Better health outcomes through artificial intelligence
Author: Paul Cronin
The rise of artificial intelligence (AI) technology is set to benefit many with its promise to mimic the perception, reasoning, and problem solving of the human mind. Over the years, most insurers have collected massive sets of data which usually reside in legacy systems. The functionality that AI offers in analysing and learning from these large data sets can now be leveraged. These ‘new’ uses of data and ways of unlocking the value will in turn ensure better outcomes for claimants and customers.
Innovations that leverage AI technology have the potential to transform the disability insurance industry globally by changing the way insurers manage claims. An early stage pilot project initiated by DXC Technology has demonstrated how it could help case managers better manage real people with real problems, and helping injured and ill people get back to health sooner.
What’s impacting outcomes?
Across all areas of the insurance sector, unprecedented cost increases are being experienced. Both Australia and New Zealand have experienced significant natural disasters in recent years with floods, earthquakes and bushfires highlighting the reliance on home and contents insurance to protect people, properties, and belongings. Private health insurance premiums have consistently risen to counteract the steady rise in claims driven by an ageing population, increasingly complex medical treatments and procedures, and new medical technology. And income protection claims have doubled in the last ten years1, symptomatic of broad macroeconomic forces and cyclical determinants like slow wage growth, unemployment, and underemployment.
In Australia, the disability insurance industry costs many, many billions of dollars. In particular, workplace injury claims are a substantial drain on society - financially of course, but more importantly, emotionally for those affected by injury and unable to return to work. Many claimants experience high levels of stress as a result of having to engage with cumbersome insurance claim processes which can adversely impact recovery times.
Looking to the future, the cost of running the types of disability insurance schemes that exist today is also set to increase. Predictions indicate that claims will increase rapidly - again due to our aging population, rising medical costs, and increasing numbers of psychological and more complex injuries being reported. This will result in a higher proportion of claims costing more, which makes existing approaches unsustainable in their current form.
How AI helps
There are many reasons to consider AI - primarily to automate manual processes based on patterns, existing knowledge and data. In the insurance context, AI can be used to increase the accuracy of decisions while making the process more scalable.
After DXC and a leading claims management organisation analysed how AI might be used, a prototype tool was built to support triage for new claims. The claims triage prototype tool was then deployed in a pilot which compared the tool’s output against historical claim outcomes. The pilot demonstrated that the predictive models were around 90% accurate and could highlight risk factors affecting claim outcomes.
Read the full insight to find out more.
About the author
Paul Cronin is an Account Chief Technologist within the Insurance and Wealth Management sector for DXC in Australia and New Zealand. With over 20 years’ experience in the IT industry, Paul advises clients, prospects and partners on the business and technology challenges faced by insurers across the region and provides guidance on solutions that deliver growth, increased efficiency and speed to market through digital transformation.