Can AI Solve Health Insurance Fraud?

Insurance fraud scams seem to make the news at least every month, as organized criminals seek to exploit the way insurers reimburse clinics, pharmacies and other providers for their services. What’s often shocking is how much money fraudsters can steal from insurers before they’re caught. Recently, in a single month, two separate alleged fraud rings based in California were busted for scams that investigators say netted $20 million or more.

Spotlight

Insurance Licensing Services of America, Inc.

Insurance Licensing Services of America, ILSA knows the complex licensing terrain inside and out. For more than a decade, ILSA has supported the Financial Services & Insurance Industry by resolving licensing issues of all types, and saving clients millions of dollars in penalties and fines. You can depend on ILSAs professional licensing experts and our all-inclusive processing services through the entire licensing process - from preparation to certification.

OTHER ARTICLES
Core Insurance, Risk Management

How Are Insurance Firms Using Artificial Intelligence (AI)?

Article | August 4, 2022

In the insurance industry, artificial intelligence (AI) has become a buzzword. Nonetheless, despite the fact that we are still in the early stages of AI implementation, the industry has made significant progress. The Need for AI in Insurance Insurance is a long-established and highly regulated industry. Perhaps as a result, insurance companies have been slower to adopt technological change than other industries. Insurance is still dominated by manual, paper-based processes that are time-consuming and necessitate human intervention. Even today, customers must deal with time-consuming paperwork and bureaucracy when filing a claim or enrolling in a new insurance policy. Customers may also pay more for insurance if policies are not tailored to their specific needs. Insurance is not always a pleasant customer experience in an age when most of our daily activities are online, digitized, and convenient. Having said that, we are beginning to see a global push by insurance companies to enhance their technological capabilities in order to do business faster, cheaper, and more securely. There have been several notable examples of insurers investing heavily in Artificial Intelligence solutions in recent years. If AI technology is fully applied to the insurance industry, McKinsey estimates a potential annual value of up to $1.1 trillion. How are insurers implementing AI? There are numerous examples of insurers around the world using AI to improve both their bottom line and the customer experience. There are also a slew of start-ups offering AI solutions to insurers and customers. I'll discuss a few interesting cases here. The Future of Artificial Intelligence in Insurance AI has the potential to transform customers' insurance experiences from frustrating and bureaucratic to quick, on-demand, and more affordable. Customized insurance products will attract more customers at lower costs. If insurers apply AI technology to the mountain of data at their disposal, we will soon see more flexible insurance, such as on-demand pay-as-you-go insurance and premiums that adjust automatically in response to accidents, customer health, and so on. Insurance will become more personalized as insurers use AI technology to better understand what their customers require. By accelerating workflows, insurers will be able to save money. They will also discover new revenue streams as artificial intelligence-driven analysis uncovers new business and cross-selling opportunities.

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Insurance Technology

Coronavirus and insurance: threat or opportunity?

Article | July 13, 2022

The world is facing an unprecedented situation like never before. In the span of a couple of weeks, a visually undetectable virus has wreaked havoc and driven everyone home. COVID-19 had led offices to close, the economy to slow down, and has isolated us in our homes. Zooming in on the insurance industry, the effects haven’t gone unnoticed here either. Since no one was prepared for a pandemic of this scale, people are scrambling to know what their insurance covers. Those who weren’t covered are enquiring if they can get covered now. Travel and health insurance are the specific types are making the most news.

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Insurance Technology

Builders Risk Insurance Vs. Liability Coverage: How Each Benefit Works

Article | July 15, 2022

For construction contractors, there is nothing more important than safeguarding your works in progress. After all, if something were to damage the property and interrupt your progress, then you might face a huge financial setback. At this point, it’s critical that you have builder’s risk insurance ready and waiting. Your policy will be there to assist you following property damage at construction sites. However, your builder’s risk policy will not offer the same coverage to injuries or property damage that you cause to other parties. In this case, separate liability insurance benefits will provide the necessary benefits. Though separate from your builder’s risk policy, liability coverage is equally important. Let’s take a closer look at how these benefits work.

