1) The document discusses an AI solution developed by AIA to automate the health insurance claims process and improve the customer experience.
2) Previously, AIA had low straight-through processing rates for claims of 3% on average, but the new AI model automated approval of 41% of all claims and 80% of outpatient claims.
3) In AIA's pilot market of Thailand, the straight-through processing rate increased from 6% in 2019 to 41% by the end of 2020 after introducing the AI solution for claims assessment.
► Life and Health Insurance Online - NZ SEO Reach 2014FIRST
► Which New Zealand Life and Health Insurance providers are maximising their market share online?
Find out which life and health insurance providers are taking the lead in organic search and how they’re doing it.
FIRST has investigated the organic search engine rankings for NZ consumer searches focused on life and health insurances, utilising FIRST’s Ranking Based Reach (RBR) analysis framework. In addition, a consumer survey was carried out to discover what is most important for Kiwis wishing to apply for an insurance.
► In this report we discovered:
According to Standard & Poor’s the insurance market has room to grow due to population growth and the low rate of New Zealanders having a life insurance.* Therefore insurance providers should not miss out, but optimise their online visibility.
Search results are broadly dispersed among a wide range of competitors, even more in mobile. In this competitive life and health insurance market, retailers are missing out optimising on the most cost effective marketing channel: Search.
Currently Life Direct stands out in the search landscape followed by AA and Pinnacle Life capturing big proportion of the voice thanks to prominent organic presence.
In our survey we revealed that 1 out of 3 Kiwis do not have any coverage due to high costs or would not qualify for insurance as they had health issues or wouldn’t need life insurance as they didn’t have any dependents.
A considered digital strategy that integrates both organic and paid search should be a key customer acquisition and revenue driver for life and health insurance providers.
Popular search phrases are missing from quite a few sites and in most cases very little is being done with organic search.
FIRST uses its bespoke metric called RBR (Ranking Based Reach) to estimate how well each company is ranking in search engines. RBR provides a simple way to compare a website’s search engine rankings with its competitors. RBR is an estimate of the percentage of available search traffic a website will receive for a set of phrases – this gives the sites share of search or reach. It is weighted based on the popularity of each search phrase and the relative click through rate (CTR) of each ranking position.
Listen to an experienced, global panel of insurance professionals present, discuss and answer your questions on the theme of “Data & Analytics from a Life & Health perspective”.
Brought to you by The Digital Insurer and sponsored by KPMG.
2021 Best insurtech and insurance prediction listAlberto Garuccio
Insurtech issue #41 Techstars Startup Digest. If you are interested in reading the digital version or subscribing visit >> https://www.getrevue.co/profile/startupdigest-insurtech
► Life and Health Insurance Online - NZ SEO Reach 2014FIRST
► Which New Zealand Life and Health Insurance providers are maximising their market share online?
Find out which life and health insurance providers are taking the lead in organic search and how they’re doing it.
FIRST has investigated the organic search engine rankings for NZ consumer searches focused on life and health insurances, utilising FIRST’s Ranking Based Reach (RBR) analysis framework. In addition, a consumer survey was carried out to discover what is most important for Kiwis wishing to apply for an insurance.
► In this report we discovered:
According to Standard & Poor’s the insurance market has room to grow due to population growth and the low rate of New Zealanders having a life insurance.* Therefore insurance providers should not miss out, but optimise their online visibility.
Search results are broadly dispersed among a wide range of competitors, even more in mobile. In this competitive life and health insurance market, retailers are missing out optimising on the most cost effective marketing channel: Search.
Currently Life Direct stands out in the search landscape followed by AA and Pinnacle Life capturing big proportion of the voice thanks to prominent organic presence.
In our survey we revealed that 1 out of 3 Kiwis do not have any coverage due to high costs or would not qualify for insurance as they had health issues or wouldn’t need life insurance as they didn’t have any dependents.
A considered digital strategy that integrates both organic and paid search should be a key customer acquisition and revenue driver for life and health insurance providers.
Popular search phrases are missing from quite a few sites and in most cases very little is being done with organic search.
FIRST uses its bespoke metric called RBR (Ranking Based Reach) to estimate how well each company is ranking in search engines. RBR provides a simple way to compare a website’s search engine rankings with its competitors. RBR is an estimate of the percentage of available search traffic a website will receive for a set of phrases – this gives the sites share of search or reach. It is weighted based on the popularity of each search phrase and the relative click through rate (CTR) of each ranking position.
