SilverBridge, HealthCloud deliver AI-driven health insights for underwriting

SilverBridge and HealthCloud have partnered to provide insurers with a solution that intelligently automates the insurance underwriting process by securely integrating health data and medical records to assess the risk of onboarding individual customers. This transforms the traditionally resource-intensive and time consuming underwriting process into a real-time customer experience.

“Healthcare data is a vital source to help underwriters make correct decisions on the risk and rating structure of individual clients. However, this information is typically spread across a variety of databases from external sources. Obtaining the information considerably slows down the process. And once collated, experts must still consider the data and perform a risk assessment,” says Patrick Ashton, Managing Executive at SilverBridge.

As the data is usually provided by clients themselves in medical questionnaires or accessed from multiple external datasets, it becomes a manual process for underwriters to allocate dedicated human resources to physically view all the information and then make the required underwriting decisions. In response to this need for external data, many insurers create their own integrations or databases that extract data from the likes of Home Affairs to verify a person’s identity and other relevant information to ascertain the risk of onboarding.

The partnership between SilverBridge and HealthCloud facilitates a secure health data exchange whereby patient data is collected from healthcare organisations, medical practices, pharmacies, laboratories, clinics, healthcare providers, and diagnostic and wearable devices, and presented to the insurer as a single data score with all available health parameters populated.

“Essentially, all this data is aggregated into a weighted single score which not only speeds up but also unlocks efficiencies in the process. In turn, SilverBridge injects sophisticated artificial intelligence (AI) algorithms, comprising the human insights of the underwriters, to automate the decision-making process as far as possible. This integrated solution alleviates much of the effort of having dedicated, senior individuals manage these onboarding processes manually.”

Following the recent partnership with Astute, which provides SilverBridge with valuable fraud risk scoring metrics, the health data and scoring provided by HealthCloud delivers a rich source of information to further automate and enhance business decisions on whether to approve policies, claims, and changes in cover. Ultimately, this provides SilverBridge with a complete 360-degree view of an individual customer’s risk profile.

HealthCloud provides a real-time overview of an individual’s medical history, including data for the past five to ten years. As such, the partnership creates proper automation in the underwriting process – especially important when it comes to both customer experience and risk management. New individual policy applications which would ordinarily require the likes of medical questionnaires, health screening, and blood tests that could take weeks to complete, can now happen in real-time thanks to the securely available and integrated health data.

”The rich data capabilities, intelligent algorithms, and secure real-time methodology that our platform offers, means that insurers now have access to a universe of health and medical record information that they would previously have found very difficult to access. Our collaboration with SilverBridge will offer the insurance industry immense value as the traditional processes are inefficient, costly and inaccurate. We aim to significantly disrupt this,” says Simon Spurr, Chief Executive Officer at HealthCloud.

A customer can therefore provide consent to the insurer as part of the onboarding process and the organisation will then be able to customise the underwriting decision in real-time based on how healthy (or unhealthy) that individual is.

“This is going to be a game-changer especially when it comes to disability cover. Instead of sending the policyholder every few months to be re-assessed, the HealthCloud data can provide insight as to whether the individual has been going for frequent medical check-ups, has been taking their chronic medication, etc. With SilverBridge, the information can be further enhanced to determine whether the individual’s condition is worsening or improving when comparing to previous periods,” says Ashton.

As the data is extremely sensitive in nature, the system relies on the scoring results provided by HealthCloud algorithms, with additional specific parameters provided, which enable decision-making but does not require data storage. The solution centres on injecting a level of AI decisioning into the process and creating full automation in a traditionally extremely manual process. By combining the respective expertise of SilverBridge and HealthCloud, a more precise understanding of an individual can be developed, and the intelligence built into the solution can show how healthy or unhealthy an individual is. The customer experience is dramatically improved as onerous questionnaires and tests are simply no longer required for decision-making.

HealthCloud will improve the speed, quality, and cost of gathering patient-centric data and enable a digital underwriting model. Combined with the SilverBridge AI and automation expertise, insurers can garner real-time insights from multiple experts such as underwriters, compliance, legal etc. and effortlessly apply those views to all new applications or changes to existing cover.

“This is a non-invasive and seamless way for insurers to make informed decisions about individual customers. It takes what was an expensive, time-consuming process, that introduced significant risk to the insurer, and redefines the process to become both easier and more dynamic for all participants,” concludes Ashton.

About HealthCloud

Using sophisticated data standards with a secure, real-time health data exchange, HealthCloud provides universal health interoperability. This innovative platform is able to centralise consumer health and medical records contained in separate systems within one facility, thus solving the problem of fragmented consumer information. HealthCloud uses Fast Healthcare Interoperability Resources (FHIR) and HL7 standards and specifications, both of which provide a framework for the exchange, integration, sharing and retrieval of electronic health information.

