Disruptive Impact of Big Data Analytics on Insurance- Capgemini Australia Point of View

The Disruptive Impact of Big Data and
Analytics in Insurance
the way we see it
Insurance

Dipak Sahoo is a Director and Industry Practice Leader for Insurance within
Capgemini’s Australia and NZ business. He is based in Capgemini’s Sydney office.
Prakash Kuttikatt is a Director within the Insights and Data practice of Capgemini.
He leads the Analytics and Business Intelligence competency in Australian and
New Zealand.
Ken Lee is an Associate Consultant in the BI & Analytics team within the Business
Information Management practice of Capgemini Australia. He has experience in
analytics and quantitative analysis spanning across insurance, financial services, and
market intelligence.
About the Authors
Dipak Sahoo is a Director and Industry Practice Leader for Insurance at Capgemini Australia.
He is based in Capgemini’s Sydney office.
Prakash Kuttikatt is a Director within the Insights and Data practice of Capgemini Australia. He
leads the Analytics and Business Intelligence competency in Australia and New Zealand.
Ken Lee is a Consultant within the Insights and Data Practice of Capgemini Australia. He has
experience in Analytics and Quantitative Analysis spanning across Insurance, Financial Markets
and Market Intelligence.
About the Authors
https://au.linkedin.com/in/dipaksahoo @sahoodk
@PrakashKuttikat
@leekenyul
https://au.linkedin.com/in/prakashkuttikatt
https://au.linkedin.com/pub/ken-yul-lee/40/1b6/757
2 The Disruptive Impact of Big Data and Analytics in Insurance

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Table of Contents
Executive Summary 5
The Big Impact 7
The Australian Insurance Landscape 6
The Early Movers 13
Progressing with a Big Data Initiative 16
References 19
3
the way we see it
Insurance

Organisations
that have a sound data
and analytics strategy, a
talented workforce and a culture
of operational excellence will be well
positioned to quickly and effectively
monetise the plethora of opportunities
made possible by the advent of digital
disruption. We believe the ability to
leverage Big Data and Analytics
intelligently in the Insurance space
will determine the winners
and losers of the future.
This fundamental shift in the business
environment is driven by data in terms
of how it is collected, analysed and
consumed to transform the current
operating model.
The innovative use of Big Data and
Advanced Analytics has completely
changed the perception and definition
of insurance for the customer, as
demonstrated by a number of case
studies. We expect this trend to
continue far into the future.
The continuous development of natural
language processing and machine
learning algorithms will enable insurers
to mine insights about risk and
behaviour from almost any source of
information and to extract the hidden
associations within. The differentiating
factor will be the ability to strategically
discern the insightful information from
the growing volume of noise.
Digital disruption and data-driven
decisions are becoming increasingly
important in the Insurance space as
traditional sources of growth no longer
provide a sustainable competitive
advantage. With 78% of executives in
the 2015 World Insurance Report citing
Big Data Analytics as a key disruptive
force, the Insurance industry needs to
shift the paradigm and be proactive in
their business approach towards their
customers.
The information asymmetry between
customer and insurer is rapidly closing
and the focus needs to be on assisting,
enabling and engaging the customer
through their insurance journey.
Customer intimacy and the ability to
analyse and correctly meet the needs
of their clients at important life events
will differentiate the market leaders from
those who will quickly become irrelevant.
Executive Summary
A clear focus on an Insights and Data
strategy as well as a willingness to take
risk and learn from past mistakes is
necessary for progress. A data driven
culture that rewards collaboration and
innovation must be infused across the
entire organisation with relevant talent
acquisition and retention as key areas of
interest in the coming years.
5
the way we see it
Insurance the way we see it

Australians use an
average of 3.1 devices
each – this is one of
the highest rates in the
world.”
— Google Consumer
Barometer, 2014
• Increasing number and sophistication
of fraudulent claims
• Technologically driven disrupters
entering the market
Within this set of issues lie key
propositions for Big Data and Analytics
to unlock previously inaccessible value
opportunities and to reduce complexity
for the consumer.
Australia, a high wealth nation with one
of the highest standards of living in the
world, is embracing digitisation.
With one of the highest uptake rates of
digital devices in the world, Australian
consumers are becoming informed
faster than ever before. Insurers, who
by nature use data in order to facilitate
the transfer of risk, need to use this
information intelligently in order to
achieve sustainable growth.
Disintermediation of distribution
mechanisms and the availability of risk
data enabled by a strong adoption of
digital technology in Australia will be of
The Australian Insurance
Landscape
The Context, Challenges
and Opportunities
The Australian insurance industry is
experiencing shifts in a variety of factors
that will make their pursuit to provide
innovative products and sustainable
returns to their shareholders a significant
challenge in the near future. Some of
these influences include:
• The aftermath of the global financial
crisis and the associated surge in
regulation and capital adequacy in
Australia and worldwide
• Prolonged low-return and low
interest rate environment in world
capital markets
• Adverse natural hazard experience
• Increasing life expectancy and ageing
population structure
• The expansion of digital distribution
and the beginnings of the
connected world
key importance in the years to come as
the insurance operating model evolves
and adapts to deal with new players and
forces in the market.
Big Data and Analytics will play an
integral role in how the Australian
Insurance sector supports customers
facing challenges such as an ageing
population, large spectrum of natural
hazards and one of the highest costs of
living in the world.

