Partners

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

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

Insurers need to find services that help them prevent damages from occurring and at the same time to become more relevant to their customers

The solution

F-Secure provides insurers with a solution to protect and advise their private and small business customers including separate Cyber app (partner branding possible) and also via SDK’s and API’s

Business benefits

• Become more relevant
  By including digital security elements protecting your customers’ and their families’ digital moments online and increasing the touchpoints to your customers
• Differentiate
  Drive sales growth by including complete digital security in your offering to protect your customers’ every digital moment, their identities and their devices
• Increase loyalty
  Enhance your customers’ experience with engaging services they’ll use not just when there’s a claim, but in their everyday lives and become more relevant to your customer
• Reduce insurance claims
  With F-Secure award-winning solutions which will prevent majority of threats from happening and clearly decreasing claims and contacts

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

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

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

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

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

When Policyholders can be tempted to switch and save, delighting and retaining customers is key. Today’s modern carriers must deliver a comprehensive billing, payments, and claims disbursements experience to increase customer satisfaction and improve operations.

The solution

With more payment methods and channels than any other provider and as the #1 best-in-class rated EBPP provider, Paymentus delivers the modern solutions insurers need and policyholders require.

Business benefits

Improved Customer Experience: Policyholders can pay exactly how they want with instant access to a robust suite of payment options and have access to faster digital claims payouts proven to increase Net Promoter Scores (NPS).
Comprehensive Real-Time Reporting: Staff can access a single, dashboard view of payment data to quickly serve customers, efficiently resolve inquiries and improve reconciliation and business operations

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

Today, policyholders expect to pay their premiums and receive their claims in ways that are fast and frictionless across multiple channels and geographies. Each market’s payment landscape is unique, and so are its participants.

The solution

Worldpay provides a unified payment solution for every payment experience across premiums and claims while opening the world to insurtechs and carriers with local payment methods. We empower insurers to settle claims quickly and easily to anyone, anywhere, and ensure they can optimize all the payments they take and make with fraud protection, chargeback management and optimization tools.

Business benefits

• Global Expertise — Our 25+ years of experience in the insurance industry helps fuel global commerce on a massive scale with 130 million transactions processed globally for over a million merchants in more than 135 currencies
• Impactful Innovation — We understand the needs of insurtechs and carriers and innovate for impact – not innovation’s sake. Our solutions help minimize fraud, ease expansion, and optimize business processes
• A Human Touch — We value our deep client relationships. We take a consultative approach to payments, spending the time to understand individual business and payment challenges before suggesting solutions

Industry challenge

Dozens of eMerge-based solutions are currently operated on IBM Z platforms. As eMerge has evolved through the years, most of the solution’s investment was exposed to external technologies adjusted that needed support of eMerge versions.

The solution

Together with eMerge IBM Z customers, Sapiens continues to enhance IBM Z platform capabilities. We are continuously improving our eMerge product to support the latest releases and functionality of IBM Z Systems customers to maintain their workload.

Business benefits

• Consistency The new back-office applications have a unified look and feel, with the reuse of web services across the various applications.
• Repository System All data from the applications are centralized in IBM Z. This can save unnecessary web services when an application needs data from a second application.
• Compliance with regulations The new application is regulations oriented.
  Digital services No more paperwork, hand files and file cabinets, no duplicate data, no business errors, everything is validated by the application.
• Accessibility The new eMerge applications on IBM Z are accessible for intern

Industry challenge

Today’s insurance industry is facing rapid change and heightened customer expectations. This is in addition to the “cost-conscious” customer, who frequently switches carriers. Now more than ever, insurance leaders are seeking transformation, innovation, and reduced expenses.

The Solution

Sapiens, in partnership with Microsoft, is an extensive technology and go-to-market strategic partnership enabling intelligent insurance and empowering more personalized and enhanced experiences.

Business benefits

• Microsoft Azure is our cloud provider for Sapiens Cloud
• Sapiens & Microsoft – integrated across Microsoft’s portfolio, including Azure, Microsoft 365, Power BI. Roadmap: Dynamics 365.
• Sapiens’ solutions are surfacing in the Azure Marketplace
• Sapiens is working closely together with MS product teams