Custom Pay-As-You-Live Insurance Software

• Automated aggregation of PAYL insurance applications and customer documents (proofs of residence, proofs of employment, health statements, etc.) from client-facing apps, email, third-party insurance platforms, and more.
• Support for various document formats (PDF, XML, JPG, etc.).
• Geography-based KYC/AML verification for new clients.
• User-defined rules for application approval or rejection (e.g., rejecting applications with partially disclosed or undisclosed personal data).

Advanced:

• Automated extraction of data provided in PAYL insurance applications using image analysis technologies.
• ML-powered cross-referencing of applicant data with information from third-party sources (e.g., ID databases, employment databases, credit rating platforms) to prove its accuracy and completeness.
• Alerts to the responsible parties about missing and mismatched data.

• Aggregation and processing of risk-relevant customer data:
  • Health data: personal and family medical history.
  • Lifestyle: occupational hazards, habits (regular training, smoking, etc.), high-risk hobbies.
  • Environmental data: historical air and water quality at the insured’s residence.
• Rule-based policyholder risk scoring.
• Dynamic risk score recalculation as the new relevant data appears.

Advanced:

• Automated capture and processing of historical and real-time health risk data from insureds’ wearable devices:
  • Health data: heart rate, blood pressure, blood glucose, blood oxygen saturation, respiratory rate.
  • Daily activities: daily steps, calories burned, exercise intensity, sleep cycle, stress level.
  • Location: spotting the insureds’ visits abroad and to potentially hazardous regions.
• Fully automated review and summarization of customer risk documentation using large language models.
• AI-powered validation of risk data obtained from customers against data from third-party sources like medical records of partnering healthcare providers, EPA databases, and social media.

• Rule-based assignment of standardized health and lifestyle improvement objectives for healthy customers, for example:
  • Health check objectives: regular doctor appointments, taking the prescribed medicines, mandatory vaccinations.
  • Physical activity objectives: scheduled exercises, steps, calorie burn.
  • Diet objectives: daily calorie intake, target food nutrition values.
• Collaborative setup and updating of personalized health objectives for insurants with preexisting conditions (requires the involvement of healthcare professionals).

Advanced:

• Personalized objectives suggested by AI based on the analysis of a customer’s as-is health state, physical activity level, diet, budget, time constraints related to job and family duties, occupational hazards, services and amenities available at a customer’s location, etc.

• Periodic objective fulfillment checks using data from policyholder wellness apps or using reports from partnering healthcare providers.
• Scheduled reminders to customers about their life and health objectives.

Advanced:

• Monitoring the fulfillment of health and lifestyle objectives by a policyholder in real time via wearable devices.
• Automated recognition of high-risk life and health conditions like extreme blood pressure levels or recurring sleep disorders and notifications to the insurer.
• AI-powered recommendations to policyholders on the proper steps to mitigate health risks, e.g., adjust sleep schedule or visit a doctor (communicated via the connected insurance app and wearables).

• Custom rules for rewarding policyholders when preset life and health improvement goals are achieved:
  • Dynamically reducing premium amounts.
  • Applying premium discounts for the next periods.
  • Providing partial premium reimbursements.
  • Providing coupons or discount vouchers for health and well-being services.
• Configurable penalties for not fulfilling the objectives, e.g., applying higher premiums or removing previously granted discounts.

Advanced:

• AI-based suggestions on the optimal discount amounts based on the analysis of client profitability, engagement, and retention.

• Real-time recalculation of personalized insurance premiums based on the current policyholder risk score and goal achievement progress.
• Automatically applying personalized financial rewards and penalties to the baseline insurance price at the beginning of each billing cycle.
• Instant notifications to customers about premium changes.

Advanced:

• AI-powered suggestions on the optimal initial premium prices for various customers and customer segments based on historical demand, price elasticity, claim costs, customer risk levels, and product profitability.

• Calculating due payments for each policyholder based on the predefined sequence and summarization rules.
• Automated generation of recurring customer invoices, applying region-specific taxes, adding payment links and QR codes.
• Scheduled invoice submission to policyholders.
• Support for multiple payment methods: bank transfer, card, e-wallet, PayPal, crypto payments, etc.
• Real-time payment processing via connected payment gateways.
• Scheduled payment collection by direct debit.
• Real-time tracking of due and received payments.
• Configurable reminders to customers about due payments.

Advanced:

• Signing invoices using an e-signature.
• Support for multi-language and multi-currency invoices.

• Automated capture and processing of PAYL insurance claims and claim-supporting documents: claimant's statements, medical reports, accident reports, etc.
• Rule-based claim approval or rejection.
• Instantly communicating claim-related decisions to customers.
• Calculating due claim payment amounts.
• Claims triaging for payment based on urgency, severity, and compensation terms.
• Automated payment of approved claims.

Advanced:

• Processing real-time claim-relevant data from customer wearables.
• AI-supported claim validation and instant fraud detection.
• Machine learning models for remote health damage inspection (e.g., based on health diagnostic statements, medical images, medical device data) and loss estimation.

• Automated tracking of PAYL insurance metrics: premiums written, customer lifetime value, retention, and churn, claims volume and costs, and more.
• Customizable dashboards for various PAYL insurance roles: agents, actuaries, claim adjusters, analysts, etc.
• Automated reporting of the required PAYL insurance metrics to senior management and regulators (e.g., fraud reporting to NICB and NAIC).

Advanced:

• Predictive analytics to forecast PAYL insurance demand and financial performance.

• Customer self-registration, managing personal information.
• Two-factor authentication.
• Template-based creation of PAYL insurance applications.
• Monitoring life and health objectives, achievements, discounts, and coupons.
• Paying premiums by a preferred payment method.
• Filing claims and tracking claim resolution statuses.
• Instant messaging with insurer reps to handle complex cases.
• Consolidated and secure data storage enabling smooth policyholder health data portability between insurers

Advanced:

• Biometric authentication (e.g., facial or fingerprint recognition).
• AI-based virtual assistants to help customers get answers to simple inquiries.