Property and Casualty Insurance Solution

In the competitive environment of P&C insurance, it is more important than ever to reduce costs, focus acquisition, retention and expansion tactics on high-value customers, and deliver the right level of service to suit a particular claim. With STATISTICA Decisioning Platform^®, predictive analytics and reporting solutions for P&C Insurance applications enable insurers to utilize data about its claims, policies, customers, and third party data sources to improve underwriting decisions, detect fraud, identify opportunities for subrogation, update reserve estimates, assign the right service level to claims, and segment customers across all product lines for: auto, worker’s compensation, home, commercial property, disability, and any other specialized product lines.

Predictive Analytics May Drive Down Claim Costs at Many Points Across the Claim Lifecycle

StatSoft has developed the Predictive Claims Flow^®, incorporating predictive modeling at each stage of the lifecycle of a claim. From first notice of loss through to closure, claim data is constantly changing.

As new information about a claim becomes available,with every new piece of information, the Predictive Claims Solution automatically scores the probability of fraud, updates the predicted reserve estimate, predicts claim complexity to determine whether the claim should be assigned to a more senior adjuster, identifies opportunities for subrogation, and determines the right level of servicing of the claim. At each stage, alerts and updates are provided with minimal human intervention to adjusters, SIU managers and claim personnel, and all other key stakeholders in the overall claims adjudication process.

Key Capabilities

Text Mining. Much of the data for the analysis of claims is unstructured text, in the adjuster’s notes, in the medical reports, emails, etc. The text mining solution combines this along with predictions from your structured data supply more accurate and precise predictions.

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 a claim as new information is made available.

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 other databases are rarely ready for analysis. STATISTICA includes all of the necessary recoding, transformation, and data aggregation procedures for preparing your 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.

Learn and Grow your Advanced Analytics Skillset with Decisioning Platform

Learn new skills and grow your team’s expertise. Shown below is a graphic that illustrates how our customers begin their journey down the road to Predictive Analytics and Data Mining. They start off by replicating and streamlining their current reporting capabilities (as illustrated by the top down flow along the right side of the graphic).The STATISTICA Enterprise Server, part of the Decisioning Platform, enables the adoption of analytic and automated decision support aids and systems throughout the enterprise. All of your users will begin their work at the same point as they extract and prepare their data, by working with the tools provided within StatSoft's Decisioning Platform to automatically source data, as depicted by the large funnel. (STATISTICA facilitates the acquisition of data with reusable, pre-configured data templates that can include filtering capabilities and access multiple databases.)

Then, based on their job roles and skill sets, users will proceed along the right or the left side of the graphic to complete their work. If their focus is on reporting, they will follow the path on the right. If they need to create a predictive model or perform some data mining activities, incorperating business rules, they will follow the path on the left.

STATISTICA Decisioning Platform – One Platform for Automated Data Preparation, Reporting, Data Mining and Predictive Modeling with Business Rules

		STATISTICA Enterprise Server Provides Prebuilt Analysis Configurations to automate routine: Data Extraction Filtering Alignment Removal of Duplicates New Variable Computation
Predictive Model Output Fraud Subrogation Reserves Rates Customer Retention Marketing Optimization		Report Output: PPT Word Excel XML PMML HTML-Portal

Figure – Reusable, pre-configured data templates that
include filtering and access to multiple databases

The benefit of this approach with the STATISTICA Decisioning Platform solution and its design is that as the reporting team becomes more proficient with the system and its capabilities to generate accurate reports, they can use the same tools and user interfaces to generate statistical analyses and predictive models. The Rules Builder tool streamlines the process of taking action on predictive analytics project results. From our experience, as users leverage our training tools and learn from one another, the business users (i.e., the analytics customers) will start to request not only reports but "deeper" analyses and predictions, and your entire team will find itself spending more time on the left side of this graphic producing high-end work products that help drive down claim costs while providing the ability to provide optimal service levels.

StatSoft’s Approach

StatSoft’s approach to engaging with a Property and Casualty 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 you collaborate to prioritize the incremental investment in order to use the ROI from the first project to pay for the next project.

Predictive Analytics Applications in Claims, Marketing, Underwriting, and Sales

 ¹ First Notice of Loss