RISK MANAGEMENT

Sun Life partners with Teledentistry.com to bring 24/7 dental provider access to members

Sun Life | January 06, 2022

tech News
Sun Life U.S. has partnered with Teledentistry.com to bring members 24/7 virtual access to dental providers, whenever, and wherever they are. The service is automatically incorporated into members' dental coverage, and provides a safety net for those who need dental care in emergencies, while traveling, or at night or on weekends.

"Oral health is part of overall health, and we are committed to helping our members get the right care when they need it, whether for regular preventive care visits or emergencies, We are thrilled to partner with Teledentistry.com to make dental benefits and urgent dental care more accessible, and meet our members where they are."

- Joi Tillman, vice president of Voluntary, Dental and Vision at Sun Life U.S.

With easy-to-navigate virtual access, members who need a dental consultation can get one quickly from a Teledentistry.com dentist, and get referred for definitive care if necessary. Consultation results are communicated to the member's dental provider for follow-up care. By accessing a Teledentistry.com dental professional any time virtually, members can get the care they need at the right time and may reduce their costs, especially in cases of emergency when the only alternative may be an ER visit.

"Teledentistry.com is dedicated to improving access to dental care, Our team of dentists is ready to help with a virtual consultation, prescribe medications as appropriate and refer patients to a local in-network dentist for regular care. We are proud to partner with Sun Life to help support their members with a virtual dentist anytime they need one."

- Dr. Vilas Sastry, CEO of Teledentistry.com.


About Sun Life
Sun Life is a leading international financial services organization providing insurance, wealth and asset management solutions to individual and corporate Clients. Sun Life has operations in a number of markets worldwide, including Canada, the United States, the United Kingdom, Ireland, Hong Kong, the Philippines, Japan, Indonesia, India, China, Australia, Singapore, Vietnam, Malaysia and Bermuda. As of September 30, 2021, Sun Life had total assets under management of C$1.39 trillion.

Spotlight

Kara Scarboro, an attorney in Saul Ewing LLP’s Insurance Practice, explains the concept of “the internet of things” and how it enables real-time data to be provided from an insured to an insurance company, growing the parties’ relationship.

Spotlight

Kara Scarboro, an attorney in Saul Ewing LLP’s Insurance Practice, explains the concept of “the internet of things” and how it enables real-time data to be provided from an insured to an insurance company, growing the parties’ relationship.

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INSURANCE TECHNOLOGY

Shift Technology Automates and Optimizes Decision Making Across the Policy Lifecycle