There were five
exabytes of information
created between the
dawn of civilization
through 2003, but that
much information is
now created every two
days.”
— Eric Schmidt, Google CEO
increasingly important in an environment
where traditional growth levers are
experiencing diminishing gains.
We will explore several opportunities
arising from current trends of
technological advancement and how
they impact on the insurance sector.
Transforming the Value
Chain with the Disruptive
Use of Insights and Data
There are a few key areas of the value
chain where data and advanced
analytics can make a big impact.
In the past, insurers relied on historical
information and specific limited
sources of external data. This is rapidly
changing with the proliferation of
new data sources, for example social
media, wearables, connected devices,
government information, corporate data
and weather recordings, along with the
ability to quickly analyse vast volumes
of data.
The effective combination of these
data sources overlayed with powerful
models has the potential to provide
more pricing choices based on a deeper
understanding of risks, implications
and associations.
A variation of the same principle is the
use of real-time collection and analysis
of data. Telematics is a good example
of innovation in this space. Telematics
allows insurers to access real-time
information about driver behaviour. This
information enables insurers to provide,
manage and price risk more accurately
and efficiently. Furthermore, there are
indications that such tools also improve
driver behaviour. Widespead adoption
could potentially reduce the incidence of
accidents on the roads.
We are converging on a world where
everyone and everything is increasingly
interconnected – a world where data
can be accessed by anyone, anywhere
at any time. This is putting pressure on
insurance organisations to go beyond
the use of internal data to tap into
new, rich and dynamic data sources
in order to better understand risks and
strengthen customer relationships.
Insurance, traditionally a reactive
industry that relies primarily on internal
data, must take a proactive role to
predict rather than react to events.
They must follow their customers
in leveraging the availability of rich
data sources to provide on-demand
business insights.
They need to ask the right business
questions, identify key value levers and
understand how Big Data and Analytical
techniques will enable them to drive
innovative, better informed and faster
decision making.
This approach requires that both
business units and supporting functions
share a common vision and begin
their transformational journey towards
evidence-based decision making and a
data-driven culture.
Insurers should break down information
silos and expertise to instil a culture
in which the use of data is everyone’s
responsibility. This is essential to the
survival and identity of insurance in the
future.
Insights and Data, if implemented with
the correct strategy and vision, has the
potential to transform the insurance
value chain into a cycle that evolves over
time, delivering increased value and
improved insights with each iteration.
The development of machine-
learning and artificial intelligence is
expanding the ability of computers to
perform non-procedural tasks. This is
A New Era in Perspective
Historically the insurance industry has
relied on data and analysis to drive
their core business; however, what
is occurring today is unprecedented.
Data volumes are growing rapidly
and the nature of data is constantly
changing. New technologies such as
the Hadoop Distributed File System
(HDFS) have made it possible to store
the ever increasing volumes of data in a
cost-effective manner.
According to Gartner, Big Data is “high-
volume, high-velocity, and high-variety
information assets that demand cost-
effective, innovative forms of information
processing for enhanced insight and
decision making”.
Big Data is commonly broken into
structured and unstructured forms:
• Structured data is commonly used
by most businesses today and
includes data that can be easily
organised, such as transactional and
demographic information
• Unstructured data, which is growing
at an unprecedented rate, is
information that is not organised in
a predefined manner and includes
sources such as speech, video, social
media, text messages and email
The Big Impact
7
the way we see it

