Artificial Intelligence in the Claims Process

Innovation Project Summary Cookhouse Lab

Artificial Intelligence in the Claims Process

Chatbots provide a huge potential to improve customer service, engagement, sales and real-time access to information.

2

WEEKS

TORONTO

2017

3

MEMBERS

1

MVP

Problem

How can an automated AI chatbot be used to simplify claims submission process, remaining easy and intuitive to use?

Claims – an unpleasant customer experience. Can chatbots make customers happy?

WHY?

The Current Claims Management Experience Pain Points

SEE

SAY & DO

HEAR

THINK & FEEL

DISCOVERY

Can a chatbot make a customer happy?

Can AI help us service clients more efficiently?

With millennials being the next generation and major target market, as an industry, we need to stay current with their service expectations.

A timeline with possible ideas and features that can be implemented today and into the future.

SOLUTION

The final output of the project was a Portfolio Solution that included three different products.

As the sprint was two weeks, our chatbot scope was limited to initiating a claim and starting the FNOL (First Notice of Loss) process with the gathering of information.

Testing results showed that AiiA was intuitive and interactive for the simple straightforward scenario that we designed.

We challenged each other to find new ways to educate AiiA for continued growth and future development. Collaboration continued in the testing stages to review and iterate the flow with enhanced customer experience as our goal.

Innovation Project Solutions AI in claims

Once client has authenticated by signing in, the bot has access to the policies that are linked to him and interacts accordingly to what is available to choose from.

AiiA gives simple options to go through step by step in order to initiate a First Notice if Loss. With user-friendly choices to click on in order to guide the client through the process. It also allows to capture the details of the claim.

Innovation Project solutions AI in claims

ESTIMATED IMPACT

Can set up an infinite number of claims at the same time.

Information gathering of all claim details.

Launches a digital process that reduced cycle times by up to 70%.

Increases profitability for all the stakeholders.

CustomerServ

Customer Service

improvement
asks the right questions and makes sense of the information received and provided

timesaving

Cycle Time

decrease
improving efficiency and productivity by reducing calls, emails and voice inquiries

AIclaims

Claim Process

improvement
live chat with Chatbot available 24/7, easy to use, pre-populated answers

RESULTS

In this two-week sprint, the project team learned how chatbots and AI work, focusing on how a chatbot must be designed and implemented to significantly improve the experience of claims notification and management.

4

Empathy Maps

5

User Tests

37

Surveys

5

Communication Trees

1

MVP

3

Prototype iterations

1

Innovation Report

3

Project Presentations

PARTICIPANTS

We also offer intro sessions that provide insurance professionals with the opportunity to experience our Cookhouse Labs methodology and a sneak peek at what it’s like to co-create and collaborate with our global community. If you are not a Cookhouse Labs member and are interested in finding out more, check out our membership benefits!

The Future of Transportation – Autonomous Vehicles

Innovation Project Summary Cookhouse Lab

The Future of Transportation - Autonomous Vehicles

“If I asked people what they wanted they would have said faster horses” – Henry Ford

4

WEEKS

TORONTO

2017

5

MEMBERS

3

MVP

Problem

The insurance industry is not prepared to seamlessly integrate with the future of transportation.

Preparing for the future of transportation

WHY?

The Autonomous Vehicle Experience Pains & Gains

CUSTOMER

PAINS

GAINS

INSURER

PAINS

GAINS

DISCOVERY

What regulations and policies need to be revisited in a fully autonomous world?

How can insurers adjust to new ownership models?

How can insurers price and adjudicate claims during the transition?

What do auto insurance products of the (near) future look like?

Autonomous Vehicles and systems are upon us and with them, some notable implications to the Auto Insurance Industry.

SOLUTION

The final output of the project was a Portfolio Solution that included three different products.

1

DISCOVERY AND AWARENESS PORTAL

Carefreeroadstar.com is a referral fee based profit system to create an incentive framework for car manufactures, dealers and insurance companies to take part in the solution.

Solution Autonomous vehicles

2

ADAPTIVE RISK MODEL

The risk model takes into account the transition period or “messy middle” environment where customers have vehicles that have some autonomous features but are not fully autonomous.