Shift Technology | January 28, 2021

Shift Technology, a supplier of AI-driven decision automation and optimization solutions for the global insurance industry, today declared availability of both new products and moves up to existing solutions inside the Shift Insurance Suite (Shift Technology Automates and Optimizes Decision Making Across the Policy Lifecycle). The Shift Insurance Suite is a bunch of cloud-based AI solutions which backing improved decision making by insurance representatives across divisions. Shift spearheaded the utilization of Artificial Intelligence (AI) to help insurers not just better spot possible fraud in the claims cycle yet in addition settle on more educated decisions about how best to react to these dubious claims. The capacity to rapidly decide whether a claim ought to be explored and assuming this is the case, recognize the ideal analytical methodology infuses huge productivity and exactness into the general claims measure. The organization based on its achievement in fraud detection to address the insurance industry's longing to eliminate grating from the claims cycle and advance toward low-contact, no-contact, and completely computerized claims settlement from first notice of loss (FNOL) through to payment. Today, Shift Claims Automation and Shift Claims Fraud Detection are the lead products in the Shift Insurance Suite. "AI is ideally suited to help insurance professionals make the best decisions possible in support of their customers and their business," stated Marcel Gordon, vice president, Product, Shift Technology. "The ability to ingest and organize massive amounts of structured and unstructured data, understand relationships and connections between individuals, and then do sophisticated analysis enables Shift to provide insurers with a new generation of tools. Shift is putting AI in the hands of operational teams at insurers around the globe." With the declaration of the Shift Insurance Suite, the organization is expanding on its accomplishment in fraud detection and claims automation with the presentation of new products focusing on extra cycles in claims and across the approach lifecycle. To help workers all the more rapidly and precisely recognize openings for subrogation, the organization is presently offering Shift Subrogation Detection. Outside of claims, Shift Underwriting Fraud Detection is intended to give basic data valuable in concluding whether to give insurance inclusion to an individual or business. The organization's new Financial Crime Detection product underpins against illegal tax avoidance, worker fraud detection, and other consistence activities. Shift's products are explicitly intended to incorporate with, and increase the value of, existing center claims management systems. "Insurance is a business of decisions, and making the optimal decision can drive incredible benefits," explained Eric Sibony, chief scientific officer and co-founder, Shift Technology. "Through our work with some of the leading insurance companies in the world we have been able to demonstrate the exceptional power of AI to both optimize and fully automate some of the most important insurance decisions, driving significant value for carriers and their policyholders." To address the decision optimization and automation necessities of the global insurance industry, Shift has assembled its solutions around a powerful AI decision engine that can break down numerous sorts of structured and unstructured data given by the insurer, the insured, and/or external third parties. This may incorporate claims data, including claims handlers' notes, photos and other checked pictures, and unique reports, to give some examples. Shift has reliably exhibited its solutions beat decides based just methodologies that can't coordinate the precision and productivity given by insurance-explicit AI. At press time, the organization has insurers at different phases of sending for every one of its decision automatization and optimization products. The Shift Insurance Suite is comprised of: Shift Claims Fraud Detection: This award-winning technology is in use by more than 80 of the world's leading insurance companies including CSAA Insurance Group and MS & AD Insurance Group to name only a few. On top of the proven capability to detect fraud using data and documents, new capabilities introduced with the launch of the Shift Insurance Suite put the power of Shift's rich insurance data model, with all of the insurer's data denoised, reconstructed and linked together, in the hands of investigators. There is expanded support for the use of images and documents in the detection of fraud, as well as visual exploration of data using a network graph and the ability to search and browse through the complete data model. Shift Claims Automation: Available in two deployment models - Digital Journey and Augmented Adjustment - this solution uses AI to automate the claims process from FNOL through to final settlement. Digital Journey empowers policyholders directly, delivering a self-service claims experience - FNOL, tracking and settlement - with AI decision-making built in. The claims experience is customized to each insurer to match their claims process, handling policies and branding. Augmented Adjustment integrates AI-supported decision making directly into the Claims Management System, decreasing turnaround time and optimizing claims handlers' time during the claims process. Through its application of advanced OCR technology, Shift Claims Automation is particularly focused on removing the need for manual document review throughout the claims process. Shift Subrogation Detection: This new addition to the Shift Insurance Suite uses AI to quickly and accurately discover opportunities to recover costs from third parties. The technology not only finds those claims for which subrogation is possible but also generates actionable cases supported by concrete evidence. Shift Subrogation Detection improves on manual and simple rules-based subrogation identification processes by focusing on coverage (reviewing every single claim), consistency (checking against known subrogation scenarios) and precision (leveraging internal and external data, from police reports to recall lists, using AI). The result includes reduced claim loss and improved deductible recovery, while freeing the claims team to focus on resolving claims. Shift Underwriting Fraud Detection: Designed to optimize decision making at the point of sale, Shift Underwriting Fraud Detection applies AI to the policy underwriting process to detect inaccurate or non-compliant policies. Actionable alerts help to minimize fraudulent policies, avoid undesired risks, and assign appropriate premiums. Shift Underwriting Fraud Detection leverages Shift's rich data model, sophisticated data analysis and deep insurance expertise to give the Underwriting team a complete view of the policy, policyholder and risk while highlighting anomalies. First Central has adopted Shift Underwriting Fraud Detection to support the carrier's auto line of business. Shift Financial Crime Detection: Insurance is a critical part of the financial system, resulting in significant scrutiny from regulators. Shift Financial Crime detection enables insurers to better understand the status of all participants in its ecosystem, including employees, to identify and investigate potential criminal behavior, including money laundering. Shift Financial Crime Detection addresses these challenges for insurers, who have little transaction data to rely upon, by making maximal use of internal and external data about all participants in the insurance process. Used together with Shift's fraud solutions, Shift Financial Crime Detection enables insurers to build an overall picture of - and response to - risk from bad actors across their business. About Shift Technology Shift Technology delivers the only AI-native decision automation and optimization solutions built specifically for the global insurance industry. Addressing several critical processes across the insurance policy lifecycle, the Shift Insurance Suite helps insurers achieve faster, more accurate claims and policy resolutions. Shift has analyzed billions of insurance transactions to date and was presented Frost & Sullivan's 2020 Global Claims Solutions for Insurance Market Leadership Award.

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INSURANCE TECHNOLOGY

Verisk Analytics Lauded by Frost & Sullivan for Pioneering Telematics Data Exchange for Usage-Based Insurance in North America

