When a loved one is sick or injured, time is of the essence. Any wasted time impedes care and causes unneeded frustration. One insurance company applied this mindset to pets as well as people. 

The insurtech firm found itself with a backlog of over 30,000 medical records and invoices for pet insurance claims, adding precious time before procedures could be performed and payments could be made, among others. 

That was unacceptable to our client, whose younger, digitally savvy customers expected both speedy and frictionless transactions as well as empathy and understanding when it came to their pets. The company’s strategic imperative was to partner AI with humans to power operational efficiency and reduce its claims backlog to zero.

Our solution

With AI regarded as insurtech’s secret weapon, the client engaged TTEC to deploy a human-driven, back-office data annotation strategy to label medical records and invoices to improve the effectiveness and scalability of its AI. Data was analyzed, classified, and tagged with high accuracy before it was imported to the client’s optical character recognition (OCR) engine for claims processing. A new app improved how documents were attached to claims to verify information. As a result, improved algorithms enabled the system to issue claims payouts automatically based on approved coverages.

Human intervention was essential to bolster the AI’s effectiveness. Without data correctly identified and annotated by knowledgeable people, a machine learning algorithm could not compute the necessary attributes. The data review process required workers who could decipher medical terminology and diagnostic acronyms unique to this line of business, pet insurance. TTEC sourced, trained, and hired a team of 25 back-office associates in the Philippines. Many workers already had veterinary education or experience as vet techs and all received training from the Pet Insurance 101 curriculum TTEC developed.

In addition, the team gained deeper visibility into associate activity to pinpoint where associates struggled and identify issues before they interfered with service levels. Rather than only getting information on missed service tickets, the team reviewed raw data on all tickets to strategize and take preventative action like adding overtime or more individual associate coaching. As a result, fewer associates fell behind with too many tickets. 

Results

The client’s backlog of 30,000 medical records and invoices was reduced to zero, thanks to TTEC’s offshore team in the Philippines who reviewed, analyzed, and annotated data that enabled the client’s OCR to process payouts of pet insurance claims faster. The team now manages 3,000 tickets per week. Customer satisfaction rose as a result, particularly among Millennials known for their willingness to spend on their pets and who expect their claims processed quickly.

Before TTEC took over, the client reached only 44% of its service level agreement (SLA) – ticket completion in five days or less. Within a year, TTEC improved efficiency by more than 2X -- consistently achieving 95% SLA attainment and exceeding the client’s SLA target of 92%. Quality scores hit 90%.

The client saved in staffing costs because the data-annotation task did not require the customer support skills and resources the client had allocated to the job prior to engaging TTEC. By unburdening its U.S.-based, salaried workers ($70,000 a year) of data annotation and transferring that task to well-qualified offshore workers, the client achieved labor savings quickly.

With high integrity data and smarter algorithms, the client’s OCR and machine learning capabilities will continue to improve, enabling faster processing and the excellent customer experience. The combination of AI and human intelligences continues to provide peace of mind for pet owners and higher efficiency for the client.