3

TRANSPORTATION SHORT LEASING/UBI APPLICATION

For consumers who don’t own a vehicle but require transportation. As autonomous vehicles are projected to be more appealing than taxis, this product is intended to be acting as a broker for autonomous transportation.

Solution Autonomous vehicles

ESTIMATED IMPACT

Platform evolves as autonomous capabilities evolve.

One-stop shopping for a variety of transportation options (per use, short lease, purchase).

Seamlessly connects the customer to the services he needs.

ReducedLoss

Direct Loss Ratio

reduced
claims payout due to increased lower risk customers

timesaving

Usage Based Insurance

increase
shift in revenues earned from traditional auto insurance

costefficiet

Claim Submission

increase
from referrals providing data to car manufacturers to improve safety

RESULTS

Over 16 days, our project team looked to define the Opportunities and Implications that Autonomous Vehicles bring to the Auto Insurance Industry.

10

Empathy Maps

12

User Interviews

38

Surveys

25

Wireframes

10

MVP Screens

2

Prototype iterations

1

Innovation Report

3

Project Presentations

PARTICIPANTS

We also offer intro sessions that provide insurance professionals with the opportunity to experience our Cookhouse Labs methodology and a sneak peek at what it’s like to co-create and collaborate with our global community. If you are not a Cookhouse Labs member and are interested in finding out more, check out our membership benefits!

Blockchain & Group Benefit Coordination

Innovation Project Summary Cookhouse Lab

Blockchain & Group Benefit Coordination

Many processes within the insurance industry are complicated and manual. Blockchain technology offers the opportunity to streamline these multiparty processes.

4

WEEKS

TORONTO

2017

4

MEMBERS

1

MVP

Problem

How might we eliminate the complexity of the coordination of benefits paramedical claims process?

Streamlining manual and complex multi-party processes

WHY?

The Current COB Experience Pain Points

CUSTOMER

SERVICE PROVIDERS

INSURER

ADJUDICATORS

DISCOVERY

What should this process look like in today’s digital age?

How can policy holders have a more seamless process similar to dental claims?

Can policy holders submit data once and have the process automated between insurers?

Typical 30 days process is reduced to only 10 minutes

SOLUTION

The team created a mockup to simulate the submission, adjudication, and validation from two different insurance carrier perspectives.

The solution, named Clowder by the project team, is focused on eliminating the need for plan members (who have multiple health coverages) to re-submit their paramedical claim to the second & subsequent insurers by using Blockchain hyperledger fabric technology. In addition, Clowder is a proof of concept for how we can leverage Blockchain technology within the insurance industry.

Group Benefits Coordination 01

In theory, any number of insurance providers and customers may be added to the solution. This would allow, for example, a single claim to be adjudicated by more than two insurers.

Group Benefits Coordination02

ESTIMATED IMPACT

Brings improved data quality through new digital tools.

Shares an immutable record of the claim across multiple insurers.

Simplifies claim process and identification of primary payer for policy holder.

costefficiet

COB Cost

Reduction resulting from resubmissions and calls associated with error in customer COB claim process

Caseunderwrite

Fraud

increase due to reliable, standardized EOB documentation through blockchain implementation

timesaving

Claim Submission

simplified, transparent, faster ensurers information consistency through collaboration

RESULTS

In this four-week sprint, the team aimed to design the minimum viable product (or MVP) to test with real customers.

5

Empathy Maps

34

User Interviews

66

Surveys

30

Wireframes

16

MVP Screens

3

Prototype Iterations

1

Innovation Report

2

Project Presentations

PARTICIPANTS

We also offer intro sessions that provide insurance professionals with the opportunity to experience our Cookhouse Labs methodology and a sneak peek at what it’s like to co-create and collaborate with our global community. If you are not a Cookhouse Labs member and are interested in finding out more, check out our membership benefits!

Millennials are not intersted in life insurance

Innovation Project Summary Cookhouse Lab

Millennials are not Interested in Life Insurance

Insurance companies are currently struggling to engage with millennials on the topic of life insurance.

