information immediacy and safety. It is now time for insurers to evolve and harness this digital shift in order to attract and retain new and old customers.

The solution

Sapiens and SPLICE Software partner to provide streamlined billing, claims, marketing and customer experience communication solutions to insurers, that are automated through Sapiens property & casualty, and life, pension & annuities platforms. This partnership enriches the customer experience and gives insurers more direct control of their customer relationships, drives engagement, increases loyalty and operational savings.

Business benefits

• Decrease the time and costs associated with the claims process
• Increase the speed of payment on overdue accounts
• Decrease inbound call volumes
• Improve the overall customer experience
• Offer choice and Opt-In and preference management
• Be up and running and see significant results within 90 days

Industry challenge

In today’s accelerated and dynamic healthcare marketplace, there is a crucial need for Medical Professional Liability carriers and Workers’ Compensation underwriters to have access to accurate provider data to mitigate risk in real-time. The current issue of maintaining provider databases through data sharing, outreach, and self-reporting is never accurate. The process is costly, inefficient and is a manual effort for every insurer.

The solution

TruthMD understands how accurate provider data transforms into effective, desirable provider networks and has been delivering industry-leading, trusted provider data solutions to Medical Professional Liability (MPL) and Workers’ Compensation insurers. TruthMD’s propriety algorithms combine artificial intelligence and machine learning to continuously monitor every MD, DO, NP and PA in the United States. MPL and Workers’ Compensation insurers are able to access TruthMD’s data in near real time this includes all Federal and State provider data allowing each insurer to manage risk, accelerate decision making, optimize the underwriting process and convert providers to policyholders. Insurers may research core demographic and practice affiliation information as well as monitor provider exclusions and sanctions.

Business benefits

• The most accurate provider data, obtained directly from primary sources, in near real-time from thousands of data sources
• Auto populate new and validate renewal MPL and Underwriting applications
• Proactively monitor locations, affiliations, licensure, disciplinary actions, investigations, sanctions, and other legal activities of each insured
• Complete sanctions database to identify and determine renewal actions

Industry challenge

Need for a faster, efficient, and modern connected way to provide payments to claimants.

The solution

Provide insurers a complete digital payment platform that will streamline operational costs, improve customer interactions, and meet the demand for fast, safe and reliable B2B and B2C claims payment processing.

Business benefits

• Rapid personalization of both claims and policy correspondence reduce cycle times by utilizing previously generated templates
• Easy access to a central repository of templates, plus automated data and content prefill document templates, save agents time
• Built-in document preview capability during authoring facilitates a quick turn-around from edit to production

Industry challenge

Pricing sophistication and agility is increasingly key to success in personal and commercial lines insurance. Insurers often need the ability to deploy rates and algorithms in real time, to test their performance against strategic objectives and to deploy at scale, all within a tightly governed process. They also need to exploit the benefits of machine learning models in the pricing process, from rate calculations, to demand and retention models, and be 100% sure that deployed rates are exactly what they had planned.

The solution

Radar enables prices, rules, adjustments, scores and other metrics to be developed and deployed 100% accurately, directly to a rating system and calculated in real time. In markets where regulation permits, this can include policy or risk-level optimisation.

Business benefits

• Pricing sophistication, permitting both simple and highly complex pricing methodologies
• Rapid reaction to market developments
• System scalability that can cope with hundreds of millions of quotes per year
• Protection of robust audit and governance controls
• Direct and error-free rate deployment