insurance claims automation, robotics and artificial ... · leo corcoran, ceo, claimvantage ... as...
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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
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Copyright © 2017 - ClaimVantageCopyright © 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
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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.
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ClaimVantage Global Partners
Consulting Partners
Implementation Partners
Technology Partners
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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
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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
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Drivers of Change for Insurance
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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
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Three companies joined together to launch…
Ping AnTencentAlibaba
...Zhong An - the first online insurance company in China
Ecommerce and mobile phone operators offering Insurance
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Internet of Things
Sensors and embedded devices are enabling insurers to monitor health, deliver personalized underwriting and reward customers for good behaviour
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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
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The Paper Shuffle
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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
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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
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The Evolution of the Claim System
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Modern Core Claims System
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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
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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.
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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.
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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.
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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.
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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
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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
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Questions?
Leo CorcoranCEO, ClaimVantage+1 207 838 [email protected]
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