Nimble Health Insurance Broker Poised to Become a Major Disruptor

You’ve heard the buzzwords for years. “Big Data,” “Algorithms,” “FinTech,” and now, “InsureTech.” It’s all about technology creating new opportunities like the new app from One World Cover that brings clarity to health insurance data. When they upend the status quo of standard procedures employed by large, established entities, the offending upstarts are dubbed “disruptors.” Whether disruption is good or bad depends on who you ask. Take a step back to consider that in 1688 Lloyd’s of London created the international insurance industry. There are those today who believe insurance has changed very little since. So maybe it’s about time.

Disruption is Good

According to Accenture’s “Intelligent Broker” series, the broker’s role is “to assess clients’ coverage needs and negotiate best terms, conditions and pricing with insurers.” Doing just that that led One World Cover (OWC) to create a technological solution to the problem of how policy holders can make sense of the claims data they receive from their insurance providers.

“We had one client tell us his claims reports might as well be in Latin for all the good they do him,” says OWC Director David Bortz. Not only do the reports not make sense but they rarely come in a timely manner or even at all in some cases.

The information in those reports forms the basis of setting premiums for your coming year. So if you can’t see or understand that information, your only choice is to trust your insurance company. But blind trust is fraught with risk, explains Dan Ariely in Forbes magazine. Ariely, a Duke University professor and the Chief Behavioral Officer at InsureTech disruptor Lemonade said, “Every dollar your insurer pays you is a dollar less for their profits. So when something bad happens to you, their interests are directly conflicted with yours. You’re fighting over the same coin.”

One World Cover’s Control Room helps us quickly identify the historical trends and issues associated with our health insurance plan and gives us the transparency we need to see if we have been overpaying

CFO, Thailand

Understanding Data Brings Transparency

“We understand that insurance companies need to make a profit,” says Bortz.  “And we consider them partners in meeting our clients’ needs. But it should be a fair profit based on clear communication of all relevant information. Understanding the data brings transparency. With transparency comes insight. We use that insight to formulate strategies that save our clients money and make their plans better for staff.”

Today, One World Cover’s Control Room is an online “software as a solution” (or SaaS) Insuretech app. It displays vital health insurance claims data clearly in visual terms with charts, graphs and timelines and brings clarity to health insurance data. The charts automatically update monthly with the latest data. That makes it easy to spot trends and avoid problems before they happen, and ultimately helps ensure users are not overpaying.

Spot Trends Before They Become Problems

Tracking when claims are incurred versus when they are paid and how that affects loss ratios on a rolling month-to-month basis pays off for One World Cover’s clients. The data shows that 90% of claims are paid within 4 months of the date of service. So within 4 months of a claims service date, One World Cover can make accurate predictions on the overall claims performance and how a client’s policy year loss ratio should finish up. And it’s a prediction that frequently conflicts with the insurance provider’s.

The renewal process involves analysis of year-to-date data available. And the timeframe of discussions takes place three to five months ahead of the renewal date. So insurance companies must predict where the claims loss ratio will eventually end up. It’s not surprising that they estimate conservatively and always in their favor. By employing trend analysis and using their proprietary claims data analysis, One World Cover has shown that very often the insurance companies are wrong. True to its name, Control Room shifts control from the insurer to their clients. It gives Control Room users the power to understand exactly what is happening with their health insurance plan and ultimately whether they are getting good value from their health insurance spend.

Control Room also delivers a visual representation of what a company’s plan has been doing for the past few years. This forms the foundation of long-term strategies for lower costs, prevents problems. And it keeps members of your group health insurance plan happy with the highest quality coverage for many years to come.

Transparency Brings Insight

Working with clients that understand their data allows One World Cover to use Control Room to guide conversations on renewal and plan refinements. Making usage patterns easier to identify and understand also pinpoints when plan members opt for more expensive healthcare providers. Plus it shows when expensive benefits are underused. Both perspectives can guide plan refinements for an effective three to five year strategy.

One World Cover is currently developing version 3.0 of their industry-first platform to offer even greater depth and functionality. The new version is scheduled to launch in Q4 2020. The current version delivers what is known as “descriptive analysis” which points out current trends. The goal is to advance that process through artificial intelligence and machine learning to include “predictive analysis” (if you do A then B will result). And the final goal is “prescriptive analysis” (where problems are spotted, outcomes predicted and and solutions recommended).

One World Cover has implemented a successful medical insurance Control Room platform which provides us with up-to-date information on how our plan “performs” – this is an excellent tool when making strategic decisions regarding provision of the health insurance for our school

Ops and Finance Director, China

Leading Edge of the Tipping Point

The insurance industry has always been cautious, slow to adopt and favors those with deep pockets who already have a seat at the table. But, say the experts at Accenture and elsewhere, dynamics have changed and brokering is approaching a ‘tipping point’ similar to what the financial advisory industry faced three to five years ago. Control Room puts One World Cover squarely on the leading edge of that tipping point. Much to the pleasure of their health insurance clients.

To find out more about how One World Cover’s health insurance claims data analysis platform or Control Room can help your company, please get in touch: [email protected]

One World Cover Insights
One World Cover Insights are original articles published by our team of consultants with insights and advice on how to run your health insurance plan and help companies get a better return on their health insurance spend.

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