Pacific Life Re introduces its Claims Rules Engine, powered by UnderwriteMe


December 17, 2018

Pacific Life Re introduces its Claims Rules Engine, powered by UnderwriteMe

Pacific Life Re first launched UnderwriteMe’s Underwriting Rules Engine (URE) to the Australian market in 2017. Now, at the end of 2018, the innovative platform has been implemented by five Australian insurers and one New Zealand insurer. Using the same industry-leading technology, Pacific Life Re has dedicated many person-years of claims and medical research, as well as development time to building a Claims Rules Engine (CRE) that will transform claims management for insurers, superannuation funds and distributors just as the URE has done for underwriting.

Pacific Life Re commissioned an external third party to complete their latest round of consumer testing for their CRE and the feedback was overwhelmingly positive for the outlook of the system.

Participants, some of which included past insurance claimants, completed and lodged complex Income Protection claims in an average of 10 minutes, and the system scored over 90% positive feedback for ease of use. Participants provided feedback that the system was simple to navigate and use and that the claim form is intelligent and intuitive. Insurer pilot testing is currently underway in Australia and to date over 95% of the recommendations are consistent with what an experienced claims assessor would have recommended. The other 5% only included minor differences in the evidence requested.

Pacific Life Re’s CRE will fully automate initial and ongoing assessments to support comprehensive straight through claims management capability. Importantly, an insurer will save approximately 1.5 to 2 hours of an assessor’s time in the initial assessment of a claim, by automating the data collection and administration processes. The technology provides consistent claims outcomes and is transparent for all parties, in the sense that there is a clear visual breakdown of how the rules are constructed and how they lead to a final decision. These are features that are essential in our current life insurance environment.

The journey for claimants using the CRE is seamless and straightforward, and reflexive rules collect the relevant information to make an informed return to work and rehabilitation recommendations. The CRE also includes business analytics that capture extensive data to cultivate an unrivalled information system that better understands trends in claims experience and how to best meet the needs of customers in their time of need. This can be used to facilitate the continual improvement of claims rules. A key feature that is unique to Pacific Life Re’s CRE is that it allows claims assessors to easily modify or change rules (within a controlled environment). Insurers are no longer constrained by relying on external IT development and can tailor bespoke claims journeys for their customers and funds.

Managing Director of Pacific Life Re Australia, Andrew Gill, said,

“We are proud to introduce our Claims Rules Engine to Australia, as the platform is like nothing else that is currently offered in the market. This is not just another online portal. Our CRE provides actual claims assessment decisions, delivering fast and consistent outcomes for customers. We are confident that our Claims Rules Engine will take the market by storm, just as our Underwriting Rules Engine has done using the same UnderwriteMe technology.”