AI and advanced analytics in long-term care: Implementing pre-claim interventions to increase value for policyholders and insurers

AI and advanced analytics in long-term care: Implementing pre-claim interventions to increase value for policyholders and insurers

Montoux recently collaborated with The Helper Bees on a webinar entitled ‘AI and advanced analytics in long-term care: Implementing pre-claim interventions to increase value for policyholders and insurers.’ The webinar addressed the benefits of offering pre-claim, tailored care options to long-term care (LTC) policyholders as well as how technical, digital, clinical, wellness and data-focused solutions can improve value for both policyholders and long-term care insurance (LTCI) carriers alike.

Speakers included:

  • Geoff Keast, CEO of Montoux
  • Char Hu, CEO at The Helper Bees


Key Insights from the webinar included:

  • Most seniors would prefer to age at home than to move into a long-term care facility, which benefits both policyholders and LTCI carriers. Improving pre-claim interventions can help make this a reality by decreasing the length of claim.
  • There are many diagnoses and triggering events that can indicate a policyholder is getting close to claim. Carriers that use data to successfully identify them can deliver more efficient claims care options, rather than the default option of care facilities, can improve policyholder value and reduce carrier costs.
  • The right data and analytical capabilities can help carriers better engage and understand their customers in a way that also deploys capital in a more efficient way.
  • Some methods of customer engagement include mailer campaigns, customer advocacy groups, and bulk mailings that lead to phone calls. The ultimate goal is providing customers with more information in a simple, digital way. 
  • Some examples of successful interventions include virtual physical therapy, hobby related virtual sessions, right size care (allowing care when customers need it), home modification, transportation, and meal delivery.
  • Key data LTCI carriers need to successfully predict claims include: claims data, policyholder data, actuarial data to better understand ROI and capital reserves, third party data.

“A constant pain point that we hear is, we can't get the data or we don't have enough data, to predict claims, however from our experience 9 times out of 10 the data is there it just might take some wrangling.” - Char Hu
“Carriers need to need to educate the models used to predict claims based on what has worked and what hasn't. This may seem like a daunting process, but the reality is carriers need to start somewhere and they need to start now. Solutions like decision science can help them do this” - Geoff Keast


For more information about Montoux’s decision science platform or about upcoming webinars, please reach out and follow Montoux on LinkedIn for announcements. 

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