In Claim Automation, Claim Management Software, Cloud Computing, Technology

Einstein is the umbrella term used by Salesforce for the AI features built into the core products. Einstein has many features across many of their product offerings, including the Sales Cloud, Service Cloud, and Community Cloud among others.

These features are designed to discover insights, predict outcomes, recommend actions and automate tasks for Salesforce customers.

In October 2016, after a number of acquisitions and two years of behind-the-scenes work, Salesforce announced the release of Salesforce Einstein at their Annual Dreamforce event. Within the first three months, Salesforce had brought eleven Einstein features to market, followed by ten more in February of this year. 

How Does This Affect Insurers?

Insurance companies are rich in data, particularly if they’ve been around for a while. Data relating to policyholders and claimants that have been collected over the years can be processed using machines to deliver meaningful insights.

Consider all of the historical claim data that exists in your organization. Feeding this data into an intelligent machine can help identify patterns in the data, which are beyond comprehensible for humans, to provide diagnostic analytics.

This data can then be used to complete a number of different analytical capabilities to build out predictive and prescriptive analytics.

  • Predictive analytics can give insurers more insight into possible future events based on their past events captured in the data set. For example, insurers could predict the likelihood of a Short-Term Disability (STD) Claim progressing to a Long-Term Disability (LTD) Claim, assigning the claim a score to indicate the likelihood. Flagging claims with a higher score allow the insurer to apply resources to these claims for additional investigation.
  • Prescriptive analytics not only tries to predict what will happen, but also tries to understand why it will happen, and presents different options on how to tackle a specific problem. Prescriptive analytics could be used to analyze historical claims and medical treatments to suggest the best actions to take on a particular claim diagnosis to get the claimant back to work faster.

Now, imagine you can combine the data your organization has collected, with the data from multiple insurers across the globe. This opens up a whole new world of opportunities; more data, more insights, more outputs and hence, better results!

What about ClaimVantage?

ClaimVantage has essentially built out the “Claim Cloud” on the platform, therefore it is our responsibility at ClaimVantage to build out powerful AI features to complement our “Claim Cloud” product. Unfortunately, there has been limited, if any, innovation in the life and health space from an AI perspective. A large part of this is the lack of structured datasets available in the public domain.

At ClaimVantage, we are working with our customers to continue to innovate in the insurance industry by building our own suite of Einstein Features powered by AI. Our beta version, which will be released by the end of this year will help insurers to:

  1. Predict Claim Longevity.
  2. Predict Claim Cost.
  3. Fraud Detection Score/Classification.
  4. Claim Activity analysis.
  5. Claim Complexity Scoring.

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