1 Dialysis Like Therapeutics, Defence Advanced Research Projects Agency (DARPA)
In the future, we believe that the
‘smart and effective’ sourcing of
data and analytics will be a key
differentiating factor that will define
leading organisations.
Sensors and Connected Devices
Sensor technology is rapidly advancing
in the area of medical research. DARPA,
the Defence Advanced Research
Projects Agency in the United States, is
currently developing an in-bloodstream
sensor prototype for the Dialysis Like
Therapeutics (DLT) project. DLT uses
a combination of advanced integrated
technologies that allow the device to
sense pathogens and toxins in the
bloodstream, diagnose the condition,
provide the appropriate treatment and
monitor the status of the patient.1
This data could be stored and analysed
in the cloud to provide a variety of
services such as:
• Remote diagnosis and
targeted therapy
• Predictive medication, based on
analysis of predisposition
• Remote patient monitoring and
contracting to local, relevant services
• Personalised insurance based on
the risk profile and physiological
data generated by the DLT
In-bloodstream sensors
• Lifestyle management
and improvement
The use of this technology with the
collaboration of medical professionals
and institutions means that patients
could receive optimal treatment based
on the condition and patient physiology
data, thereby reducing risk and
minimising mortality.
Access to this type of data can uncover
new revenue opportunities for insurers
and at the same time provide targeted
policies to help policyholders at different
points in their life journey. These
targeted policies could help to reduce
the rapidly rising cost of healthcare,
making it more affordable.
Wearable devices provide another
potential source of data inputs for
insurers. Clothing retailer Ralph Lauren
is due to launch a Polo Tech shirt that
can track and stream real-time biometric
information to your mobile device.
Building on successful concepts already
present in the market, such as ‘Fitbit’
and ‘Jawbone’, the Polo Tech shirt takes
this technology to the next level.
Connected devices are another
transformational development that
will have a pronounced impact on the
insurance sector. Nest Labs, recently
acquired by Google, offers a range
of vital home systems that possess
self-learning capability to offer a more
intelligent home device experience. We
expect to see more products that will
effectively monitor, manage and even
protect the home through a remote
interface in the near future.
Sales, Marketing
and Distribution
Distribution, Management
and Optimisation
The rise of the digital experience and
the exponential growth of the IoT are
likely to provide a range of opportunities
to simplify the insurance distribution
vector. Disintermediation through the
digital realm looks more likely with every
passing day.
With more and more information
available online every day, policyholders
will no longer be bound to the direct
advisor relationship due to the
breakdown of information asymmetry.
The internet allows consumers to do
their research online and compare
policies by key criteria which includes
price, policy features and customer
ratings to make a decision on the
product ideally suited for their set
of circumstances.
Direct sales, although growing steadily
for so long, has been strongly correlated
with policy churn and lapse. The
potential for an effective direct channel
between policyholder and insurer
provides an attractive opportunity for
insurers to address structural concerns
linked to sales incentive structures in an
effective manner.
This disintermediation may take the
form of a seamless experience. With
our reliance on smart devices and
the growing market for connected
devices, it is conceivable that in the
future state of the connected world our
everyday devices will have the ability
to communicate within a closed and
personal network.
In this world, the seamless customer
experience might look something
like this: A consumer is at home,
researching a new insurance product
that has just been released. Upon
leaving home for work, the information
about the product they had been
researching appears on their mobile
phone summerised in a concise manner
with text or voice prompts to aid
investigation and to push the optimal
product for that individual.

Underwriting and
Policy Management
The Segment of One and
Individual Risk Assessment
The ability to understand and assess risk
accurately is a primary focus for insurers,
and comprehensively understanding
and interpreting macro and micro level
trends gives organisations a significant
competitive advantage.
Today data can be collected from
anyone, anywhere and at anytime. This
presents a new and extensive set of
analysis points the insurer can use
to more accurately profile the risk of
its customers. This has the flow on
effect of enabling the insurer to have a
heightened appreciation of the customer
demand curve, enabling insurers to
clearly differentiate insurance offerings
through optimal product composition
and customer experience.
Traditionally, insurers use demographic
information, industry data and
retrospective claims experience to
construct models to predict future
liabilities. While this approach is
somewhat accurate, the method of
pooling policyholders in actuarial
categories in order to estimate the
overall experience for a population is
utilised due to insufficient data, tools and
technologies to collect and disseminate
information at an individual level.
With emerging methods, tools and
techniques that can store, manage,
process and analyse data more
efficiently and effectively than ever
before, the ability to harness and distill
these reservoirs of information means
that organisations can fully understand
the risk an individual represents to their
business in real-time.
Insurers will also have access to
new information such as political
risk, terrorism, cybercrime and geo-
localisation which can then be used
to provide dynamic pricing in real-time
that adjusts to environmental and
individual parameters.
The discovery of new information
perspectives and improved explanatory
factors will help to improve the insurer’s
ability to accurately reserve for future
expected claims and more accurately
underwrite low probability and high
impact events, such as floods and
earthquakes.
This information will also allow for the
provision of insurance for previously
uninsurable risks. It will assist in
establishing more powerful internal
controls and hypothetical analyses
to approach improved legislative
compliance and solvency by being able
to take a myriad of macro and micro
level data factors into account.
The development of technologies, such
as Telematics, integrated sensors
and wearable devices will further
contribute to the volume and variety
of data that is waiting to be harnessed.
Properly managing and using this
information is an essential step to allow
for the accurate transfer of risk from
policyholder to insurer.
Claims Process
Improvement and
Fraud Detection
Insights and data can help insurers
improve their claims process and fraud
detection capability to achieve a number
of benefits for their organisation and for
their clients.
The rapid development of the analytical
capability of natural language algorithms
and machine learning techniques means
that it will soon be possible to automate
low-skill and highly repetitive tasks, for
example approving settlement of low
value claims, verification of customer
identity and data entry. These sorting
and analysis algorithms can also be
used in initial assessment engines to
determine prior likelihood of the claim
being fraudulent, invalid or valid.
The capability of machine learning
based algorithms to accurately sort
documentation, mine internal and
external data for patterns and extract
missing data continues to develop. We
foresee the accuracy of such techniques
exceeding that of human capability in
the near future.
Claims with low likelihood of fraud
and no critical flagging would be
automatically processed to achieve
faster time to settlement. This Straight
Through Processing (STP) of the majority
of low fraud risk claims would give claim
managers and analysts more time to
focus on the areas which require a
high degree of expertise and human
judgement. Flagged claims would be
diverted to case investigation specialists.
As fraud techniques become more
people-centric, insurers will be able
to analyse behaviour across multiple
claims, understand associated social
networks and their behaviour and study
fraud clusters that could also identify
rogue service providers. We expect
some of the biggest early gains to come
from more effective fraud management.
9
the way we see it