Listen to an experienced, global panel of insurance professionals present, discuss and answer your questions on the theme of “Data & Analytics from a Life & Health perspective”.
Brought to you by The Digital Insurer and sponsored by KPMG.
2021 Best insurtech and insurance prediction listAlberto Garuccio
Insurtech issue #41 Techstars Startup Digest. If you are interested in reading the digital version or subscribing visit >> https://www.getrevue.co/profile/startupdigest-insurtech
Insurance Industry Trends in 2015: #1 Big Data and AnalyticsEuro IT Group
By implementing customized big data solutions, Euro IT Group can help you unlock the tones of information already flowing through your organization, analyze it, extract value and transform it into insight that drives growth and revenue.
Transforming Insurance Risk Assessment with Big Data: Choosing the Best PathCapgemini
Insurers are realizing that big data has the potential to create competitive advantage. There is a gold mine of information residing across the large volumes of data available in multiple sources and disparate formats, if only it can be efficiently mined to support key operational decisions and improve the customer experience. Commercial risk assessment is data intensive and ripe for the incorporation of real-time external data. In this paper, we explore the ways commercial insurers can gain accurate and comprehensive risk assessments when underwriting policies by using big data.
Data has always played a central role in the insurance industry, and today, insurance carriers have access to more of it than ever before. We have created more data in the past two years than the human race has ever created. Insurers—like organisations in most industries—are overwhelmed by the explosion in data from a host of sources, including telematics, online and social media activity, voice analytics, connected sensors and wearable devices. They need machines to process this information and unearth analytical insights. But most insurers are struggling to maximise the benefits of machine learning.
Webinar: Digital Health Strategy: Leveraging Emerging Technologies in HealthcareIntellectsoft
WEBINAR VIDEO - https://www.intellectsoft.net/l/31/webinar-digital-healthcare
JOIN OUR WEBINAR TO:
- Explore what changed for healthcare practices and operations during COVID-19 and predict what leaders can expect in terms of recovery;
- Discover today’s featured examples of our clients’ technology solutions that can help you provide better and more efficient services;
- Discuss how to evolve and adapt for the rest of 2020 and into 2021 using emerging technologies and more efficient solutions.
BEST FOR:
- Сhief Medical Officers
- Doctors Pharmaceuticals
- HR Department Outstaffing
- Telemedicine Workers
- Insurance Companies
- Pharmacies
- Laboratories
- Private Hospitals
- Academical Health Centres
- Private Healthcare Facilities
- Management Information Systems
https://www.intellectsoft.net/
This presentation provides a brief insight into the need to undertake an analytics project, particularly as it pertains to claims management and fraud. To this end the presentation will touch on the general challenges confronting the property and casualty insurance industry, as well as the challenges and lessons learnt from early adopters of business intelligence. In the face of these challenges analytics holds the potential to generate substantial value as evidenced by several short case study examples. The presentation concludes with a look at the issue of fraud as it pertains to the industry and some of the metrics that are influenced by it.
The presentation draws extensively, and focuses on, the work and viewpoints from industry participants including; Accenture, IBM, Ernst & Young, Strategy Meets Action, Ordnance Survey, Gartner, Insurance Institute of America, American Institute for Chartered Property Casualty Underwriters, International Risk Management Institute and John Standish Consulting. References are included on each slide as well as on the “References” slides at the end of the presentation.
This deck contains the information on how you can use the cognitive service in the Microsoft Bot Framework. Technologies used Azure Bot Framework, Azure Cloud and Cognitive Services. You can configure this bot on multiple channels like Web, Telegram, Skype and many more.
Please find the bot URL: https://insurancebotweb.azurewebsites.net/About
The insurance industry has remained much the same for more than 100 years, but over the past decade it has seen a number of exciting new innovations and new business models.
Thousands of Employees, Millions of Devices, Billions of Things – Welcome to ...Capgemini
The Internet of Things is a network of connected devices fast becoming pervasive. These devices are bringing fundamental changes in the way business is done today; along with organization's internal processes and its digital strategy. These changes have already spurred a new wave of innovation and efficiency.
As the technology evolves, businesses should develop the ability to separate the true game changers from the hype and be prepared for a world where the number of things to be managed increases by an order of magnitude.
