insurance claims automation, robotics and artificial ... · leo corcoran, ceo, claimvantage ... as...

Copyright © 2017 - ClaimVantageCopyright © 2017 - ClaimVantage

Insurance Claims Automation, Robotics and

Artificial Intelligence

Leo Corcoran, CEO, ClaimVantageClaimVantage is the leading international provider of automated

Life, Health & Absence claim management software

Copyright © 2017 - ClaimVantage


Overview1. Introduction

2. Drivers of Change for Insurance

3. Insurance Claims Management

4. Automation

5. Robotics and Artificial Intelligence

6. Conclusion

7. Questions

Copyright © 2017 - ClaimVantageCopyright © 2017 - ClaimVantage2


ClaimVantage

• The leading international provider of automated Life, Health & Absence claim management software.

• Founded in 2006 in Ireland.

• Grown its business in the world’s leading insurance markets in North America.

• Now expanding into other markets, including Europe, Australia, Asia and Africa.

Copyright © 2017 - ClaimVantage3


ClaimVantage Clients



ClaimVantage Global Partners

Consulting Partners

Implementation Partners

Technology Partners

5


Drivers of Change for Insurance

of insurance customers would consider purchasing policies from organisations other than insurance companies. of insurance customers will switch companies based on a bad claims experience.

of policyholders said they would never use an insurer that didn’t offer digital channels.

of customers open to providing their personal usage or behavior data to companies.

Source: Accenture Claims Customer Survey 2014

67%65%50%

35%Copyright © 2017 - ClaimVantage

6


70% of Insurance CEOs see technology / customer behaviour change as disruptive to their business model

– more than any other industry.

Source: PWC Global CEO Survey 2015

Copyright © 2017 - ClaimVantage 7

Drivers of Change for Insurance


What’s Pushing This Change?

Who will be your competitor in 5 years?

Investment in InsureTech

growing rapidly

InsureTech is 5years behind

FinTech (Banking)

Less than 50% of Millennials like

current consumer engagement model

Consumers prefer smart tech to

human contact



Three companies joined together to launch…

Ping AnTencentAlibaba

...Zhong An - the first online insurance company in China

Ecommerce and mobile phone operators offering Insurance



Internet of Things

Sensors and embedded devices are enabling insurers to monitor health, deliver personalized underwriting and reward customers for good behaviour



Sales & Underwriting

CustomerService

Policy Administration

Claim Administration

• Acquire customer• Underwrite risk

• Billing• Policy Admin

• Customer• Omni Channel

• Claim Admin• Claim Experience

Role of the Claims DepartmentCopyright © 2017 - ClaimVantage 11

Copyright © 2017 - ClaimVantageCopyright © 2017 - ClaimVantageCopyright © 2017 - ClaimVantage 12

The Paper Shuffle


Claims Management is Broken

Claims Departments use Legacy Systems65%

“IT do not have time to update the system”

Paper Files, Data Silos

Double-data Entry

Manual Workarounds

Access Db & Spreadsheets

Lack of Report Capability



Paper based system with little automation - Legacy focus on policy admin and billing

1980s 1990s 2000 2005 2010 2015 2020

Workflow and imaging systems - still a lot of manual intervention and double data entry

IntegrationPortalsPush TechnologySelf ServiceFraud detectionClaim Analysis

The Future:Auto AdjudicationSocial MediaEasy configurationPredictive ModelingRoboticsArtificial intelligenceAgile

In-house systems, spreadsheets and Access Databases. Still lots of paper

Rules Engines - eligibility, work load balancing, etc. Cost of automation increasing.

The Cloud - Opportunity to reduce cost of automation

Increasing AutomationCopyright © 2017 - ClaimVantage

13

The Evolution of the Claim System


Modern Core Claims System



What does the future hold?

• Digital transformation is not an option - It is a given!

• Customers want Omni-channel service

• Advanced Business Intelligence - Analytics

• Artificial Intelligence - Chatbots



Artificial Intelligence

• Computer systems able to perform tasks normally requiring human intelligence, such as visual perception, speech recognition, decision-making, and translation between languages.

• The 1956 Dartmouth Artificial Intelligence (AI) conference gave birth to the field of AI.

• Original goal was to map the human conscience to a machine.



Robotics

• Robotics - design, construction, operation, and application of robots.

• Robot - machine capable of carrying out a complex series of actions automatically.

• Software robot - runs on a host device rather than existing as a standalone machine, e.g. virtual assistants and other chatbots.

• Chatbot - computer program which conducts a conversation.



Artificial Intelligence and Robotics in Insurance

• 25% of insurance CEOs see automation as solution to skills gaps.

• Robotics Process Automation (RPA)

• Benefits of automation, robotics and AIo Consistencyo Less errorso Audit trailo Reduced cost

• Challenges - 91% of insurance CEOs worried about integration.

Source: KPMG survey of 100 Insurance CEOs.



Some Technology Solutions

• IBM Watson - cognitive system enabling a new partnership between people and computers.

• Salesforce Einstein - learns from data to deliver predictions and recommendations.

• Modern automated insurance claims management systems.



ClaimVantage Leveraging Einstein

• Predicted claim longevity

• Predicted claim cost

• Fraud detection score / classification

• Intelligent claim assignment

• Claim activity analysis

• Claim complexity scoring

• Recommended communication to claimant / vendor

• Recommended data to call centre chatbotsCopyright © 2017 - ClaimVantage

21


ClaimFirst: Life & Health Claim Management

Increased Efficiency

Reduced Claim

Duration

Business Intelligence to make informed

decisions

Integrated Solution

Better Access to Data

Cloud-based Technology

CentralizedDatabase

2 major software releases annually

OnlinePortals

Data Analytics

& AI

Copyright © 2017 - ClaimVantage 22A Virtuous Circle


Questions?

Leo CorcoranCEO, ClaimVantage+1 207 838 [email protected]


insurance claims automation, robotics and artificial ... · leo corcoran, ceo, claimvantage ... as...

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