Partners

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

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

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

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

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