This presentation introduces the capabilities and imperatives that organizations need to advance.
Presented at Mobile World Congress 2015 by Simon Short.
Please find here our first Insurance Review on Digital Disruption of the Insurance sector. We've put together the best, most shared and liked articles on this topic. All articles have been published before on our Financial Services blog
As the US economic recovery gains momentum, unemployment is falling and consumer confidence is on the rise, creating a more conducive environment for carriers to market their products and services. This year’s Outlook discusses bigger picture issues likely to have a significant effect on consumer behavior and insurer operations in 2015 and beyond.
Insurance Industry Trends in 2015: #1 Big Data and AnalyticsEuro IT Group
By implementing customized big data solutions, Euro IT Group can help you unlock the tones of information already flowing through your organization, analyze it, extract value and transform it into insight that drives growth and revenue.
Transforming Insurance Risk Assessment with Big Data: Choosing the Best PathCapgemini
Insurers are realizing that big data has the potential to create competitive advantage. There is a gold mine of information residing across the large volumes of data available in multiple sources and disparate formats, if only it can be efficiently mined to support key operational decisions and improve the customer experience. Commercial risk assessment is data intensive and ripe for the incorporation of real-time external data. In this paper, we explore the ways commercial insurers can gain accurate and comprehensive risk assessments when underwriting policies by using big data.
Data has always played a central role in the insurance industry, and today, insurance carriers have access to more of it than ever before. We have created more data in the past two years than the human race has ever created. Insurers—like organisations in most industries—are overwhelmed by the explosion in data from a host of sources, including telematics, online and social media activity, voice analytics, connected sensors and wearable devices. They need machines to process this information and unearth analytical insights. But most insurers are struggling to maximise the benefits of machine learning.
Webinar: Digital Health Strategy: Leveraging Emerging Technologies in HealthcareIntellectsoft
WEBINAR VIDEO - https://www.intellectsoft.net/l/31/webinar-digital-healthcare
JOIN OUR WEBINAR TO:
- Explore what changed for healthcare practices and operations during COVID-19 and predict what leaders can expect in terms of recovery;
- Discover today’s featured examples of our clients’ technology solutions that can help you provide better and more efficient services;
- Discuss how to evolve and adapt for the rest of 2020 and into 2021 using emerging technologies and more efficient solutions.
BEST FOR:
- Сhief Medical Officers
- Doctors Pharmaceuticals
- HR Department Outstaffing
- Telemedicine Workers
- Insurance Companies
- Pharmacies
- Laboratories
- Private Hospitals
- Academical Health Centres
- Private Healthcare Facilities
- Management Information Systems
https://www.intellectsoft.net/
This presentation provides a brief insight into the need to undertake an analytics project, particularly as it pertains to claims management and fraud. To this end the presentation will touch on the general challenges confronting the property and casualty insurance industry, as well as the challenges and lessons learnt from early adopters of business intelligence. In the face of these challenges analytics holds the potential to generate substantial value as evidenced by several short case study examples. The presentation concludes with a look at the issue of fraud as it pertains to the industry and some of the metrics that are influenced by it.
The presentation draws extensively, and focuses on, the work and viewpoints from industry participants including; Accenture, IBM, Ernst & Young, Strategy Meets Action, Ordnance Survey, Gartner, Insurance Institute of America, American Institute for Chartered Property Casualty Underwriters, International Risk Management Institute and John Standish Consulting. References are included on each slide as well as on the “References” slides at the end of the presentation.
This deck contains the information on how you can use the cognitive service in the Microsoft Bot Framework. Technologies used Azure Bot Framework, Azure Cloud and Cognitive Services. You can configure this bot on multiple channels like Web, Telegram, Skype and many more.
Please find the bot URL: https://insurancebotweb.azurewebsites.net/About
The insurance industry has remained much the same for more than 100 years, but over the past decade it has seen a number of exciting new innovations and new business models.
Thousands of Employees, Millions of Devices, Billions of Things – Welcome to ...Capgemini
The Internet of Things is a network of connected devices fast becoming pervasive. These devices are bringing fundamental changes in the way business is done today; along with organization's internal processes and its digital strategy. These changes have already spurred a new wave of innovation and efficiency.
As the technology evolves, businesses should develop the ability to separate the true game changers from the hype and be prepared for a world where the number of things to be managed increases by an order of magnitude.