4

WEEKS

TORONTO

2017

4

MEMBERS

3

RESULTS

Problem

As a Millennial, aged 18-29, the problem is how to be smart with my money to be able to afford my current needs, support my changing lifestyle, and achieve my future goals.

Do existing life insurance products meet the needs of millennials? Are millennials aware of, and able to access, the existing products? Increasing millennial participation in life insurance.

WHY?

Our millennial Key Personas

CHRIS

AGE 18
JOB Part Time
INCOME 12K
STATUS Single

EMILY

AGE 23
JOB Junior Contract
INCOME 30K
STATUS Single

DAN

AGE 28
JOB Full Time
INCOME 60K
STATUS Long Term Relationship

JANET

AGE 33
JOB Senior Full Time
INCOME 70K
STATUS Married
CHILDREN 1

DISCOVERY

Do existing life insurance products meet the needs of millennials?

Are millennials aware of, and able to access, the existing products?

How can we provide relevant information to help millennials make faster decisions on insurance products when hitting life insurance purchase triggers?

Some highlights from our largest Survey about millennials!

SOLUTION

The team focused their efforts on addressing the problem statement from the perspective of millennials, agreeing that by taking a Customer Centric Approach, the problem from the insurers’ perspective would also be resolved.

1

LIFE JOURNEY MAP

To help us understand what the needs (or lack thereof) were for our personas, we wanted to try to capture the key life events in their lives along with their needs at that stage.

Innovation Project Millennials Journey Map

2

ENGAGEMENT FRAMEWORK

The team identified 23 key activities or tactics that they felt would engage Millennials as they are going through their key life events, i.e., going to school, graduation and getting a job.

These tactics were based on raising awareness of financial and insurance needs and the advice and tools available.

To help build out the tactics of the engagement framework, the team developed three scenarios to further refine the tactics and to better understand what could be potentially implemented. Also conducted workshops and surveys with millennials to validate and rank those tactics.

Innovation Project Millennials Engagement Framework

ESTIMATED IMPACT

Pop-up advice centre where students find out information and un-biased advice about financial planning.

Online toolkit with a blog, access tools and information about financial planning and potentially create an online marketplace.

Workshop delivered by a professional in financial topics.

costefficiet

Financial Education

increase
millennials want transparency and avoid to be misled

timesaving

Engagement

increase
to meet their evolving needs

customerfeed

Customer Data Collection

increase
allowing the creation of new products and opportunities

RESULTS

Over 3 months a new underwriting solution was developed with the potential to bring about +$80MM in benefits to the Canadian Life Insurance Industry.

10

Empathy Maps

31

User Interviews

108

Surveys

5

Revelations

2

Millennials Life Journey

1

Engagement Framework

1

Innovation Report

3

Project Presentations

PARTICIPANTS

We also offer intro sessions that provide insurance professionals with the opportunity to experience our Cookhouse Labs methodology and a sneak peek at what it’s like to co-create and collaborate with our global community. If you are not a Cookhouse Labs member and are interested in finding out more, check out our membership benefits!

Blockchain & Insurance

Innovation Project Summary Cookhouse Lab

Blockchain & Insurance

The objective of this initial project was to begin the Blockchain Journey and see where our collective ideas can take us.

4

WEEKS

TORONTO

2017

8

MEMBERS

3

USE CASES

Problem

What is Blockchain and how can it be used to improve insurance?

Blockchain, is a transparent secure chronological public ledger. It’s said Blockchain will have the same impact on global society as the internet. It will revolutionize payment processing. It will democratize banking for the globe. It will not just disrupt payment processing and financial services, but every sector of the world from politics to land title.

WHY?

SWOT for Blockchain

STRENGTHS

WEAKNESSES

OPPORTUNITIES

THREATS

DISCOVERY

Identify and prioritize customer and business pain-points across the insurance lifecycle.

Develop an understanding of Blockchain including high-level technical functionalities, history, existing use cases and its potential future applications.

The success of this initiative would depend on all provincial regulators committing to full cooperation and participation at the outset.