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How Will COVID-19 Affect Insurtech

Article | April 13, 2020

It is common knowledge that there is virtually no industry that has been immune to the effects of COVID-19. The global pandemic has caused massive shifts in individual and industrial behavior and will continue to do so in the months, if not years, to come. The P&C industry, like many others, is reeling from the effects of the virus. Amidst all these events, it is important to assess how the insurtech industry is going to be affected by COVID-19.

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Spotlight

Insurance Licensing Services of America, Inc.

Insurance Licensing Services of America, ILSA knows the complex licensing terrain inside and out. For more than a decade, ILSA has supported the Financial Services & Insurance Industry by resolving licensing issues of all types, and saving clients millions of dollars in penalties and fines. You can depend on ILSAs professional licensing experts and our all-inclusive processing services through the entire licensing process - from preparation to certification.

Related News

Insurance Technology

AgentSync Launches API to Streamline Insurance Producer Onboarding and Compliance

PR Newswire | January 29, 2024

AgentSync today announced the launch of its first commercially available ProducerSync API for carriers, MGAs, and agencies to manage producer and adjuster licensing and appointment validation without the paperwork. The ProducerSync application programming interface (API) acts as a menu, allowing insurance businesses to draw from a selection of National Insurance Producer Registry (NIPR) data on licensing, appointing, and personal information for producers. AgentSync humanizes and contextualizes the data so end users have actionable information from the industry source of truth without hours of manual research. "ProducerSync API represents a key step in our long-term strategic vision. By streaming accurate and comprehensive data to our customers' existing systems, ProducerSync API drives better business decisions," said Jenn Knight, Co-Founder and CTO of AgentSync. "We're focused on building modern technology that unlocks value for our customers, and highly flexible and adaptable products like ProducerSync API do exactly that by leveraging current data for better all-around business outcomes." The ProducerSync API uses REST API architecture, making it lightweight, scalable, and flexible, and is the first of AgentSync's planned suite of APIs to be available to the wider insurance market. It joins a family of modern business solutions the company uses to connect the industry. "Our first product, Manage, has had strong customer adoption by delivering superior business data with a modern user interface and comprehensive features for compliance and producer management," said Knight. "ProducerSync API builds on this vision, giving customers programmatic access to NIPR data elements in a way that is highly modular and reusable for a variety of use cases." Insurance runs on data, but maintaining the accuracy and quality of producer data across ecosystems is, historically, a challenge for all stripes of insurance organizations. With ProducerSync API, users can have confidence in their data while reducing maintenance, driving down business risks, enabling better-informed decisions, and eliminating inefficiencies with a scaled, secure solution. About AgentSync AgentSync builds modern insurance infrastructure that connects carriers, agencies, MGAs, and producers. With customer-centric design, seamless APIs, automation, and unparalleled service, AgentSync's solutions provide data intelligence and streamlined onboarding and compliance management processes that reduce costs, increase efficiency, and get producers ready to sell in hours instead of weeks. Founded in 2018 by Niranjan "Niji" Sabharwal and Jenn Knight, and headquartered in Denver, CO, AgentSync has been recognized as one of Denver's Best Places to Work, a Forbes Magazine Cloud 100 Rising Star, and as an Insurtech Insights Future 50 winner, and was ranked 65 in Forbes – America's Best Startup Employers 2023.

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Insurance Technology

Ladder and Envestnet | MoneyGuide Announce Integration to Provide More Advisors Digital Access to Term Life Insurance Offerings