This presentation introduces the capabilities and imperatives that organizations need to advance.
Presented at Mobile World Congress 2015 by Simon Short.
Please find here our first Insurance Review on Digital Disruption of the Insurance sector. We've put together the best, most shared and liked articles on this topic. All articles have been published before on our Financial Services blog
As the US economic recovery gains momentum, unemployment is falling and consumer confidence is on the rise, creating a more conducive environment for carriers to market their products and services. This year’s Outlook discusses bigger picture issues likely to have a significant effect on consumer behavior and insurer operations in 2015 and beyond.
Conceptual model for digitally enabled health insurance claim settlementAnurag Johari
Health Insurance Claim Settlement is a shopping window for customer acquisition and retention both. Emerging digital technology can be leveraged to make this process more efficient without compromising the effectiveness.
Understanding Basics Of Internal Medicine Billing And Coding.pdfRichard Smith
Medical billing and coding are critical components of the healthcare industry, ensuring that healthcare providers are reimbursed for their services accurately and efficiently. For those specializing in internal medicine, understanding the basics of internal medicine billing is essential.
Understanding Basics Of Internal Medicine Billing And Coding.pptxRichard Smith
Medical billing and coding are critical components of the healthcare industry, ensuring that healthcare providers are reimbursed for their services accurately and efficiently. For those specializing in internal medicine, understanding the basics of internal medicine billing is essential.
You know medical billing is a crucial part of your private practice, but why exactly is it so vital? This presentation explains why medical billing is a matter of survival. Claims must be submitted in a timely manner in order for physicians to get paid for their services.
Looking for ways to maximize reimbursement? Interested in outsourcing your medical billing?
Visit Our Website: http://www.CaptureBilling.com/
Billing Basics for Mental Health Professionals (1 CE Credit)Procentive
Practicing psychologist Richard Sethre, Psy.D., L.P. and Marjie Brinkman, Director of BillCare, combine real world experience and industry knowledge for an informative and practical presentation outlining key billing concepts and issues. They will help you understand how claims are created by billing services, how claims are processed by insurance companies, and how you should respond when there are problems like denials or other payment issues.
Unless you stay current on billing issues and love doing it, this webinar will help you… a busy professional who provides great care but also knows that getting paid for it is pretty important.
Watch the presentation & get continuing education credits here. https://procentive.com/billing-basics/
Mental Health Billing And Credentialing Services For Solo Practitioners.pptxRichard Smith
Solo mental health practitioners play a vital role in the healthcare system, providing essential services to those in need of mental and emotional support. However, managing the administrative aspects of their practice, including mental health billing and credentialing, can be a significant challenge.
Mental Health Billing And Credentialing Services For Solo Practitioners.pdfRichard Smith
Solo mental health practitioners play a vital role in the healthcare system, providing essential services to those in need of mental and emotional support. However, managing the administrative aspects of their practice, including mental health billing and credentialing, can be a significant challenge.
A Detailed Guide To Cardiology Medical Billing.pptxRichard Smith
Cardiology is a branch of medicine that deals with the diagnosis and treatment of disorders of the heart and blood vessels. Medical billing and coding for cardiology services is a complex process that requires a thorough understanding of the billing codes, reimbursement rules, and regulations related to cardiology. The purpose of cardiology billing services is to collect patient charges and record them in the medical record.
A Detailed Guide To Cardiology Medical Billing.pdfRichard Smith
Cardiology is a branch of medicine that deals with the diagnosis and treatment of disorders of the heart and blood vessels. Medical billing and coding for cardiology services is a complex process that requires a thorough understanding of the billing codes, reimbursement rules, and regulations related to cardiology. The purpose of cardiology billing services is to collect patient charges and record them in the medical record.
A Detailed Guide To Cardiology Medical Billing.pdfRichard Smith
Cardiology is a branch of medicine that deals with the diagnosis and treatment of disorders of the heart and blood vessels. Medical billing and coding for cardiology services is a complex process that requires a thorough understanding of the billing codes, reimbursement rules, and regulations related to cardiology.
A Detailed Guide To Cardiology Medical Billing.pptxRichard Smith
Cardiology is a branch of medicine that deals with the diagnosis and treatment of disorders of the heart and blood vessels. Medical billing and coding for cardiology services is a complex process that requires a thorough understanding of the billing codes, reimbursement rules, and regulations related to cardiology.