Discovery Blockchain use cases

SOLUTION

Over the 4-week project period, the project team developed a comprehensive list of 34 Blockchain use cases, and created a selection criteria to determine the top three use case categories among them.

1

AUTOMATED INSURANCE PRODUCTS / CLAIMS PAYMENTS

Insurance companies coordinate the payment of claim with smart contract, automating the process from notification to payment.

Blockchain Use case 01

2

COMMUNICATION AND INTEGRATION

The Blockchain’s shared ledger provides permissioned parties, such as the contractor, insurers and reinsurers, with clear visibility to the characteristics of the risk and ­financial information pertinent to bond issuance.

Blockchain Use case 02

3

INDUSTRY WIDE BLOCKCHAIN APPLICATIONS

Fine-tuned access control: Easy to pool data & restrict access to sensitive fields. High security/integrity of the data. Anti-fraud database. Broker/insurer platform for licensing requirements.

Blockchain Use case 03

ESTIMATED IMPACT

Brings Improved Data Quality through New Digital Tools.

Facilitates the creation of new products and services with an enhanced customer experience.

Launches a Digital Process with Increased fraud detection.

Increases Profitability for all the stakeholders.

timesaving

Time Saving

automated
transactions can be triggered nearly immediately and reliably

costefficiet

Cost to Serve

reduction
the efficient exchange of accurate information enable lower transaction fees

customerfeed

Human Error

decrease
no need for human intervention and validation. Mistakes are less likely to happen

RESULTS

The Blockchain & Insurance project took place over four weeks at the Cookhouse Lab premises in Toronto, Canada.

15

Empathy Maps

6

Expert Presentations

34

Use Case Ideas

1

Selection Methodology

3

Selected Categories

6

Selected Use Cases

1

Innovation Report

3

Project Presentations

PARTICIPANTS

We also offer intro sessions that provide insurance professionals with the opportunity to experience our Cookhouse Labs methodology and a sneak peek at what it’s like to co-create and collaborate with our global community. If you are not a Cookhouse Labs member and are interested in finding out more, check out our membership benefits!

Delays in APS

Innovation Project Summary Cookhouse Lab

Delays in APS

A leading cause of delays in life and health insurance policy issue is often due to time lags in receiving the Attending Physician Statement (APS) also known as Third Party Reports and how that impacts the underwriting process.

12

WEEKS

TORONTO

2017

7

MEMBERS

1

MVP

Problem

Customers are waiting months to recieve life and living benefits coverage due to poor data quality, lack of physician motivation and paper based process culminating in long APS cycle times.

Disrupting a +30 year old process

WHY?

The APS Experience Current Pain Points

APPLICANT

BROKER/ ADVISOR

INSURER

PHYSICIAN

DISCOVERY

What should this process look like in today’s digital age?

How can we expedite the Third Party Reports request process?

How can we provide a risk relevant synopsis of these reports to the underwriter for a faster risk premium classification?

Typical 90 days process is reduced to only 2 weeks

SOLUTION

To encapsulate these innovations, the team created a new digital platform called “Road Runner” focused on accelerating the APS process.

One platform where all the roles can access, upload and review information. The content displayed responds tp the role specifics (e.g. Insurer, Underwriter, Physician)

Using the platform, the Underwriter sends a digital request for the APS that bypasses the TPA and notifies the client’s physician.

Once the request is receivede by the physician, following a directed digital process, theu complete the APS request much quicker through digital forms.

The Underwriter receives the request back, the information has already been identified and summarized for the underwriting process.

The insurer finishes underwriting the life application and the broker (in turn the customer) is happy to get life insurance coverage in less than two weeks.

ESTIMATED IMPACT

Brings improved data quality through new digital tools.

Introduces a new physician bonus incentive program.

Launches a digital process that reduces cycle times by up to 70%.

Increases profitability for all the stakeholders.

costefficiet

APS Cost

up to 70%
Reduction in costs to request and pricess APS documentation

timesaving

Cycle Time

50% to 95%
increase in the time it takes to complete an APS request

Caseunderwrite

Case Underwriting

100% to 400% increase the number of cases underwritten per day which require an APS

RESULTS

Over 3 months a new underwriting solution was developed with the potential to bring about +$80MM in benefits to the Canadian Life Insurance Industry.

