NewgenONE Platform for
Underwriting for Health Insurance
Empower your underwriters with an end-to-end automated process
Manually underwriting health insurance can be fraught with errors as underwriters need to analyze medical history, demographic profile, lifestyle, and other sources of information to determine the applicant’s risk. With an automated underwriting process, insurers can get a consolidated view of the application and the applicant’s health-related data, improve risk analysis, offer personalized and competitive rates, improve customer conversion, and increase internal efficiency. With Newgen’s underwriting solution, built on a configurable low code platform, insurers get the flexibility to meet regulatory requirements and quickly adapt to dynamic business needs.
Features of Underwriting Solution For Health Insurance
Omnichannel Request Initiation and Data Capture
Enable omnichannel case initiation and proposal registration via portal, mobile, and email. Initiate new business requirements via portal and easily capture all proposal data and member details. Provide customer-specific product recommendations for insurance solutions.
Core Underwriting Engine
Determine risk levels through underwriting rules management. Enable member-wise underwriting and business rules execution at the back end. Facilitate straight-through processing of low complexity submission with dynamic rules and automate key underwriting tasks.
Easy Configurability and Integration
The solution offers configurable user interface to define i-forms for handling different products and plans, such as floater plans, fixed health plans, etc. Seamlessly integrate with core system, third party administrators (TPA) for getting medical tests conducted, and legacy applications such as policy administration and CRM for data push.
Rule-based Case Routing & AI/ML-led Decisioning
Automatically assign cases based on the defined authority matrix, restrict access rights based on users, groups, etc., and enable ad-hoc referral of cases to multiple departments. Improve agility and accuracy in the decisions to identify defaulters with AI-based data models. Predict morbidity over a 15-year period using data from different sources by analyzing patterns.
Automated Checks and Validations
Conduct application screenings with KYC, AML, and Dedupe for customer verification and risk assessment. Utilize color-coded risk scoring to categorize different risks identified by the system. Gain access to comprehensive case details, preexisting medical conditions, and customer behavior to ensure informed decision-making. Perform quotation validations with the help of rules configured in the back end.
Extensive Underwriting Evaluation
Deliver counteroffers to members with revised policy rates. Automate policy evaluation to maximize the percentage of straight-through pass cases for quick policy issuance. Auto-classify non-straight-through cases and route to underwriters based on authority limit. Analyze medical test report data and execute business rules to identify the pass vs. fail cases. Easily raise member-specific medical and non-medical requirements by the customer. Leverage the MDM module to auto-populate exclusion details and capture member-level exclusions along with ICD code mapping, underwriting remarks, and additional clauses. Utilize sophisticated dashboards for in-depth data analysis and report generation and 360-degree visibility of the policy application to evaluate and reduce risk.
Brands using Newgen Platform