PR Newswire | January 29, 2024

Today at the T3 Technology Conference, Ladder, the insurtech offering digital, flexible life insurance in minutes announced an integration with Envestnet | MoneyGuide, a leading financial planning software company serving over 107,000 financial advisors. This will empower more financial advisors with the capabilities to provide clients with term life insurance issued by reputable insurers. With this partnership, financial advisors utilizing Envestnet I MoneyGuide Elite's Advanced Lifetime Protection tool will be able to offer their clients digital, convenient, and affordable term life insurance. Financial advisors will be able to estimate clients' coverage needs, generate a quote, and send clients a link to apply—all from within the Envestnet | MoneyGuide platform. MoneyGuide's Advanced Lifetime Protection tool is designed to illustrate how a clients' protection needs can change over time. This tool may help advisors identify an opportunity to improve a client's probability of successfully achieving the goals in their client's financial plan. "Life insurance is a critical piece of a comprehensive financial plan," says Mike Izakov, Head of Financial Institution Partnerships at Ladder. "We believe MoneyGuide has the most robust planning tool in the industry, and we're excited to make it even easier for advisors to get clients the coverage their plans call for." With Ladder's industry-leading digital capabilities and proprietary flexible coverage (i.e. "laddering"), advisors using Envestnet | MoneyGuide will be able to utilize a visualization showcasing how a strategically laddered Ladder policy may save clients up to 40%* over a 30-year term compared to traditional term coverage. "Envestnet's generational research shows that a surprising 50% of Baby Boomers are not formally organizing their long-term finances," said Rose Palazzo, Group President of Envestnet Financial Planning. "Through our partnership with Ladder, our advisors are better equipped to help their clients take action on organizing their financial plans, including the important step of seeking to secure their financial futures through life insurance coverage. Ladder provides our advisors with digital access to term life insurance products, with an integration built right into our protection planning solution." Ladder offers term life insurance for coverage between $100,000 and $8 million, for terms ranging from 10 to 30 years. There are no medical exams required for coverage up to $3 million, just questions about an applicant's health are asked. The pricing is fully underwritten and backed by reputable carriers. Ladder offers a variety of partnership and compensation models to meet the needs of fee-based and insurance-licensed financial advisors. About Ladder Ladder is the first full-stack, digital life insurance company offering flexible online term coverage in minutes that can save policyholders up to 40%* by adjusting their coverage as their life changes. Ladder uses real-time underwriting to make life insurance as accessible, affordable, and beloved as it should be. The company is headquartered in Palo Alto, CA, and offers coverage up to $8M with no hidden fees. ABOUT ENVESTNET Envestnet is transforming the way financial advice is delivered through an ecosystem of technology, solutions, and intelligence. By establishing the connections between people's daily financial decisions and long-term financial goals, Envestnet empowers them to make better sense of their finances and live an Intelligent Financial Life. With more than $5.4 trillion in platform assets—more than 107,000 advisors, 16 of the 20 largest U.S. banks, 48 of the 50 largest wealth management and brokerage firms, more than 500 of the largest RIAs, and thousands of companies, depend on Envestnet technology and services to help drive better outcomes for their businesses and for their clients.

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Core Insurance

Inszone Insurance Services Continues Expansion in Colorado with the Acquisition of High Desert Insurance

Business Wire | January 29, 2024

Inszone Insurance Services, a rapidly growing national provider of commercial, personal, and benefits insurance, is pleased to announce its recent acquisition of High Desert Insurance, out of Pueblo, Colorado. High Desert Insurance, born in 2011, has been a trusted insurance go-to for over ten years. Starting with three employees, they've grown into a team of seven, always coming through with top-notch insurance solutions for individuals and businesses. The values of High Desert Insurance mesh perfectly with what Inszone Insurance is all about, making this acquisition a great fit as Inszone looks to grow its services in Colorado. "We are delighted to welcome High Desert Insurance to the Inszone family," expressed Chris Walters, CEO of Inszone Insurance Services. "With a decade-long track record of delivering outstanding outcomes for its clients, High Desert Insurance has built a commendable legacy. Our commitment extends to preserving and enhancing this legacy by offering comprehensive back-office support and access to additional markets to the High Desert team." The newly acquired High Desert Insurance will operate under the Inszone Insurance brand and maintain its existing Pueblo, Colorado, location, ensuring a seamless transition and consistency in service for its valued clients. Inszone Insurance is dedicated to retaining the experienced team from High Desert Insurance to ensure the continuation of the high-quality service that clients have come to expect. As Inszone Insurance continues its strategic growth, the acquisition of High Desert Insurance represents not only a significant expansion but also a blending of values, reinforcing the commitment to excellence in service within the dynamic landscape of Colorado. Founded in 2002 and headquartered in Sacramento, California, Inszone is a full-service insurance brokerage firm that provides a broad array of property & casualty insurance and employee benefits solutions. With a strong, experienced management team, Inszone continues to grow organically and through acquisitions. With 54 locations across California, Arizona, Colorado, Idaho, Illinois, Kansas, Michigan, Missouri, Nevada, New Mexico, Oregon, Texas, Utah, and Washington, the company is looking to expand further throughout the United States.