Liberty Kenya mitigates risk of lockdown with SilverBridge digitalisation project

Liberty Kenya partnered with SilverBridge Holdings to digitalise its paper-based onboarding process with the intention of improving the customer experience while delivering on the digital enablement of beneficiaries. The foresight of the insurer to modernise this business-critical process also enabled it to mitigate the business impact of the unforeseen COVID-19 lockdown conditions in the country.

A manual customer onboarding process tends to result in human errors that would slow down delivery time on loading policies. Furthermore, any mistakes on an application form or errors inputting the information required Liberty Kenya to embark on an extensive review process that would potentially delay the application.

The digitalisation of these processes had to be an extension of the existing administrative solution to empower advisors to engage with customers across a multi-channel environment for a seamless experience.

“SilverBridge has been a technology partner for Liberty Kenya for more than 12 years, so the decision to work with us on this exciting digitalisation project reinforced the value the organisation provided to Liberty Kenya. Our deep industry knowledge coupled with our understanding of the Liberty Kenya business proved invaluable on the project,” says Alma Joubert, Portfolio Manager at SilverBridge.

The implementation took a little over a year to complete with the new digital environment operational at the end of 2019. There was significant engagement between the SilverBridge and Liberty Kenya teams to ensure the success of the project.

“Liberty advisors were integrally involved in the digitalisation process working with the SilverBridge team to address the business-critical issues important to them that were identified by the previous manual process. This saw the advisors embracing the system in its entirety resulting in significantly improved customer experience and, ultimately, customer satisfaction. Policies can now be loaded virtually in real-time,” adds Joubert.

The resultant implementation has seen the customer onboarding process being reduced from three weeks due to the manual system to real-time. Due to virtually eliminating paper-based forms, Liberty Kenya has also been able to decrease the administrative expenses associated with onboarding by 50%.

“The digitalisation of the on-boarding process has been a game changer for Liberty Life Kenya and has positively transformed the advisor, customer, and employee experience in a significant way,” says Asman Mugambi, General Manager: Operations at Liberty Life Kenya.

Thanks to this new digital onboarding environment, the Liberty Kenya advisors were able to rapidly adopt and continue with the sales engagements during the first several weeks of the lockdown, despite restrictions on physical interaction with customers.

“Policies can now be loaded virtually and in real-time. This digital enablement of its advisors means customer engagement can continue using a variety of platforms that mitigate the risk of any future lockdown conditions,” concludes Joubert.

To read more about the Liberty digitalisation project, access the full case study here

SilverBridge, Astute reinvent insurance claims

SilverBridge and Astute Financial Services Exchange have partnered to deliver a fully automated intelligent claims processing solution. It uses artificial intelligence (AI) modelling of insurer expert decision-making which enables claims to be processed in real-time while providing maximum risk oversight.

“Astute has a proven reputation within the insurance industry for delivering extremely valuable risk scoring metrics to assist with risk mitigation when onboarding customers or processing claims. For our part, SilverBridge has extensive experience in developing solutions for the insurance industry with expertise in automating and simplifying complex business processes as well as providing AI components to virtualise human decision-making,” says Patrick Ashton, managing executive at SilverBridge.

Bringing full automation to the claims process, which includes risk scoring and an intelligent decisioning, to assist insurers with straight-through processing (STP) of claims is seen as extremely valuable. The collaboration between the two organisations will result in improved risk processes and a better customer experience. Furthermore, it will dramatically improve efficiencies within the business processes of an insurer.

“The fast-paced evolution of technology-savvy customers increases the demand for insurers to improve responsiveness and service efficiencies, specifically when it comes to onboarding and paying out claims. Combining the Astute and Silverbridge core strengths provide insurers with an efficient single solution, turning data into wisdom, to proactively combat insurance fraud and deliver world-class service at the same time,” says Jacques Rossouw, Group CEO for Astute.

The solution includes direct integration into an insurer line of business system, Astute RMS scoring of the claim, and all parties associated with the claim. It features Department of Home Affairs VOPD (Verification of Personal Details) of relevant claim participants and SilverBridge AI models to create claim decisions as to whether to pay, decline, or refer claims.

“The AI modelling process virtualises expertise of the best decision-makers at an insurer thereby ensuring expert attention can be given to every claim processed within the organisation. These models are continually assessed to ensure they make the best decisions possible. They can quickly be retrained and redeployed in reaction to market changes with no impact on existing business processes,” says Ashton.

Initially, the solution is being rolled out to selected insurers on a proof of value (POV) basis. This is designed to ensure the value to the insurer within the business process is evident. The POV is designed to use production data for limited types of claims before rolling it out to support additional claim types.