Case investigators could be aided by the
use of interactive virtual environments
to explore and discover nuances
present within the data, further enriched
by embedded analytical processes.
Virtual interaction with that data in an
investigative environment would facilitate
faster discovery of trends, patterns of
behaviour and root causes, thereby
allowing case investigators to obtain a
complete view of the claim event.
There are a number of ways the use
of data and analytics can improve the
claim procedures and fraud detection
capabilities of insurance organisations.
Benefits to insurance organisations
through use of data for fraud detection
and claims process improvement
include:
• Significant increases in claim process
efficiency and reduction of labour
costs concerning low-skill processes
Analytics Enabled Straight Through Processing
Lodge Score Investigate Settle
Claim is lodged by
policyholder
Predictive Model
scores claim based
on fraud likelihood
Flagged claims are
investigated throughly by
case investigators using
data driven assistive
analytics
Claims are rejected or
settled depending on the
decision made
Figure 1: An example of a streamlined STP Process: Capgemini Analysis
• Significant gains in productivity -
automation of low-skill and highly
repetitive tasks mean that employees
can focus on more complex cases
• Savings from improved fraud
detection and prevention
• An enhanced customer experience
with a simpler and faster
claims process

Customer Engagement
Perfect Customer Profiling
Insurance organisations have been
progressively moving away from
a policy-centric approach to a
customer-centric focus. While this
shift to a customer-centric approach is
recognised as a necessity for insurance
organisations in today’s competitive
market, many insurance systems today
still remain largely policy-centric.
Big data provides an increased pool
of sources, for example data from
on-boarding form and medical reports,
to provide the organisation with a
deeper and more customer centric view.
These sources could be further enriched
by sales and customer care call logs,
which although unstructured in nature,
could provide a wealth of untapped
information. The aggregation of these
sources with channels such as social
media, web traffic and browsing history
will enable insurers to gain a complete
view of the customer.
The ability to extract and analyse
different data sources, for example
geospatial data which includes weather
information, will provide opportunities
for insurers to move towards a proactive
advisory role to their clients while
allowing them to more effectively
manage risk.
These new customer engagement
opportunities will assist to broaden
and develop the relationship with
the customer.
New innovation in analytical
technologies and techniques have
unlocked a variety of opportunities.
Many cross-sell recommendations
will become immediate and highly
contextual through real-time access of
large volumes of information to make
better decisions faster. Real-time
predictive models will prompt call-
centre operators with the right scripts
to engage with the customer. Access
to social information will provide more
insight and context in order for client
facing staff to better understand
customer preferences.
Potential access to information on
connected devices will further deepen
knowledge about the customer and also
enable insurers to broaden their portfolio
offerings beyond traditional insurance
products.
The use of data and analytics for perfect
customer profiling will be vital in the
future and will give your organisation
a real competitive advantage.
Organisations will differentiate
themselves by the degree of knowledge
of, and intimacy with, their customers.
Insurers must make a rapid transition or
risk being left behind.
11
the way we see it