State of ICS and IoT Cyber Threat Landscape Report 2024 previewPrayukth K V
The IoT and OT threat landscape report has been prepared by the Threat Research Team at Sectrio using data from Sectrio, cyber threat intelligence farming facilities spread across over 85 cities around the world. In addition, Sectrio also runs AI-based advanced threat and payload engagement facilities that serve as sinks to attract and engage sophisticated threat actors, and newer malware including new variants and latent threats that are at an earlier stage of development.
The latest edition of the OT/ICS and IoT security Threat Landscape Report 2024 also covers:
State of global ICS asset and network exposure
Sectoral targets and attacks as well as the cost of ransom
Global APT activity, AI usage, actor and tactic profiles, and implications
Rise in volumes of AI-powered cyberattacks
Major cyber events in 2024
Malware and malicious payload trends
Cyberattack types and targets
Vulnerability exploit attempts on CVEs
Attacks on counties – USA
Expansion of bot farms – how, where, and why
In-depth analysis of the cyber threat landscape across North America, South America, Europe, APAC, and the Middle East
Why are attacks on smart factories rising?
Cyber risk predictions
Axis of attacks – Europe
Systemic attacks in the Middle East
Download the full report from here:
https://sectrio.com/resources/ot-threat-landscape-reports/sectrio-releases-ot-ics-and-iot-security-threat-landscape-report-2024/
Dev Dives: Train smarter, not harder – active learning and UiPath LLMs for do...UiPathCommunity
💥 Speed, accuracy, and scaling – discover the superpowers of GenAI in action with UiPath Document Understanding and Communications Mining™:
See how to accelerate model training and optimize model performance with active learning
Learn about the latest enhancements to out-of-the-box document processing – with little to no training required
Get an exclusive demo of the new family of UiPath LLMs – GenAI models specialized for processing different types of documents and messages
This is a hands-on session specifically designed for automation developers and AI enthusiasts seeking to enhance their knowledge in leveraging the latest intelligent document processing capabilities offered by UiPath.
Speakers:
👨🏫 Andras Palfi, Senior Product Manager, UiPath
👩🏫 Lenka Dulovicova, Product Program Manager, UiPath
Accelerate your Kubernetes clusters with Varnish CachingThijs Feryn
A presentation about the usage and availability of Varnish on Kubernetes. This talk explores the capabilities of Varnish caching and shows how to use the Varnish Helm chart to deploy it to Kubernetes.
This presentation was delivered at K8SUG Singapore. See https://feryn.eu/presentations/accelerate-your-kubernetes-clusters-with-varnish-caching-k8sug-singapore-28-2024 for more details.
Slack (or Teams) Automation for Bonterra Impact Management (fka Social Soluti...Jeffrey Haguewood
Sidekick Solutions uses Bonterra Impact Management (fka Social Solutions Apricot) and automation solutions to integrate data for business workflows.
We believe integration and automation are essential to user experience and the promise of efficient work through technology. Automation is the critical ingredient to realizing that full vision. We develop integration products and services for Bonterra Case Management software to support the deployment of automations for a variety of use cases.
This video focuses on the notifications, alerts, and approval requests using Slack for Bonterra Impact Management. The solutions covered in this webinar can also be deployed for Microsoft Teams.
Interested in deploying notification automations for Bonterra Impact Management? Contact us at sales@sidekicksolutionsllc.com to discuss next steps.
Software Delivery At the Speed of AI: Inflectra Invests In AI-Powered QualityInflectra
In this insightful webinar, Inflectra explores how artificial intelligence (AI) is transforming software development and testing. Discover how AI-powered tools are revolutionizing every stage of the software development lifecycle (SDLC), from design and prototyping to testing, deployment, and monitoring.
Learn about:
• The Future of Testing: How AI is shifting testing towards verification, analysis, and higher-level skills, while reducing repetitive tasks.
• Test Automation: How AI-powered test case generation, optimization, and self-healing tests are making testing more efficient and effective.
• Visual Testing: Explore the emerging capabilities of AI in visual testing and how it's set to revolutionize UI verification.
• Inflectra's AI Solutions: See demonstrations of Inflectra's cutting-edge AI tools like the ChatGPT plugin and Azure Open AI platform, designed to streamline your testing process.
