In many ways, life insurance has not changed much over decades except for the utilization of blood tests during the underwriting process and recent patterns in underwriting fraud. Things that have changed are the increased competition among life insurance companies and the impact of lower yields from investments. Both factors demand more accurate and aggressive underwriting decisions and better integration between claims payouts and the links to the underwriting decisions for the respective policies.
Fraud, subrogation and complex claims all contribute to the escalating costs of insurance, and the Claims Management solutions can help to curb those costs as shown in the following example.
STATISTICA provides the unique combination of traditional approaches for predictive modeling (e.g., linear modeling) and the latest developments in advanced analytics and data mining to deliver more accurate underwriting models. Utilizing customer and claims data, the models determine the most important factors responsible for historical claims. Importantly, the STATISTICA solution enables the analysis of losses based on their original underwriting decisions.
StatSoft’s approach to engaging with a Life Insurance Company is very collaborative and results-oriented. StatSoft’s predictive modeling, analytics, and reporting solutions are designed to enable your company’s personnel; the StatSoft team works with your company’s key stakeholders to understand current personnel, processes, and systems. The STATISTICA solution is configured to fit and augment your company’s current capabilities. The collaboration begins with an assessment and agreement on business goals and the way that the results from the use of the STATISTICA solution will be measured. From that starting point, StatSoft and your company agrees on the prioritization and an approach to incremental investment that matches the expected and achieved payoffs.
- Predictive Modeling. The STATISTICA solution includes both traditional analytics capabilities (e.g., linear models) as well as the latest data mining and predictive modeling approaches for improved flexibility and accuracy.
- Real-time Predictions and Integration with Claims Management Systems. The STATISTICA Solution is optimized for performing real-time predictions for supporting instant underwriting decisions or evaluating claims.
Reporting. Aggregated summary reports and configurable dashboards provide valuable information both to management and for tracking key performance indicators related to each functional area.
- Reason Codes. In addition to predictions and recommendations, the STATISTICA solution provides information about the reasons for the decision both for the awareness of key personnel and regulatory reasons, when applicable.
- Integration with Data Sources. The STATISTICA solution simplifies access to data from your company’s customer database, policy database, claims database, and third party data sources.
Data Preparation and Management. Data in databases are rarely ready for analysis. STATISTICA includes all of the necessary recoding, transformation, and data aggregation procedures for preparing these data for analysis and scoring.
- Resources Management. The STATISTICA solution provides the capabilities for managers to provide input and direction about the available personnel resources. For example, SIU Managers can decide how many claims the department can handle so that the claims that are the highest probability for fraud are the ones that are reviewed and investigated, making better utilization of available resources and assigning the most complex claims to the more senior personnel.