Usage-Based
Insurance is predicted
to be worth €50 Billion
by 2020.”
— PTOLEMUS Consulting
Group, 2013
African insurer UAP has also harnessed
data and analytics to provide micro-
insurance to farmers, allowing them to
affordably transfer the risk of adverse
weather. Based on weather trends
over the past 30 years, settlement is
automatic for conditions that exceed the
predetermined average for the region
over a fixed period of time.
Telematics for Car Insurance
Telematics, a wireless technology
pioneered by the General Insurer
Progressive in early 2002, accurately
captures and records measures of driver
behaviour, such as average speed and
braking force, in near real-time. It is a
small plug-and-play device that can be
easily installed in newer vehicles and
gives insurers a granular view of the
behaviour of individual drivers.
Premium discounts are offered to safer
drivers who are assessed on driving
behaviour captured via the Snapshot
Telematics device. Known as
Usage-Based Insurance it contrasts
heavily to No Claim Discount (NCD)
and population based premium
pricing models used by the majority of
automotive insurers.
Progressive have also developed a
feedback portal which allows customers
to view their own driving behaviour and
provide suggestions to improve their
driver rating and reduce their premium.
Global adoption of this technology has
been increasing, with over 70 suppliers
currently offering a similar product to the
Progressive Snapshot. Although market
penetration remains low at this point in
time, with the improved awareness of
such devices and reduction in cost of
technology, Usage-Based Insurance
is predicted to grow market share to
approximately €50 Billion by 2020.4
Product Development
Analytics for Agricultural
Insurance
Climate Corporation, acquired by
agricultural giant Monsanto in 2013,
provides crop insurance for farmers in
the United States. They use weather
data, such as temperature and rainfall,
as the basis for the policy and provide
quantitatively driven insurance. Policy
holders do not need to file a claim;
rather claims are processed and paid
automatically based on the threshold of
measurement and the specifications of
the policy.2
This has provided opportunities for
agriculturalists to invest in high risk and
specialty crops which are not covered
under the Federal Crop Insurance
Program in the US.
Another pioneer in the same field is
Farmers Edge Laboratories, which is
an agricultural analytics firm based in
Canada. They use computer-based
models to analyse satellite, weather
and agricultural data to help farmers
understand and predict future trends.
Some current product offerings include
crop yield analysis, irrigation optimisation
and diagnostics for agricultural
equipment.3
By using analytics as a primary
differentiator, both Farmers Edge and
Climate Corporation have effectively
demonstrated their presence as
technologically enabled disrupters in
the insurance market. They not only
improve coverage to agriculturalists, for
example by providing insurance options
for speciality crops not covered under the
US Federal Crop Insurance Program, but
they also showcase the potential of Data
and Insights to unlock value in the offering
of previously unquantifiable risks.
Early innovators who have leveraged
data and analytics have achieved
substantial value benefits. While
market penetration for solutions
such as Progressive’s Telematics are
still relatively low, the simpler data-
driven nature of the product allows for
considerable competitive advantage that
will only increase as costs of living and
demand for goods continues to rise.
Pioneers within the Insights and Data
space have, in most cases, utilised
a targeted approach with a focus
on segments of the value chain that
already have considerable data analytics
maturity or that offer significantly shorter
time-to-value.
We will explore how some of these
innovators have begun to develop the
analytical foundation that will shape
the Big Data driven transformation in
insurance across various segments of
the value chain.
The insurance sector has been lagging
behind in the adoption of data and
analytics. However, a few early adopters
have already achieved considerable
competitive advantage through
implementation of such strategies
and technology.
The Early Movers
2 Vance A, “Monsanto Billion Dollar Bet Brings Big Data to the Farm”, Bloomberg Business Week, 2 October 2013
3 Hay, T “Farmer’s Edge Bringing Big Data to Farms with Kleiner Perkins Investment” Venturewire (Dow Jones & Company Inc.), 10 November 2014
4 Ref: PTOLEMUS Consulting Group, “Usage-Based Insurance, Global Study”, 2013 Edition
13
the way we see it

