In today’s ever evolving insurance business landscape, successful strategies of the past may not prove to be sustainable, let alone profitable in the future. Over the last 50 years, the Indian insurance industry underwent three radical transformations.
- The first transformation was when the private insurance industry with the usual level of government supervision, was nationalized. This was carried out in two stages - life insurance in 1956 and general insurance in 1972. This transformation created a monopoly in life insurance sector and a terrified oligopoly in the non-life sectors.
- The second transformation in 2000 saw the re-entry of a new breed of private companies and also foreign players (with a restricted stake of up to 26 per cent).
- The third transformation in 2007 saw the safety net of tariff based pricing being withdrawn in general insurance, leading to increased competition. With abiding speculations about the restrictions on foreign ownership being relaxed and the introduction of the new risk based capital norms along with various other changes, the industry is all set to metamorphose into a new landscape.
So, what does this mean in terms of business strategy for Indian insurance? What will be the impact of this anticipated future on today’s strategies? While in the long run, insurers may have to reinvent their present methods of doing business and adopt new and unforeseen initiatives, it would serve them well to optimize their current strategies to adapt to the business environment in the near future. In a data driven industry such as insurance, companies will not only need to compete in terms of their product offerings, but will also need to leverage business intelligence enabled analytics for a competitive edge.
In today’s increasingly competitive scenario, profitable growth is an elusive goal for the insurance industry. Rapid development and deployment of new products and product features, balancing broader distribution channel opportunities, managing risks across the organization, responding to increasingly demanding regulatory and reporting agency demands, and providing more precise pricing levels require effective decisions to be made with greater accuracy, efficiency and transparency. Insurers will need to analyze the impact of optimum non-financial performance in driving optimum financial performance. Instead of reacting to sudden changes, they would need to make accurate forecasts of future performance to plan business strategy.
Optimizing strategies: A driven by intelligent business analytics
In order to optimize their business processes, insurers will have to stabilize their existing operations and then accelerate profitability by understanding their optimum shape, product mix and operations. This translates into well defined strategies for the core areas of Marketing, Cost Management and Risk Management. Their strategies should empower them to: offer the most profitable product mix through the most cost-efficient channels to the most profitable customer; reduce operational losses through efficient claims fraud management and economic claims settlement; and effective risk based capital management. To dramatically improve efficiency and enhance business performance, strategic decisions should be aided by better executive and operational insight, by having the right infrastructure to support, analyze and understand the underlying complexities. The strategic insights gained into these core areas for insurance companies, both in the life as well as the non life sectors, by the use of intelligent business analytics are discussed in more detail in this article.
Marketing needs to focus on customer segmentation and effective distribution networks. Insurers experiencing poorer customer loyalty levels and increased costs, will need to become more customer-centric rather than product-focused. It will become extremely important for insurers to segment customers based on their behavior and potential profitability. Analytics can help them select more accurately, which policies and services to offer to which customers. To increase market share, insurers will have to employ cross-sell and up-sell techniques, facilitated by market basket analysis carried out on the basis of historical data of policies held by clients, as well as details of active policies, customer demographics, claims propensity and other key variables. Data from not only the traditional sources such as the insurers own records, but also sources such as records of the parent organizations can be used to identify various customer segment attributes. Apart from customer segmentation techniques, data mining can also be used to predict the likelihood of policy cancellation in advance, to aid in customer retention analysis by analyzing previous cancellation trends. Simulation models can also be used to generate the probable cash flows and compute the present value of a customer, by estimating the difference between the total amount of revenues from the customer and the expenses for the customer during the whole relationship period, known as the Customer Lifetime Value.
Increased competition is already putting downward pressure on premiums. This coupled with high customer churn and high customer acquisition costs has led insurance companies to implement multi-channel integration strategies. Distribution analytics can enable insurers to conduct “deep dives” into causal factors to answer a variety of questions. Issues such as unmet demand due to improper market assessment, segmentation, positioning and sales support, can be addressed. Similarly compensation and recognition programs influencing leading / lagging sales productivity and agent retention can be designed. All this can help in developing more effective sales channels.
New product development could also be positively influenced by better data analysis. Insurers’ portfolios of new products could be shaped by the new market opportunities which evolve from recent natural catastrophes, the latest technology, feedback from agents and customers, the availability of capital, the actions of competitors and changes in laws. With the use of data mining and predictive analytics, insurers can identify characteristics of individual risks and this will change how insurers see their market. New market opportunities can be identified by evaluating four main parameters. Firstly, by paying attention to the new and emerging needs of the customers. Secondly, by understanding the trends in the global marketplace, both demographically and geographically, and what the insurance implications of those trends might be. Thirdly, by developing new products in accordance with changes in legislation or regulatory environment. Fourthly, identifying new market opportunities by zeroing in on market needs that follow catastrophes.
Getting the right mix of price, claim, channels to market, operations and product differentiation is crucial for success and this can be achieved using business analytics.
Cost Management: Focus on claims fraud prediction and intervention.
As claims are prone to fraud or value inflation, the handling of claims affects the long-term sustainability of the company’s profits. Thus analytical solutions which can help manage the complex claims process effectively and help detect claims fraud by accurately forecasting likely outcomes in order to mitigate the severity of the claim, will be invaluable inputs in decision making and forecasting the loss reserves. Analytics can be used to benchmark claims to detect where padding might have occurred. Most companies have sufficient data to create claims benchmarks and claim value models. To manage fraud, companies can adopt a hybrid approach to detection, using a combination of profiling, rules to filter out fraudulent transactions and advanced analytics software.