Whether you're a developer, tester, or QA professional, this webinar will give you valuable insights into how AI is shaping the future of software delivery.
Let's dive deeper into the world of ODC! Ricardo Alves (OutSystems) will join us to tell all about the new Data Fabric. After that, Sezen de Bruijn (OutSystems) will get into the details on how to best design a sturdy architecture within ODC.
Connector Corner: Automate dynamic content and events by pushing a buttonDianaGray10
Here is something new! In our next Connector Corner webinar, we will demonstrate how you can use a single workflow to:
Create a campaign using Mailchimp with merge tags/fields
Send an interactive Slack channel message (using buttons)
Have the message received by managers and peers along with a test email for review
But there’s more:
In a second workflow supporting the same use case, you’ll see:
Your campaign sent to target colleagues for approval
If the “Approve” button is clicked, a Jira/Zendesk ticket is created for the marketing design team
But—if the “Reject” button is pushed, colleagues will be alerted via Slack message
Join us to learn more about this new, human-in-the-loop capability, brought to you by Integration Service connectors.
And...
Speakers:
Akshay Agnihotri, Product Manager
Charlie Greenberg, Host
Builder.ai Founder Sachin Dev Duggal's Strategic Approach to Create an Innova...Ramesh Iyer
In today's fast-changing business world, Companies that adapt and embrace new ideas often need help to keep up with the competition. However, fostering a culture of innovation takes much work. It takes vision, leadership and willingness to take risks in the right proportion. Sachin Dev Duggal, co-founder of Builder.ai, has perfected the art of this balance, creating a company culture where creativity and growth are nurtured at each stage.
Essentials of Automations: Optimizing FME Workflows with ParametersSafe Software
Are you looking to streamline your workflows and boost your projects’ efficiency? Do you find yourself searching for ways to add flexibility and control over your FME workflows? If so, you’re in the right place.
Join us for an insightful dive into the world of FME parameters, a critical element in optimizing workflow efficiency. This webinar marks the beginning of our three-part “Essentials of Automation” series. This first webinar is designed to equip you with the knowledge and skills to utilize parameters effectively: enhancing the flexibility, maintainability, and user control of your FME projects.
Here’s what you’ll gain:
- Essentials of FME Parameters: Understand the pivotal role of parameters, including Reader/Writer, Transformer, User, and FME Flow categories. Discover how they are the key to unlocking automation and optimization within your workflows.
- Practical Applications in FME Form: Delve into key user parameter types including choice, connections, and file URLs. Allow users to control how a workflow runs, making your workflows more reusable. Learn to import values and deliver the best user experience for your workflows while enhancing accuracy.
- Optimization Strategies in FME Flow: Explore the creation and strategic deployment of parameters in FME Flow, including the use of deployment and geometry parameters, to maximize workflow efficiency.
- Pro Tips for Success: Gain insights on parameterizing connections and leveraging new features like Conditional Visibility for clarity and simplicity.
We’ll wrap up with a glimpse into future webinars, followed by a Q&A session to address your specific questions surrounding this topic.
Don’t miss this opportunity to elevate your FME expertise and drive your projects to new heights of efficiency.
To Graph or Not to Graph Knowledge Graph Architectures and LLMs
TDI 2021 Insurer Innovation awards submission AIA
1. AIA confidential and proprietary information. Not for distribution.
Transforming the health insurance experience
AI in action at AIA
2. AIA confidential and proprietary information. Not for distribution. 2
Customer demands and expectations are increasing…
… and global volume and scale are growing.
The world of health insurance is changing.
3. AIA confidential and proprietary information. Not for distribution. 3
…is to feel supported through injury and illness. They need help to
get back on their feet as quickly as possible so they can get on with
their lives.
They expect a seamless, convenient and stress-free experience.
But what they’re getting is long-winded, heavy-handed paperwork.
Uncertainty. Frustration. Inconvenience.
What customers want…
4. AIA confidential and proprietary information. Not for distribution. 4
You can access your banking online in a matter of seconds.
You can buy products or services from the other side of the world.
You can watch your favourite movies or programmes at the touch
of a button.
But when it comes to making an insurance claim, it’s a
different world.
Imagine you’re a customer…
5. AIA confidential and proprietary information. Not for distribution. 5
Helping them get back on their feet after illness or injury is a crucial part of this.