10

Empathy Maps

45

User Interviews

5

Surveys

35

Wireframes

80

MVP Screens

4

Prototype iterations

1

Innovation Report

3

Project Presentations

PARTICIPANTS

We also offer intro sessions that provide insurance professionals with the opportunity to experience our Cookhouse Labs methodology and a sneak peek at what it’s like to co-create and collaborate with our global community. If you are not a Cookhouse Labs member and are interested in finding out more, check out our membership benefits!

Drone Insurance – no history, no data, no coverage?

Innovation Project Summary Cookhouse Lab

Drone Insurance - no history, no data, no coverage?

With the increase of civilian and commercial use of drones comes a new market for insurance products and services.

4

WEEKS

TORONTO

2017

5

MEMBERS

1

MVP

Problem

Drone fliers do not have options to protect themselves or their drones when they fly.

Design and create a product offering for personal and commercial drone insurance

WHY?

The Drone Experience Pain Points

RECREATIONAL

PROSUMER

INSURER

UNDERWRITER

DISCOVERY

How can insurers gain insights on the new risks, in order to develop adequate risk models?

How can insurers design a product offering for personal and commercial drone insurance?

The problem visualized! Insurance market with a roughly substantiated one-size-fits-all risk price, but avoid tail risk issues.

SOLUTION

The group decided on two possible approaches, both focus on data gathering and social sharing. Creating a stand-alone insurance product.

1

Launch a community App to provide a digital social experience for pilots to meet, learn and gamify their flights with others.

The goal would be to construct a credible risk model and rating matrix for the stand-alone insurance product using flight data from the insured drones.

2

Launch an introductory stand-alone insurance product, with one-size-fits-all pricing that targets the ‘prosumer’ class.

To broaden the scope of this insurance product over time, its digital experience should incorporate the required ongoing data discovery aspect.

Drone solution 02

ESTIMATED IMPACT

Brings improved data quality through new digital tools.

Gamification approach makes data gathering user-friendly and sustainable.

Lower friction points for the customer, so they remain engaged.

Increases profitability for all the stakeholders.

DroneData

New Data Acquisition

increase
underwriters access to policyholder flight data and behaviour

costefficiet

Proper Margins

accuracy
change proper premiums while allowing for usage based discount pricing

customerdata

Reduced Fraud

detection
service which combines user data with publicly accessible social media data

RESULTS

During this 4 weeks sprint, the team identified the problem statement and developed solutions to meet the needs of drone users.

5

Empathy Maps

15

User Interviews

171

Surveys

25

Wireframes

15

MVP Screens

2

Prototype iterations

1

Innovation Report

3

Project Presentations

PARTICIPANTS

We also offer intro sessions that provide insurance professionals with the opportunity to experience our Cookhouse Labs methodology and a sneak peek at what it’s like to co-create and collaborate with our global community. If you are not a Cookhouse Labs member and are interested in finding out more, check out our membership benefits!

Insurance Loyalty & Rewards

Innovation Project Summary Cookhouse Lab

Insurance Loyalty & Rewards

A loyalty program creates a relationship between a consumer and a brand. Companies oer their customers promotions, exclusive products or pricing in return for their loyalty.

12

WEEKS

TORONTO

2017

5

MEMBERS

1

MVP

Problem

Insurers do not know how to show customers that they care about their life, wellness and behavioral changes, therefore they don’t retain them.

Building an insurance customer relationship

WHY?

Insurance companies need customer loyalty otherwise they become a commodity

CUSTOMER

CUSTOMER'S FAMILY

INSURER

REINSURER

DISCOVERY

Connect insurance to daily used appliances via Internet of Things

Create an online environment and communities for users with gamification and social media integration

Collect, analyze and provide data and information

Motivate and reward customers to engage and mitigate risks

Nowadays people show a lack of interest in financial products mainly resulting from a limited understanding and awareness.

