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Aflac normally takes on promises worries to scale AI efforts


Mar 15, 2023
Aflac takes on claims challenges to scale AI efforts

This article is component of a VB special concern. Read the full collection right here: The quest for Nirvana: Making use of AI at scale.

For Aflac, which presents supplemental insurance policy to a lot more than 50 million persons around the world (and is perfectly-acknowledged for its duck mascot), providing AI at scale across the business has develop into a top priority because the pandemic.

Aflac has been forced to accelerate its digital transformation, like synthetic intelligence (AI), as the pandemic severely challenged the company’s conventional in-person, independent agent/franchise organization. The trick, however, has been deciding upon the finest AI use instances amongst competing priorities, states Shelia Anderson, who joined Aflac as CIO previous July. 

“We’re imagining about the organization problem and outcomes we’re seeking for,” she advised VentureBeat. 

When it arrives to AI and machine understanding, that incorporates concentrating on the all round viability and desirability of the company’s types, and inquiring questions these types of as: Is the product necessary by the organization? Is it resolving a precise enterprise need to have? Does the company have the technical answers it desires? How very long will it just take for the model to provide worth to the small business? 

A obvious option to automate statements

Aflac has extensive had a concentrate on major details. Currently, Aflac supports agents and brokers with AI and ML models that help in suggestive promoting, flagging at-chance accounts and identifying dormant accounts that are candidates for reactivation. 

But acquiring a resolution that could scale AI throughout the firm has been a significant precedence given that 2020, reported Anderson. Just very last year, the business rolled out what Anderson calls its initial substantial AI-driven platform that takes advantage of AI and ML to completely transform how Aflac procedures statements.

The platform consists of a set of styles experienced on small business policies customized to the company’s different merchandise strains. The aim is to automate routine processes, permitting the company to fork out claims more rapidly.

There are 3 principal factors to the platform:

  1. An AI-based doc digitization pipeline to automatically extract, classify, annotate and index evidence-of-loss paperwork
  2. Knowledge graphs to map extracted info from paperwork for a improved context of processed info.
  3. An conclude-to-stop, AI-primarily based statements processing workflow for adjudication throughout different lines of business enterprise, allowing for totally automatic or assisted, error-free of charge, human-in-the-loop processing.

“This aids our clients to be adjudicated a lot quicker and with extra accuracy,” Anderson claimed, pointing out that before the AI alternative was applied, about 46% of Aflac claims were not fully automated. 

Aflac has quite a few various assert sorts, she explained, but a single of the very first very clear alternatives to scale AI was all around the company’s wellness advantages. These are incorporated in most of its incident, medical center indemnity and most cancers insurance coverage procedures. Fundamentally, Aflac pays customers revenue for having yearly checkups and health care screenings this kind of as physicals, dental tests and eye checks. 

It turned out there was a superior volume of lessen-greenback payout promises necessitating time-consuming customer interactions. 

“For simple promises that really do not need proof of reduction, like wellness promises, we want to pay out speedily,” mentioned Anderson. This “allows our shopper care professionals to acquire treatment of our policyholders [who have] much more complex cases.”

Scaling the AI platform

Now, Aflac is doing the job to scale its statements automation system to other varieties of promises. 

“The advantages that the business scenario has confirmed are improved shopper relieve, minimizing our discomfort points by means of the journey, and expanding our touchless promises, which was a gain to our internal workforce as properly as our claimants,” Anderson mentioned. “Streamlining with a regulations-centered AI cuts down mistake charges and frees up our sources so they can target on more crucial claims exactly where individuals may perhaps truly will need to hear a voice on the other close of the phone, probably dealing with more serious health and fitness-similar troubles exactly where that personalized contact is desired.” 

Anderson said she believes Aflac has only just strike the “tip of the iceberg” when it will come to applying the system. She has options to grow the exact same functionality throughout the firm in 2023. That, she pointed out, is the value of getting a model that will work perfectly, one particular that solves a standard obstacle and can take benefit of an prospect in the marketplace.

“You can take that and stamp it throughout your other traces of company with a related difficulty,” she reported. “So we’re having this and increasing it in our accident and medical center traces of small business, and we’re also introducing other abilities in the future about cancer, dental and eyesight.”

In addition, she added, there is an opportunity to lengthen these AI capabilities outside of the promises process, to any use situation that desires to be automatic primarily based on prediction.

Aflac’s most important AI scaling worries

Apart from prioritization, one particular of the biggest troubles in scaling any AI hard work throughout Aflac is receiving participation from numerous organizational entities, Anderson explained.

“For case in point, our companion that runs the analytics aspect of our small business has a front-end crew,” she defined. “We have a again-finish knowledge staff and then we have small business teams that we work with as properly. So controlling and prioritizing throughout that ecosystem, whether it is AI or irrespective of whether it is an additional organization initiative, which is always likely to be something that is a obstacle for us.”

In addition, in a substantial-desire area like AI and device learning, attracting and retaining expertise with the proper talent established is a main obstacle. “It’s anything we all have to continue to be laser-targeted on,” she mentioned. 

Implementing AI to enhancing customer retention 

General, Aflac’s statements automation system has aided with consumer assistance and buyer retention, Anderson mentioned. 

It is about “how we expend the time that we require for those people optimum-precedence buyers and claims though automating many others,” she said. “I feel that client company is heading to be important in leveraging AI in the long term.” 

That reported, she extra that she thinks allowing for some AI capabilities to experienced has been an crucial component of Aflac’s journey — getting time to make positive it doesn’t get useless dangers with purchaser interactions. 

“If you want to be to start with to market with a thing, of course, which is just a chance you’re heading to have to take,” she claimed. “But for Aflac, I imagine that allowing for some of these capabilities to experienced was surely part of the journey.”

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