Robotics Will Transform Healthcare Insurance, Says UiPath’s Kulpreet Singh

Here is a little think piece on the topic of automated systems and how they impact the Life and Healthcare Insurance sectors;

Forward-thinking healthcare insurers are transforming the business through robotic process automation (RPA) and cognitive technologies says Kulpreet Singh, Managing Director EMEA, UiPath

The healthcare insurance industry is particularly ripe for robotics. Many businesses are already deploying robots in claims and applications processing, but more innovative businesses are moving towards the automation of decision-making in front-office functions such as underwriting.

Kulpreet Singh md UiPath automated systems

There are specific challenges which hamper the operational abilities of healthcare insurers, such as managing risks and reducing costs while stimulating dynamic, high-growth business. Insurers now find themselves in a tricky position, facing strong customer demand while operating within an increasingly onerous regulatory environment on legacy systems that are too rigid and outdated to adapt to these demands.

Insurance customers are no different from customers in other industries who have high expectations from businesses today. Being savvier, more demanding and better connected than ever before, customer experience must be transparent, empowering and as close to instantaneous as possible. Customers expect to be able to connect with any business, on any of their devices from anywhere with a connection.

Meanwhile, the majority of insurers are stuck attempting to innovate with enterprise applications that are between 10 and 30 years old. These systems simply cannot provide the flexibility required, partly because they have become more complex and rigid over time, but mostly because they were never designed with the capabilities required in today’s evolving insurance market in mind.

There is a common perception among health insurers that the investment and risk associated with upgrading legacy systems is prohibitive. However, those that are exceeding customer expectations are doing so through the use of robotic process automation (RPA) solutions. Not only does this technology connect them with the capabilities and features that are essential to remaining agile and competitive, it also allows them support existing EAI and BPM architecture while integrating core systems and ancillary software applications in a non-invasive way.

One insurance company that I have worked with handles thousands of customer enquiries across two call centres each month. Dealing with direct sales, claims status requests and claims submissions, the business recognised the requirement to better its customer service, improving customer service levels and increasing agency productivity. After one year of investment towards these goals, the business saw no improvement. With the goals unfulfilled, the problem was eventually identified as being customer service agents placing data into and pulling data from a complex series of legacy systems, Citrix environments and siloed databases.

This complex operation meant that even a simple customer request such as a change of address would require a lengthy process involving a multitude of systems and databases – a frustrating operation for both customers and customer service agents resulting in irate customers and strained employees. The wider impact was a high staff turnover in the customer services department and an unsuitable training environment. What this insurer required was a platform that could fully integrate with the insurer’s back office systems and databases.

The challenges in finding such a solution were the potential high cost, the length of the project and the risk that such a project might not even pay off. However, an RPA solution provided an answer to each of these challenges. Combining the ability to interface in a non-invasive way (as humans do) with Citrix, mainframe, and legacy automation technologies, the complexity and cost of back office issues were easily solved.

For this insurer, the results speak for themselves: agent-assist workstation robots have led to productivity gains of over 30 percent. The complex, disconnected system is no more as each customer service agent now benefits from a holistic view which has in turn created significant reductions in call time resolution. Customer service surveys have shown customer service ratings to be consistently higher since the implementation of the new system.

Another insurance company that had quickly grown to 500 employees across 30 offices through organic growth and acquisitions has found (unsurprisingly) that processes, procedures and system architectures varied across its estate. The lack of profitability from policy renewals was quickly attributed to this complex, disjointed landscape of varying systems, practices and processes.

An audit of operations exposed poor process controls for the entire renewal workflow, particularly around information collection and procedures. Processes were reconciled across the entire business and robots were deployed to immediately mend the most serious renewal workflow weakness: underwriting. It emerged that some agents were not underwriting, offering discounts on the current policy instead. Other company policy violations such as lowering valuations to offer attractive premiums and making arbitrary discounts were also common practice and the resulting low premiums were severely impacting profits.

With an RPA solution now in place, renewal policies move swiftly through automated underwriting work queues with robots pulling valuations from various sources and settling on an average valuation through the application of business rules. Those valuations then form the basis for quoted premiums through the rating engine. This RPA solution has effectively removed the need to wait for process re-engineering and has created gains in both precision and reliability of valuation data and substantial gains in the profitability of premiums.

While it’s understandable that health insurers are anxious about the risk of updating or upgrading legacy systems, RPA solutions are delivering worthwhile, and rapid, returns on investment.

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