Transforming Underwriting Efficiency with AI: Solving the Challenges of Medical Record Review in Insurance

In a recent interview with Insurance Thought Leadership.com, Michael Reilly, managing director at Accenture, highlighted a pressing issue in underwriting: underwriters spend only about 30% of their day actually underwriting. The remaining time is consumed by paperwork and sales-related tasks. Medical record reviews, in particular, are a significant drain on productivity, as underwriters must sift through extensive documents to extract crucial information.

Manual medical record reviews are time-consuming and prone to errors, requiring underwriters to comb through pages of data, cross-reference details, and highlight key insights. This administrative burden becomes even more challenging as data volumes continue to grow. The amount of data available to underwriters has doubled over the past decade, and underwriters and claims adjusters are often overwhelmed, struggling to keep up with the data influx. As a result, critical information remains trapped in outdated systems, stifling innovation and preventing data-driven insights. This inefficiency limits smarter decision-making, optimized outcomes, and innovative solutions.

The Beginnings of DigitalOwl: A Frustration with Inefficiency

This frustration with inefficiency is where DigitalOwl’s journey began. As a former personal injury lawyer, I spent hours combing through medical records, looking for key details buried within vast amounts of data. I knew there had to be a better way to manage this information—one that could streamline the process, eliminate redundancy, and allow professionals to focus on higher-value tasks.

The Solution: Leveraging AI for Greater Efficiency

Enter advanced technologies like AI, GenAI, and machine learning. These innovations are reshaping how the insurance industry handles data, enabling underwriters and claims adjusters to review medical records with an unprecedented level of efficiency. Clients using DigitalOwl’s technology have reported a remarkable 60% to 70% boost in the efficiency of their medical record reviews, freeing underwriters to focus on tasks that leverage their expertise.

A 2021 McKinsey report underscores the transformative potential of advanced analytics in insurance. Insurers that adopt sophisticated data analytics can see loss ratios improve by 3% to 5%, business premiums increase by 10% to 15%, and customer retention in profitable segments jump 5% to 10%. Although this study spans the broader P&C sector in Europe and North America, it highlights the impact of innovation in the industry, showcasing how technology can drive efficiency and reshape processes.

So, What Does DigitalOwl Do?

Powered by a powerful trio—Generative AI, an advanced Entity Recognition engine, and an ever-expanding Medical Knowledge Base—DigitalOwl’s platform enables underwriters to streamline workflows, structure data, and interact with medical information seamlessly, all from one place. Our platform includes the following innovative products:

• View: AI-enhanced summaries that enable underwriters, claims adjusters, and legal professionals to access a 360-degree view of an individual's medical history and de-duplicate data to surface critical details within hundreds of pages.
• Triage: AI-driven audit reports that automate the triaging process with an AI-powered solution that seamlessly flags pre-defined data points from a bulk of cases.
• Connect: Our Data API which enables the seamless integration of all previously unstructured and semi-structured data points into existing systems for more efficient data retrieval and analysis.
• Chat: Our AI-powered chat, which empowers insurance and legal professionals to instantly uncover medical data insights by directly chatting with the records, bypassing the needs to sift through pages for answers.
• Workflows: AI-assisted decisions that transform the complexity of creating workflows and decision trees into a straightforward, user-friendly experience.
• Case Notes: Decision-supporting medical insights powered by the first AI agents designed specifically for medical records to surface only the most relevant information for each case.

DigitalOwl’s platform is built with transparency in mind, incorporating a "click-to-evidence" feature. This functionality allows professionals to verify each data point instantly, ensuring that insights are accessible and traceable to the original source.

The Future of the Industry: What This Means for Insurance Carriers

For insurance carriers, integrating technology like DigitalOwl means faster, more efficient processes, better resource allocation, and improved outcomes. As the industry faces an evolving regulatory landscape, choosing the right AI provider becomes even more critical. Providers that emphasize transparency, compliance, and data accuracy will be best positioned to support carriers as regulations adapt to technological advancements.

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