TAL Life Australia
realized a 30% increase
in new business within
the first year, reduction
of NTUs by 25% and
unit cost reductions of
40% through the use of
Big Data.”
— Munich RE, 2012
Sales, Marketing
and Distribution
Managing Direct
Distribution Channels
Several insurers have taken the lead
in distribution management by using
predictive analytics to source, select and
retain the best sales agents.
By tracking sales performance against
metrics such as early customer-lapse
rates, average policy size and disclosure
rates, they can understand and design
commission structures that align the
interests of the insurer with those of
the distributor.
Sales-support tools are also a major
area of development. MassMutual
financial group provide their sales team
with a mobile application that highlights
customers with the highest propensity to
convert to another insurer. The ability to
identify these customers has improved
placement rates by 5 percent in 18
months.5
Another leader in this space is ICICI
Prudential Life Insurance. Through their
tablet-based application, NEO, they are
able to recommend the optimal product
mix based on a detailed life-goal analysis
of their customers, and provide a digital
upload of policy documents for selected
sales advisers.6
Underwriting and
Policy Management
Automated Underwriting
The benefit of data and analytics for
underwriting and policy managment is
best explained through a case study.
TAL Life Limited in Australia was
experiencing constant not-taken-up
rates (NTUs) and losses in sales due to
5 Bringing Big Data to Life: Four Opportunities for Insurers, BCG, 2014
6 Capgemini Analysis, 2014
7 TAL Life boosts revenue, strips internal costs, and serves advisors and customers with amazing speed, Munich RE, 2012
uncompetitive underwriting. Customer
experience was inconsistent with their
coverage expectations and they were
dissatisfied with the entire process.
In order to improve the underwriting
process, TAL Life Limited implemented
a powerful classification engine that
not only delivers significantly faster time
to settlement but can be dynamically
altered to capture new trends in
the market.
Their direct adviser channel, which
drives approximately one third of
revenue, experienced improvements
in productivity due to the use of the
automated underwriting system and
mobile applications that enabled
advisers to close sales on the spot. For
example, one direct adviser was able
to insure a mining electrician within
53 minutes, representing a significant
efficiency improvement.
TAL Life Limited provides an example
of how insurers can use data and
analytics to realise significant business
benefits. For TAL Life Limited, these
benefits included a 30 percent increase
in new business within the first year, a
25 percent reduction in NTUs and 40
percent of unit cost reductions in their
business operations, resourcing and
underwriting segments.7
Satellite enabled flood prediction
The Fully Automated Aqua Processing
Service (FAAPS) utilises the European
Space Agency (ESA) ASAR Satellite
to generate accurate and large scale
flood mapping capability. Developed
by Capgemini in partnership with the
European Space Agency it aims to
support Austrian disaster management
authorities in providing pre-emptive
assessment of flooding risk as well
as impact assessment after a severe
flood event.
This is done in near real-time (NRT)
and provides a significant advantage
over current ground and aircraft based
methods due to the fact that it can
operate in all weather conditions. The
European Space Agency plans to make
this satellite flood data freely available.
This technology will give insurers the
opportunity to provide improved and
NRT risk assessment of coverage areas
and allow for quantitative measurement
of flood impact over large areas in order
to establish settlement suitability.
Claims and Benefits
Management
Analytics Transformation
in Health Insurance
Blue Cross and Blue Shield of North
Carolina (BCBSNC) is a health insurer
connected to 99 percent of state
hospitals and covering approximately 3.6
million consumers. Using data collected
from all around the State of Carolina they
analyse patterns between providers to
look for trends in provider practices, for
example, by location and demographic.

By implementing
advanced fraud analytics
Allianz in the Czech
Republic managed to
identify an additional
426 cases worth over
CZK 10 million in the
first year.”
— SAS
Providers are then indexed against
state and national averages in order to
determine a ranking of most effective
healthcare providers. They are then able
to refer or affiliate their policyholders
to the top rated and most efficient
practitioners.
Healthcare providers themselves have
welcomed the new approach and have
utilised the information provided by
BCBSNC to accelerate improvements
in practice efficiency and quality, in line
with the pressures instigated by health
care reforms.8
Analytics for Fraud Detection
Allianz Insurance in the Czech Republic
is using SAS Analytics to identify and
prosecute cases of insurance fraud.
The use of statistical models to assign
a likelihood rating to each case means
that investigators can focus their efforts
on claims with the highest probability
of being fraudulent. Network and
associative analysis is also being used
to provide a visual representation of
potential links between fraudulent activity
and potential collaboration points.
Within the first six months of
implementation Allianz managed to
identify 1,161 insurance fraud cases
worth more than CZK 62 million
(AUD$3.25 million), a vast improvement
from the 426 cases worth CZK 10
million (AUD$0.5 million) that had been
identified over the previous year.
Other benefits included the ability to
investigate 26 percent more cases, the
submission of 40 percent more proven
fraud cases for criminal prosecution and
savings of approximately CZK 110 million
(AUD$5.78 million) per year due to the
reduction in fraudulent claims paid.9
8 Analytics Drives Cost, Quality Improvements for NC Insurance Provider, SAS
9 Where Human Capabilities Fail, SAS,
Customer Engagement
Customer Centricity
In the customer engagement space
the insurer MetLife has reinvented the
customer experience with a display that
allows employees to plot vast amounts
of data and information on an interactive
platform.
The MetLife Wall integrates information
from 70 legacy administrative systems
into one platform to provide an overall
map of interactions with each customer
at each state and touch point of their
journey with MetLife.
The ability to see the big picture and
interact with all this information has
driven better call centre experiences for
customers. Customer representatives
are able to quickly and efficiently answer
questions, manage claims and offer
relevant services or promotions with
reduced call and wait times.
The Way Forward
The opportunities that data and
analytics holds for the insurance industry
cannot be ignored. Institutions must
seek to develop a vision, capability and
instil a data-driven culture within their
organisation.
Insurance organisations must focus
on Insights and Data and how this
information can be gathered and
analysed to:
• Understand and price risk more
accurately and equitably
• Manage distribution channels and
study behaviour patterns of the
impact of direct sales on lapse, churn
and retention rates
• Optimise the claims process and
improve the accuracy of fraudulent
claims detection
• Develop a meaningful and positive
relationship with the customer to
maximise cross-sell opportunities and
retention rates
Development and retention of talent
will be a key differentiator in this space,
as the data scientist - with business
acumen, statistical expertise and a
thorough knowledge of computer
programming languages - is in high
demand and is hard to find.
The right employees will assist across
the insurance value chain in every
function to create opportunities and
develop analytical maturity to propel
the organisation forward and provide
a platform for sustainable growth. This
expertise must be found, nurtured and
given opportunity to flourish.
15
the way we see it