Frost & Sullivan | August 17, 2021

Based on its recent analysis of the North American telematics data exchange market, Frost & Sullivan recognizes Verisk Analytics with the 2021 North American Company of the Year Award for pioneering connected telematics data exchange technology. With the largest data repository of connected vehicle driving data in North America, the Verisk Data Exchange provides significant value to consumers, insurers, and original equipment manufacturers. Consumers benefit from personalized premiums, insurers gain unprecedented access to telematics data from connected vehicles and operational efficiencies for their usage-based insurance (UBI) programs, and OEMs are able to deliver enhanced connected services that enrich the overall ownership experience for their drivers. "Verisk has successfully built a platform that supports major stakeholders, such as insurers and OEMs, while planning for the future of connectivity," said Niranjan Manohar, Consulting Director, Mobility. "By providing instant access to telematics data from connected vehicles, its platform allows insurers to assess risks accurately. The resulting operational efficiencies enable them to not only streamline underwriting processes but identify and retain safer drivers and increase customer touchpoints." With driver cosent, Verisk's platform collects data from more than 8 million telematics-equipped vehicles through relationships with four major OEMs: Ford, GM, Honda, and Hyundai. Through Verisk's risk analytics capabilities and reach to insurers, these OEM alliance partners can deliver high-value connected services that enhance the ownership experience, helping drivers improve and making it easier to unlock behavior-based discounts. Even though other telematics service providers draw data from millions of vehicles, few companies can boast the network effect that Verisk achieves through its Verisk Data Exchange. In addition to connected vehicles, the platform also supports other sources of telematics data: third-party telematics solution providers (TSPs), aftermarket hardware solutions, and smartphones. This source-agnostic approach allows the Verisk Data Exchange to support both personal and commercial lines of auto insurance. The data exchange model changes the dynamics between insurers and customers by enabling continuous and ongoing interactions. As connected vehicles become standard, insurers will find it easier to onboard new customers to usage-based insurance (UBI) policies because embedded telematics requires no additional monitoring. Verisk's popular DrivingDNA® solutions deliver advanced telematics risk scores and normalized telematics data to insurers at point of quote, allowing them to calculate safe driving discounts upfront. Furthermore, insurers can use this data to assess portfolio risk more accurately, create driver scoring models, and improve customer engagement tools, benefitting policy holders. "In a space that has seen many new entrants emerge, Verisk remains a trusted name with years of experience. Besides four of North America's largest OEMs signing into the network, Verisk serves five of the top 10 insurers as well as numerous other mid-market, regional, and insurtech customers," noted Niranjan Manohar. "As the network of connected vehicles continues to expand, the Verisk Data Exchange is poised to scale and adapt to the needs of insurance partners, OEMs, and drivers." Each year, Frost & Sullivan presents a Company of the Year award to the organization that demonstrates excellence in terms of growth strategy and implementation in its field. The award recognizes a high degree of innovation with products and technologies and the resulting leadership in terms of customer value and market penetration. Frost & Sullivan Best Practices Awards recognize companies in a variety of regional and global markets for demonstrating outstanding achievement and superior performance in areas such as leadership, technological innovation, customer service, and strategic product development. Industry analysts compare market participants and measure performance through in-depth interviews, analyses, and extensive secondary research to identify best practices in the industry. About Frost & Sullivan For six decades, Frost & Sullivan has been world-renowned for its role in helping investors, corporate leaders, and governments navigate economic changes and identify disruptive technologies, Mega Trends, new business models, and companies to action, resulting in a continuous flow of growth opportunities to drive future success.

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INSURANCE TECHNOLOGY

Sedgwick acquires Managed Care Advisors

Sedgwick | September 24, 2021

Sedgwick, a leading global provider of technology-enabled risk, benefits and integrated business solutions, today announced it has acquired Managed Care Advisors, Inc. (MCA), a Bethesda, Maryland-based government contracting firm and leading provider of workers' compensation and specialty health plan products and services to the U.S. federal government. Managed Care Advisors' expertise includes a comprehensive, outsourced federal agency workers' compensation case and claims management solution, anchored by the full functionality of its technology platform. MCA's federally compliant solutions and established performance record will broaden Sedgwick's access to a wide range of public sector opportunities. The acquisition will also enable MCA to expand its breadth and depth of offerings to the government to include a broad array of world-class risk management and claims solutions that Sedgwick currently delivers in the commercial sector. Sedgwick and Managed Care Advisors have a shared focus on delivering excellence and taking care of people. We are well aligned to optimize outcomes for our clients and look forward to bringing our combination of value-added services to the employees of federal government agencies. - Elizabeth Demaret, Sedgwick president, specialty. MCA will operate as a wholly owned subsidiary of Sedgwick Public Sector, a Sedgwick holding company dedicated to delivering claims services to government entities. Joining forces with Sedgwick opens the door to new opportunities for bringing the public sector an even higher level of industry best practices and expertise. I'm excited for what lies ahead in our next chapter with Sedgwick. - Lisa Firestone, Managed Care Advisors president and CEO. About Sedgwick Sedgwick is a leading global provider of technology-enabled risk, benefits and integrated business solutions. The company provides a broad range of resources tailored to our clients' specific needs in casualty, property, marine, benefits, brand protection and other lines. At Sedgwick, caring counts; through the dedication and expertise of more than 27,000 colleagues across 65 countries, the company takes care of people and organizations by mitigating and reducing risks and losses, promoting health and productivity, protecting brand reputations, and containing costs that can impact the bottom line. Sedgwick's majority shareholder is The Carlyle Group; Stone Point Capital LLC, Caisse de dépôt et placement du Québec (CDPQ), Onex and other management investors are minority shareholders. About Managed Care Advisors Established in 1997, Managed Care Advisors specializes in workers' compensation, case and claims management, disability and absence management, analytics, technology solutions, specialty health plan management and employee benefits. Based in Bethesda, Maryland, Managed Care Advisors services customers throughout the United States and all U.S. territories. Since 2005, MCA has provided a comprehensive suite of products and services to the federal market to support federal agencies in improving outcomes, reducing costs, and avoiding unnecessary medical and vocational disability resulting from work-related injuries and illnesses.

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