Health insurers may develop predictive models to decrease claims costs by analyzing claim characteristics from their own claim files. This can
help them develop benchmark costs for various diseases by regions or by provider type or by severity. Such models can be used to identify highest-cost providers, claims having a higher propensity for fraud or enrollee with significant exposure. A step by step approach towards achieving this:
a) Acquire, load, and cleanse data from both internal and external sources, such as enrollment and TPA records.
b) Develop a methodology for carrying out effective analysis of variables, such as cluster diagnosis codes into easy to analyze disease categories.
c) Analyze and report on correlation of claim variables by geography, age, provider etc.
d) Utilize output to create package rates for treatments, set limits on benefits or undertake focus negotiations with providers.
As a consequence of the above actions, an insurer would be able to identify cost saving opportunities and develop tiered networks or disease specific limits to help achieve targeted loss ratios.
Risk Management: Focus on economic capital and solvency.
As every insurer has limited capital upon which to write new business, profitability is ultimately tied to effective risk management of capital. To adapt to a risk based approach, insurers will have to implement an economic capital regime, where they predict and evaluate the risk profiles of the underwritten business under both best case and worst case scenarios, and thus determine the prudent level of economic capital for sufficient reserves. Simulation techniques and stochastic models for various risks, such as credit, market, liability, group, underwriting and operational risk can be used for scenario and stress testing to determine the optimum economic capital level. This will not only facilitate risk-based capital but also enable real time solvency monitoring. Such a model would be adaptive to the insurer’s evolving environment, by adjusting its parameters as the economic conditions and liabilities change. The capability to accurately project its capital requirements can also be used to continuously monitor solvency since it can also estimate the change in the value of the time zero balance sheet as market conditions move.
An alternative to this approach is to calculate the solvency position on a statutory basis, but this would not measure the true likely response of the insurer to market events. Another possible approach is to use closed-form calculations for the cost of guarantees; however, these would be inaccurate because they do not allow for management actions and would thus result in only very approximate results. Such complex specifications cannot be met by traditional methods and require a state-of-the-art stochastic modeling approach, which is smart, fast and flexible.
Overcoming obstacles in implementation: Data quality and its capabilities
The issue of data has presented several challenges to all insurance industry stakeholders. Being able to conduct an in-depth analysis to provide critical strategic inputs directly depends on the quality of data. Over the past couple of years the awareness about utility of data in building rating structures, product design and flexible pricing systems has increased. However the industry has not fully transferred this knowledge to action. This was partly due to the fact that earlier the data was hard to use, it was frequently of poor quality and incomplete. In addition, different data was captured in different formats, thus making data aggregation and analysis at the insurance company’s end a very daunting task. This has changed over the past few years.
Suitability of data for analytical purposes can be ensured by focusing on two aspects - completeness and standardization. To ensure that the data is complete and accurate, validation features need to be introduced in the business front end and claims processing software tools. In addition to validation checks, it is imperative that the data must be collected in a standardized format. This can be achieved by standardizing the various forms used across the industry.
Insurance Regulatory and Development Authority (IRDA) has recognized that collection and dissemination of reliable and accurate data is important for the insurance industry and has formed the nodal Insurance Information Bureau (IIB). IIB has created a data repository to enable insurance companies, other stake holders and researchers to have easy access to validated data from one source.
However, data quality is only one side of the coin. The other side, supporting IT infrastructure, is again an area where insurers will have to work upon. An insurance IT system should capture and analyze information across all lines of business and risks. In addition, the system should provide analytic capabilities and produce reports for a variety of users. In general, a technology platform for deployment of a business intelligence analytical application should include the following:
- Data integration technology that can capture data, clean, transform and load data from operational systems into a data warehouse in near real-time to enable offline analysis as well as on-line analytical processing (OLAP).
- Data warehouse data management technology to manage information held in an operational data store, historical data marts for dimensional analysis, and analytical data stores for scoring and predictive data mining.
- Dedicated servers to analyze data for multiple user reporting and analytical applications.
- Tools to allow power users, managers and executives to build reports, slice, dice and drill, and mine data to model, score and predict.
Insurance is a data-rich industry and unfortunately, most of that data is underutilized. The key to gaining a competitive advantage in the insurance industry is found in analyzing this data and getting a greater business insight. Insurers can unlock the intelligence contained in their operational applications - like policy administration, claims management and CRM solutions - through modern data mining and analysis technology. Data mining uses predictive modeling, database segmentation, cluster analysis, neural networks and combinations thereof to quickly answer crucial business questions with greater accuracy. Business needs and business strategy must drive decisions about the structure and functionality of the business intelligence platform including the data warehouse and the data mart to enable this.
In summary, insurers should harness the power of extensive data provided by their business environment, conduct an extensive analysis of the data to model that environment and predict the consequences of alternative actions to guide executive decision making.
Business analytics solutions could be used by insurers to take rapid, effective and precise operational decisions in highly competitive markets, which maximize organizational value and minimize risks.
Submitted By,
Kichawele D. Msuya.
Roll Number: 12157.