As a major provider of strategy and solutions in the Insights and Data space, we commonly hear clients ask “how do we set up an
Insights and Data initiative?” There is no silver bullet; however we can recommend the following steps based on our experience and
success in this field.
Progressing with an
Insights and Data Initiative
Establish key business
drivers and scenarios
Determine the required data Agree on the technology
Establishing the key business
drivers and scenarios is the first,
and arguably the most important,
step in the journey. Areas that
could generate immediate benefits
include revenue increases,
reduction in fraud costs and
improved retention of customers.
This process should involve the
business unit leaders and it is
essential to identify a committed
sponsor, key stakeholders and the
working team for the initiative.
It will also be of value to produce
an initial straw man of an Insights
and Data road map to identify
possible value opportunities over a
period of time. Ideally at the end of
this phase there will be a prioritised
list of business scenarios that
will be addressed as part of the
initiative.
There are a wide variety of
valuable data sources that
could be employed to solve the
prioritised business scenarios.
This data must be identified and
sourced based on collective
business knowledge.
It is essential to consider all
possible data points that could
add value to the particular
scenario, remembering that
external and unconventional
information may also provide
significant value opportunities for
the organisation.
The next step is to select the
right technology. The situation will
govern whether to leverage internal
technology resources or seek
specialised assistance from an
external party. There are a myriad
of options and the final choice will
depend heavily on technology,
business strategy, current industry
landscape and skills.
There are many innovations
to choose from in today’s
marketplace. Technologies such
as In-Memory Computing and
Massively Parallel Processing
(MPP) make it possible to run
large complex algorithms across
very large data sets in real-time.
The Hadoop Distributed File
System (HDFS) enables storage
of large volumes of unstructured
and structured data at a very low
cost. These new technologies,
combined with analytical software
products from vendors such as
IBM, SAS and their open-source
competitors Python and R, have
drastically increased the ability of
insurers to predict outcomes in
real or near real-time.
Key benefits of these new
technology options are:
• Ability to handle data of any
structure
• Easy to scale
• Fast processing speed
• Optimal cost
1
2
3
5
4
Establish
key business
drivers and
scenarios
Determine
the required
data
Agree on
the
technology
Adoption
and
growth
Piloting
and
implementation

Some evolving trends that we have identified include:
• Government regulators will be reactive as technological change outpaces regulatory policy and processes
• Customers still place a high degree of trust in organisations so long as they ensure transparency about the use of
personal information
• Increased regulation on the use of personal data and new privacy laws means that customer permission will be required for
use of their personal data
• Customers are seeking something in exchange for the information they share about themselves
The New Era of Privacy
and Regulation
Personal data has often been described
as the oil of the internet. The vast
amounts of personal data collected by
sensors and connected devices bring
with it new issues regarding ownership
and effective regulation to ensure
prudent use of personal information.
With the increasing prevalence of
smart devices and the Internet of
Things (IoT), the granular details of an
individual’s lifestyle is projected into
the public sphere. It becomes easier
for organisations to access information
about driving behaviour and fitness
preferences, right down to how much
time is spent around the dinner table.
Wireless pacemakers also transmit the
personal data of millions of people who
use them daily. Most consumers are
probably unaware that the data from
their new Tesla car is sent directly to
the manufacturer, or that information
collected from wearable devices such
as Fitbit and Google Glass is also sent
to the product manufacturer.
The question becomes who owns
this information, how security can be
ensured and what regulatory processes
are in place to ensure an equitable
outcome.
Piloting and implementation Adoption and growth
It is important to strike a balance
between ease of use and
business value when choosing a
pilot project. Clear expectations
must be set in terms of the
iterative nature of the work. In its
execution, the pilot should to be
a collaborative initiative between
the business, technology and
analytics stakeholders.
Once a few of the pilot cases have
been accepted as successful
outcomes, they can be integrated
as business–as-usual (BAU)
processes. For example, if it is a
predictive churn model, it needs
to be embedded in the retention
management program. Likewise,
if it deals with claims modelling, it
needs to be integrated with claims
related processes.
Communication and broader
engagement is vital for the
ongoing adoption and growth of
the business. It will be of value to
identify departmental champions,
who can identify new value driven
opportunities by leveraging the
wealth of information that exists
in the organisation. The role of
the sponsor plays a critical part
in ensuring wider organisational
adoption. This is a good point in
time to re-evaluate the original
concept and begin to build a long
term Insights and Data strategy.
Finding and growing the right
skills continues to present a
challenge. As part of their strategy,
it makes sense for organisations
to consider the right mix of internal
and external sourcing. Acquiring
the required skills from an external
source for an initial phase in many
cases assists in accelerating the
growth progress. This approach
also enables insurers to continue
to bring the latest thinking and
skills into their organisation.
17
the way we see it