Whatever claim they’re making, they’re already under stress and out of pocket.
Making a claim should be a positive, stress-free experience.
Which is why we’re working with markets across Asia to automate our claims
process for outpatient healthcare and improve our straight-through processing
(STP).
At AIA, we’re helping customers live healthier,
longer, better lives.
6. AIA confidential and proprietary information. Not for distribution.
Our objective: to develop an AI solution to automate the claims assessment for OPD cashless claims. Maximizing claims auto-adjudication, but minimizing claims leakage.
Claims
Incident
Digital Claims
Submission
By Provider through
Smart Claims system
CMIC
Claims Management
Platform
Document Review
Electronic Submission
vs
Billing Documents
Claims Adjudication
AI MODEL
Accept Claim
Above Threshold
>=0.64
Below Threshold
< 0.64
Decline
Claims maybe denied by the
Smart Claims System based on
policy status, ICD codes etc.
The customer is then required to
file a cash (non-digital) claim.
Coverage Eligibility
Medical Necessity
Customer Profile
Claim No. Claim Assessment Score
34595683 0.56
23566578 0.87
34676 0.21
Majority of claims were
subject to manual
assessment. Only a small
sample was subject to QC.
Claims Assessors
Review
Our game-changing Claims Automation Model
7. AIA confidential and proprietary information. Not for distribution.
In 2019, we processed 2.457 million claims with a STP rate of just 3%.
On average, customers were waiting up to three days for a response to their claim. Some
customers were waiting much longer.
With AI and machine learning, we’ve automated 41% of all claims and 80% of outpatient
claims approvals.
It’s transformed the claims experience.
Straight-through processing for outpatient healthcare increased from 3% to 41% during 2020,
with more improvements to come.
We expect the results at scale to be significant.
Our pilot market, Thailand, has already seen
staggering results.
8. AIA confidential and proprietary information. Not for distribution. 8
Transforming the claims experience in Thailand
The AI Solution has already contributed to increase the Claims E2E STP rate from 6% in 2019YE to ~41% in Dec 2020.
6%
39% 40% 41%
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
Jan-20 Feb-20 Mar-20 Apr-20 May-20 Jun-20 Jul-20 Aug-20 Sep-20 Oct-20 Nov-20 Dec-20
Thailand Claims STP Rate
Parallel Run
Full Production
9. AIA confidential and proprietary information. Not for distribution. 9
Data attributes for our AI model
Document
Review
Claims
Adjudication
Coverage Eligibility
• Diagnosis Code (ICD Codes)
• Historical amendments
• Providers
• Doctors
• Claim amount
• Historical claims amendments
• Accident Date
• Hospitalization Date
• Policy Exclusions
General, specific, diagnosis codes etc.
• Cause of Illness
Accident vs General
• Credit Limit
Max. benefit, claim frequency, incident date, location etc.
• Document submission date etc.
• Other (IPD claims)
Impairment code, contestable period, chronic illness, waiting period
• Diagnosis (ICD10 Codes)
• Injury type
• Claims history
Accepted claims, declined claims
(by diagnosis)
• Procedure Codes (IPD only)
OPD Cashless Claims IPD Cash + Cashless Claims
Medical Necessity Customer Profile
• Age
• Customer Segment
• Suspicious Activities
Claim frequency, declined claims,
further claim etc.
• Other (IPD only)
EarlyClaims
Policy
Status
• Policy Status
Premium paying, lapsed etc.
• Claims vs Premium Payment
Claims made during grace period, after lapse etc.
Working together with theThailand ClaimsTeam, we considered more than 580 data attributes for model development
to reflect the key claims assessment criteria.
10. AIA confidential and proprietary information. Not for distribution. 10
Customers with simple claims receive a much faster decision and get their
money quicker.
They can move on with their lives.
Customers with more complex claims get the personal attention of human
assessors.
The reassurance of expertise.
Our customers are at the heart of everything we do.
11. AIA confidential and proprietary information. Not for distribution. 11
The new process frees up the time of our busy claims assessors so they can
focus their expertise where it matters.
It’s transformed from a complicated people- and paper-intensive process
to a streamlined, simplified experience.
Customers are happier. Claims assessors are less stretched.The move
from paper to digital makes the world a better place.
It’s a win-win-win.
12. AIA confidential and proprietary information. Not for distribution.
The future is now.