Streamline Your Healthcare Contract Management Solutions for Insurance Industry

Healthcare contract management solutions for Insurance Industry

[Music] hello everyone I'm Jim burnick from my CIS hello and my name is Matthew wolf I'm a partner with PWC so Matt let's explore how contract intelligence can help insurance companies in the reinsurance business yes absolutely so I think one of the important parts of reinsurance to understand it within the broader context is that the reinsure pay plays a very important Capital role within how insurance is placed so frequently we will all know what we call the primary insur these are the ones that spend billions of dollars during advertising on the Super Bowl but at the end of the day while they take a lot of that risk some of that risk actually shifts to the reinsurance companies who you who more likely than not on the retail basis you have never heard of before so you can think of them almost as like the equival of the bond market versus the stock market in terms of equity um the important part for the reinsurers is that they have to make really key decisions in very broad terms around how is the performance of the underlying Insurance Market going to be and then how do they bring that Capital to the right providers so it's a really important part of the of the market that may not necessarily be the focus of everybody with that said in the context of of basically life cycle management and contracts everything within Insurance fundamentally again is a legal contract construct so what we have is we have the primary party which is the reinsurer and then we have the counterparty which is the primary insurer and really understanding how those contracts are structured whether it's a facultative or a treaty reinsurance at what point do does for example if there's a catastrophe loss does that actually trigger a reinsurance contract these are all important elements today historically they're done very manually they they might be actually still in Excel files they might actually be just sitting in pieces of paper and emails and things like that and so when really significant events happen it tends to become a very legal and manual process and so again incorporating these things into good technologies that can support it are will bring better insight into the Frontline Underwriters as well as the Risk Managers that sit within the insurers and Matt and staying with that theme with reinsurance how about between the reinsurer and the agency yeah so what what are the what are some of the challenges they face today and um some of the opportunities I guess that contract intelligence could play a role in that relationship that fundamental Rel relationship y So within so fundamentally within the insurance market today we are still somewhat old school I will say which is not a criticism it's maybe a statement of fact um very frequently what happens is the counterparty so between the insurers and the reinsurers and some cases the brokers in the middle um they will actually be moving documents around which is called is our term is called a bordero um and basically you can think of it as a fancy Excel file so as I was saying before how this part of the market tends to be very manual um there's really not a lot of I would say Advanced Technologies that have been brought to bear here but when we talk to our commercial insurers in particular this upfront placement piece as well as this kind of day-to-day management around premiums moving back and forth as well as claims today they understand that you know it worked this way for the past 00 years and that's been fine but now we really need to advance as an industry and and really automating and basically taking these documents making them electronic using proper things like apis using proper things like AI to understand pattern matching these are all important differentiators in the market and so I would say we're seeing some nent Innovation here particularly in the reinsurers mostly coming out of Europe um but certainly what happens in the reinsurance market tends to spread more broadly so I I think I think if I'm if I'm sitting here in in the domestic Market I'm kind of looking to see where that goes um I would say the discussion here in the next five to 10 years it's going to be everything to be much more advanced in this particular area H interesting um how about AI I so I think AI ultimately our view our pwc's view around AI um is that you really need to use the right tool for the job there are many AI tools right now that are very well established um those are explainable fundamentally so that's important um we are in a very highly regulated industry as we all know um and so anytime we're using AI we need to be very careful we have to have good governance and then we have to be able to explain it to a regulator right that's kind of our our B base standard of using AI there's been lots of discussion around more advanced models large language models in particular with things like open AI um with that said there's lots of opportunities for those we are a little more cautious as in general because those are very complex and you may not be able to explain every step with that said as as I said a minute ago it's really the right tool for the job some cases the llms will make sense some cases the more traditional models that we're all really used to will make sense as well I think when you look at contracts where we see that llms perform really well is you have large data sets of written language extracting that out creating summaries creating Insight out of that that's a very powerful tool you can also do things like identify risk words for example so maybe we don't like a term that's put in there maybe we don't like a limit that might be in that contract um so it's really kind of taking the work that today you would expect a human to do around reading these very legal contracts using the a to surface up some insight and then in some cases we might have someone actually do some underwriting review on it we may go to a referral so it's using the right tool to basically make people more effective it's kind of similar to a co-pilot model when you when you might hear that in the market thank you Matt we'd love to hear from you if you'd like to hear more about contract intelligence and your reinsurance business please contact us [Music]