Read More

Insurance Technology

AgentSync Launches API to Streamline Insurance Producer Onboarding and Compliance

PR Newswire | January 29, 2024

AgentSync today announced the launch of its first commercially available ProducerSync API for carriers, MGAs, and agencies to manage producer and adjuster licensing and appointment validation without the paperwork. The ProducerSync application programming interface (API) acts as a menu, allowing insurance businesses to draw from a selection of National Insurance Producer Registry (NIPR) data on licensing, appointing, and personal information for producers. AgentSync humanizes and contextualizes the data so end users have actionable information from the industry source of truth without hours of manual research. "ProducerSync API represents a key step in our long-term strategic vision. By streaming accurate and comprehensive data to our customers' existing systems, ProducerSync API drives better business decisions," said Jenn Knight, Co-Founder and CTO of AgentSync. "We're focused on building modern technology that unlocks value for our customers, and highly flexible and adaptable products like ProducerSync API do exactly that by leveraging current data for better all-around business outcomes." The ProducerSync API uses REST API architecture, making it lightweight, scalable, and flexible, and is the first of AgentSync's planned suite of APIs to be available to the wider insurance market. It joins a family of modern business solutions the company uses to connect the industry. "Our first product, Manage, has had strong customer adoption by delivering superior business data with a modern user interface and comprehensive features for compliance and producer management," said Knight. "ProducerSync API builds on this vision, giving customers programmatic access to NIPR data elements in a way that is highly modular and reusable for a variety of use cases." Insurance runs on data, but maintaining the accuracy and quality of producer data across ecosystems is, historically, a challenge for all stripes of insurance organizations. With ProducerSync API, users can have confidence in their data while reducing maintenance, driving down business risks, enabling better-informed decisions, and eliminating inefficiencies with a scaled, secure solution. About AgentSync AgentSync builds modern insurance infrastructure that connects carriers, agencies, MGAs, and producers. With customer-centric design, seamless APIs, automation, and unparalleled service, AgentSync's solutions provide data intelligence and streamlined onboarding and compliance management processes that reduce costs, increase efficiency, and get producers ready to sell in hours instead of weeks. Founded in 2018 by Niranjan "Niji" Sabharwal and Jenn Knight, and headquartered in Denver, CO, AgentSync has been recognized as one of Denver's Best Places to Work, a Forbes Magazine Cloud 100 Rising Star, and as an Insurtech Insights Future 50 winner, and was ranked 65 in Forbes – America's Best Startup Employers 2023.

Read More

Insurance Technology

Ladder and Envestnet | MoneyGuide Announce Integration to Provide More Advisors Digital Access to Term Life Insurance Offerings