References
1. World Insurance Report 2014, Capgemini and Efma, 2014
2. Bring Big Data to Life: Four Opportunities for Insurers, Boston
Consulting Group, 2014, <https://www.bcgperspectives.com/content/
articles/insurance_digital_economy_Bringing_big_data_life/>
3. Usage-Based Insurance Global Study, PTOLEMUS Consulting Group,
2013 Edition <http://www.ptolemus.com/ubi-study/>
4. Dialysis Like Therapeutics, Defence Advanced Rese arch Projects Agency
(DARPA), <http://www.darpa.mil/Our_Work/BTO/Programs/DialysisLikeThera
peutics%28DLT%29.aspx>
5. Clarke, R and Libarikian, A “Unleashing the Value of Advanced
Analytics in Insurance”, McKinsey & Company, Insights & Publications,
August 2014, <http://www.mckinsey.com/insights/financial_services/
unleashing_the_value_of_advanced_analytics_in_insurance>
6. Analytics drives cost, quality improvements for NC insurance provider,
SAS, <http://www.sas.com/en_us/customers/bluecross-blueshield-nc-
analytics.html>
7. Vance, A “Monsanto Billion Dollar Bet Brings Big Data to the Farm”
Bloomberg Business Week, 2 October 2013, <http://www.bloomberg.com/
bw/articles/2013-10-02/monsanto-buys-climate-corporation-for-930-million-
bringing-big-data-to-the-farm>
8. Hay, T “Farmer’s Edge Bringing Big Data to Farms With Kleiner Perkins
Investment” Venturewire (Dow Jones & Company, Inc.), 10 November 2014,
<http://pevc.dowjones.com/Article?an=DJFVW00120141110eabaaxojy&cid=
32135029&ctype=ts&ReturnUrl=https%3a%2f%2fptop.only.wip.la%3a443%2fhttp%2fpevc.dowjones.com%2fAr
ticle%3fan%3dDJFVW00120141110eabaaxojy%26cid%3d32135029%26cty
pe%3dts>
9. TAL Life boosts revenue, strips internal costs, and serves advisers and
customers with amazing speed, Munich RE, 2012 <http://www.munichre.
com/site/mruk-allfinanz/get/documents_E-136648740/mruk/assets.
uk.allfinanz/Documents/Publications/TAL-Case-Study.pdf>
10. Analytics drives cost, quality improvements for NC insurance provider,
SAS, <http://www.sas.com/en_us/customers/bluecross-blueshield-nc-
analytics.html>
11. Where human capabilities fail, SAS,
<http://www.sas.com/en_us/customers/allianz-fraud-management.html>
19
the way we see it

About Capgemini
With more than 145,000 people in over 40 countries, Capgemini is one of
the world’s foremost providers of consulting, technology and outsourcing
services. The Group reported 2014 global revenues of EUR 10.573 billion.
Together with its clients, Capgemini creates and delivers business and
technology solutions that fit their needs and drive the results they want.
A deeply multicultural organization, Capgemini has developed its own
way of working, the Collaborative Business ExperienceTM
, and draws on
Rightshore®
, its worldwide delivery model.

For further information visit
www.au.capgemini.com/insights-data
or contact us at
capgemini.marketing.au@capgemini.com
The information contained in this document is proprietary. No part of this document may be reproduced or copied in any form
or by any means without written permission from Capgemini. ©2015 Capgemini. All Rights Reserved.
Rightshore®
is a trademark belonging to Capgemini.
the way we see it
Insurance
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