SOLUTION

The project team developed a high fidelity minimum viable product (prototype) insurance focused customer caring mobile application nicknamed as “BACON”.

Single place to easily manage your insurance. New communication channel and data sources (IoT) to enable a better understanding of end customers.

A digital experience to engage users through gamification providing challenges that incentivize risk mitigating behavior. Motivate and reward customers for risk mitigating activities.

Loyalty and Rewards platform that focuses on caring. Overall view of customers life and the areas they care about. Place to store all insurance information. Channel of communication with the customer.

ESTIMATED IMPACT

An “everything in one place” experience where customers have all their insurance info in one place organized by care categories rather than products.

Positive behavior driven challenges and rewards to further protect the customer’s insurance care items using daily used IoT-connected appliances.

customerfeed

Customer Engagement

increase
with insurance literacy and a gamification approach for motivation

loyaltyincrease

Customer Loyalty

increase
through a personalized insurance experience rewarding positive behavior challenges

customerdata

Customer Data Collection

increase
allowing a better risk assessment understanding and tailored product offerings

RESULTS

Over 3 months an insurance focused customer caring app was created to attract new and retain existing customers focused on mitigating risk altogether.

6

Empathy Maps

93

User Interviews

67

Surveys

52

Wireframes

160

MVP Screens

7

Prototype iterations

1

Innovation Report

6

Project Presentations

PARTICIPANTS

We also offer intro sessions that provide insurance professionals with the opportunity to experience our Cookhouse Labs methodology and a sneak peek at what it’s like to co-create and collaborate with our global community. If you are not a Cookhouse Labs member and are interested in finding out more, check out our membership benefits!

Insurers Aren’t Prepared for the Future of Transportation – Learnings & Wrap Up

“Insurers are not prepared to seamlessly integrate with the future of transportation.”

This was one astounding conclusion that our project team came to at the end of our 4-week sprint. Through 16 days, 11 participants, 5 companies, and 4 partnerships, we inferred that the auto insurance industry needs to move quickly to adapt to the shifting change in risk.

And although the project team had originally determined 2050 as a placeholder date for the mass adoption of fully autonomous vehicles, through the course of the sprint, two problems became apparent:

  • The anticipated date of 2050 is in fact, too far out
  • Insurers are not ready for this disruption

Our Proposed Solution

To tackle both of these problems, the team created a portfolio solution with the following three elements:

  • Discovery and Awareness Portal
  • Adaptive Risk Model
  • Transportation Short Leasing/UBI Application

The ultimate goal of these three elements is to provide a comprehensive solution for auto insurers while providing a user-friendly experience for the average driver. 

1. Discovery & Awareness Portal

This portal will address the safety concerns of the customer by providing a manufacturer agnostic resource where customers can learn and experience what it’s like to be in an autonomous vehicle. 

2. Adaptive Risk Model

This risk model will take into account the transition period (or the “messy middle” environment) where customers will be driving vehicles that have some autonomous features, but are not yet fully autonomous. 

3. Transportation Short Leasing/UBI Application

 This application is aimed towards consumers who do not own a vehicle, but still require transportation. This is intended to be more financially appealing than taxis and this type of broker for autonomous transportation is projected to become more relevant over time. 

Next steps for the Autonomous Vehicle Project Team

In addition to the above deliverables, the team produced a business case that outlined how the sustainable business model, which was presented at the team’s final presentation. The final valuation of all of these products was a whopping $150 MM.

Immediately following the presentation was a next steps session where the audience and project team discussed how to bring the proposed MVPs to market. The following priorities were identified to be further defined in 2018:

  • Getting buy-in from regulators for these new insurance models
  • Creating partnerships with manufacturers
  • Communicating the value of autonomous vehicles to consumers
  • Creating insurance for pay-per-ride insurance
  • Creating and refining the steps to aggregate information 
  • Designing an operational plan (how to make the $$)
  • Bringing e-call (automated emergency calling) to Canada
  • Collaborating with private and public sectors to improve safety in the transition period
  • Creating data privacy guidelines
  • Standardizing AV guidelines
  • Creating a risk model