“We have had positive initial engagements with insurers and identified many manual components within the claims process which create operational inefficiencies and have an impact on customer satisfaction levels. The improved risk mitigation of the solution will be invaluable for those risks within industry data that are not always accounted for. Automating the decisioning process will improve customer experience as there is no internal bottleneck waiting for human experts to manage the process,” adds Ashton.

While this solution will initially focus on the claims process, other opportunities where it can add value to business processes include customer onboarding or policy alterations where risk scoring frameworks and industry experience can add substantial value.

About Astute

The Financial Services Exchange – ASTUTE has been successfully hosting and managing industry platforms for the secure exchange of data within the financial services industry for two decades. Market analysis has shown that these platforms have provided significant value to both the Financial Services Provider (FSP) and their client, as the FSP is able to mitigate their risk and the client user experience increases with less friction throughout the customer journey.

SilverBridge supports AirBuy in driving fintech innovation

SilverBridge and innovative fintech Airbuy have entered the second year of an enterprise development programme, highlighting how the technology solutions provider can assist start-ups in unlocking additional value by providing them with the relevant expertise to navigate the complexities surrounding the financial services industry.

“At the time, SilverBridge interviewed numerous start-ups to identify one that provided them with a good cultural fit from an enterprise development perspective. Airbuy stood out from others due to the passion and commitment of the founders, and how focused they were at realising their idea. They also wanted to make a difference in their communities which is something SilverBridge feels quite strongly about,” says Ruth Wotela, People Wellness Executive at SilverBridge.

The Airbuy payment gateway allows e-commerce sites to accept payments without customers needing to provide their banking details. For the end user, this entails using only their mobile number to set up and complete a transaction.

“Given the increasing connectedness of people thanks to the ubiquity of smartphones, we identified a huge gap in the market. Mobile penetration is significant not only in this country, but throughout the continent. It therefore made sense to harness the power of the mobile phone allowing us to create the opportunity for all South Africans to buy online and also experience the product accessibility and convenience benefits on offer. Of course, Airbuy not only ensures increased accessibility, it also caters for those users who are sceptical about the security of saving their credit card details on e-commerce sites. Airbuy has developed a proudly South African solution to cater for those requirements,” says Njabulo Makhathini, co-founder and head of business development at Airbuy.

SilverBridge supports Airbuy with office resources in a shared environment as well as access to several experts in different areas that include marketing, IT, HR, compliance, and business.

“We identified individuals at the company to provide Airbuy with guidance and mentor the team in different ways. It is not a case of changing their vision but supporting them and encouraging the business to grow. We are supporting them and empowering them to do what they want through not only access to our experts but also our network of partners,” says Wotela.

Tshepang Kobo, co-founder and CEO of Airbuy, believes SilverBridge gave them the structure required to think more strategically about their goals.

“Before, we were very free flowing. But working with SilverBridge made us realise there are certain elements to consider and being cognisant of their long-term impact on the business,” says Kobo.

“Even though we are passionate about our idea, we learnt very quickly in the journey that starting a fintech is not the same as doing, for example, a delivery app. There are significant legal and regulatory elements that must be in place. SilverBridge helped us every step of the way and enabled us to grow quicker than we anticipated and scale our systems accordingly,” adds Makhathini.

He points out that the biggest lesson is that a start-up does not necessarily require funding but the right expertise.

“It is easy to spend funds in the wrong way. It is more about getting the right resources and making less mistakes on spending money inefficiently.”

For Kobo, the SilverBridge relationship brought with it a lot of stability.

“Previously, we used to meet at coffee shops or worked at various incubators for a few weeks at a time. This was a very volatile approach but SilverBridge gave us a safe environment to work from.”

As to be expected, Airbuy dealt with setup-related issues in 2019, but now it is focused on scaling up. It plans to expand into another country by 2024 but will remain reliant on SilverBridge consulting throughout the process.

“Even though we might not be working from their offices by then, we will always use them from a consulting perspective. They have vast experience in scaling solutions across Africa which is extremely valuable for us as we focus on growing Airbuy,” adds Makhathini.

According to SilverBridge’s Wotela, the relationship is very flexible.

“SilverBridge is there to support Airbuy. We believe in what they are doing and hope they continue with the innovative work for years to come. Our support is focused on assisting them as they navigate through their business developments,” concludes Wotela.

About SilverBridge

SilverBridge has over 24 years’ experience as a leading provider of insurance software solutions in the African financial services industry. Our experience includes working with over 60 customers across 16 African countries. SilverBridge’s digital insurance suite allows financial services companies the opportunity to respond quickly to changing markets. With customers throughout Africa, SilverBridge has the knowledge, experience, and technology capabilities to help its clients do better business.