PR Newswire | January 29, 2024

Today at the T3 Technology Conference, Ladder, the insurtech offering digital, flexible life insurance in minutes announced an integration with Envestnet | MoneyGuide, a leading financial planning software company serving over 107,000 financial advisors. This will empower more financial advisors with the capabilities to provide clients with term life insurance issued by reputable insurers. With this partnership, financial advisors utilizing Envestnet I MoneyGuide Elite's Advanced Lifetime Protection tool will be able to offer their clients digital, convenient, and affordable term life insurance. Financial advisors will be able to estimate clients' coverage needs, generate a quote, and send clients a link to apply—all from within the Envestnet | MoneyGuide platform. MoneyGuide's Advanced Lifetime Protection tool is designed to illustrate how a clients' protection needs can change over time. This tool may help advisors identify an opportunity to improve a client's probability of successfully achieving the goals in their client's financial plan. "Life insurance is a critical piece of a comprehensive financial plan," says Mike Izakov, Head of Financial Institution Partnerships at Ladder. "We believe MoneyGuide has the most robust planning tool in the industry, and we're excited to make it even easier for advisors to get clients the coverage their plans call for." With Ladder's industry-leading digital capabilities and proprietary flexible coverage (i.e. "laddering"), advisors using Envestnet | MoneyGuide will be able to utilize a visualization showcasing how a strategically laddered Ladder policy may save clients up to 40%* over a 30-year term compared to traditional term coverage. "Envestnet's generational research shows that a surprising 50% of Baby Boomers are not formally organizing their long-term finances," said Rose Palazzo, Group President of Envestnet Financial Planning. "Through our partnership with Ladder, our advisors are better equipped to help their clients take action on organizing their financial plans, including the important step of seeking to secure their financial futures through life insurance coverage. Ladder provides our advisors with digital access to term life insurance products, with an integration built right into our protection planning solution." Ladder offers term life insurance for coverage between $100,000 and $8 million, for terms ranging from 10 to 30 years. There are no medical exams required for coverage up to $3 million, just questions about an applicant's health are asked. The pricing is fully underwritten and backed by reputable carriers. Ladder offers a variety of partnership and compensation models to meet the needs of fee-based and insurance-licensed financial advisors. About Ladder Ladder is the first full-stack, digital life insurance company offering flexible online term coverage in minutes that can save policyholders up to 40%* by adjusting their coverage as their life changes. Ladder uses real-time underwriting to make life insurance as accessible, affordable, and beloved as it should be. The company is headquartered in Palo Alto, CA, and offers coverage up to $8M with no hidden fees. ABOUT ENVESTNET Envestnet is transforming the way financial advice is delivered through an ecosystem of technology, solutions, and intelligence. By establishing the connections between people's daily financial decisions and long-term financial goals, Envestnet empowers them to make better sense of their finances and live an Intelligent Financial Life. With more than $5.4 trillion in platform assets—more than 107,000 advisors, 16 of the 20 largest U.S. banks, 48 of the 50 largest wealth management and brokerage firms, more than 500 of the largest RIAs, and thousands of companies, depend on Envestnet technology and services to help drive better outcomes for their businesses and for their clients.

Read More

Core Insurance

Inszone Insurance Services Continues Expansion in Colorado with the Acquisition of High Desert Insurance

Business Wire | January 29, 2024

Inszone Insurance Services, a rapidly growing national provider of commercial, personal, and benefits insurance, is pleased to announce its recent acquisition of High Desert Insurance, out of Pueblo, Colorado. High Desert Insurance, born in 2011, has been a trusted insurance go-to for over ten years. Starting with three employees, they've grown into a team of seven, always coming through with top-notch insurance solutions for individuals and businesses. The values of High Desert Insurance mesh perfectly with what Inszone Insurance is all about, making this acquisition a great fit as Inszone looks to grow its services in Colorado. "We are delighted to welcome High Desert Insurance to the Inszone family," expressed Chris Walters, CEO of Inszone Insurance Services. "With a decade-long track record of delivering outstanding outcomes for its clients, High Desert Insurance has built a commendable legacy. Our commitment extends to preserving and enhancing this legacy by offering comprehensive back-office support and access to additional markets to the High Desert team." The newly acquired High Desert Insurance will operate under the Inszone Insurance brand and maintain its existing Pueblo, Colorado, location, ensuring a seamless transition and consistency in service for its valued clients. Inszone Insurance is dedicated to retaining the experienced team from High Desert Insurance to ensure the continuation of the high-quality service that clients have come to expect. As Inszone Insurance continues its strategic growth, the acquisition of High Desert Insurance represents not only a significant expansion but also a blending of values, reinforcing the commitment to excellence in service within the dynamic landscape of Colorado. Founded in 2002 and headquartered in Sacramento, California, Inszone is a full-service insurance brokerage firm that provides a broad array of property & casualty insurance and employee benefits solutions. With a strong, experienced management team, Inszone continues to grow organically and through acquisitions. With 54 locations across California, Arizona, Colorado, Idaho, Illinois, Kansas, Michigan, Missouri, Nevada, New Mexico, Oregon, Texas, Utah, and Washington, the company is looking to expand further throughout the United States.

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