Exploring s.360 Interactive Manual
The Convergence of Technology and Medical Underwriting for Life and Health Insurance
With the necessary medical knowledge and 35 years of experience in the market, Samplemed has written its own Underwriting Manual aiming for a more dynamic, clear, and user-friendly solution focused on the underwriter. A dynamic solution for a complex problem.
In the context of insurance medical analysis — especially Life and Health insurance — various sources of data and information are interconnected in a complex network. As technology seeks to streamline processes, its goal is not to replace but to complement the work done by professionals. Simone Melnick joined the team in 2015 to conduct medical interviews at the homes of life insurance applicants. About six months later, she was hired as an underwriter, also providing medical advice in the underwriting area. Simone graduated in Medicine from UNIFESP and says that the Manual is a completely innovative and multidisciplinary project.
About the routine at Samplemed Group and the day-to-day insights for the task of producing a underwriting manual for Life risks, Simone explains:
“We participate in an assembly process of questionnaires that is dynamic, we have very specialized systems that enhance the underwriter’s work. Always dealing with underwriting medical advice, conducting and preparing to apply training, participating in the process of developing a new life insurance product — it’s all very rich.”
Let’s learn a little more about this final product, the Samplemed Underwriting Manual, already available in the market and constantly improving.
TOP Benefits of the Interactive Underwriting Manual
New demands and needs are emerging, driven by collaboration between humans and technology. Samplemed’s manual is the first to use a underwriting web semantic for life insurance, which involves creating a structure of interoperable and standardized data that allows for the integration and sharing of relevant information in an automated way among different systems and data sources. Simply put, it’s a way to leverage technological advances to make the underwriting process more efficient, precise, and personalized.
Today, the Manual, linked to a complex group of taxonomies as the backbone of the system’s interactivity, reveals the milestone achieved of 11,000 pre-automated rules on the s.360 platform — and counting. An achievement like this belongs to all the dedicated teams of specialists from various areas who contributed to the creation and maintenance of the manual.
Samplemed offers its manual as a framework for underwriting teams to delve into research and generate their own sets of rules and risks, using the core sample in the system as a basis. With this, they aim to empower teams to expand and refine their underwriting strategies.
Additionally, interesting details, the Samplemed Interactive Manual also features:
- Over seven insurance coverages including Life, Accidents, and related with final decisions;
- Fifteen types of automated final decisions within the major groups of Acceptances, Declines, Inconclusives, and Aggravations;
- An assistant that helps the underwriter choose questions when creating a questionnaire, based on selected diseases, using over 1,000 mapped questions as suggested investigation for specific risks and 3,000 expected response options;
- A specific module for studying and correlating comorbidities and exception mapping.
Simone says that the greatest differential of Samplemed’s Manual is the possibility of integration with all underwriting models in a single environment, which is essential for tracking processes and generating opportunities.
“I see that it really started from a daily underwriting need. I was positively surprised by the way it happened. And everything goes hand in hand with the company’s mission, of technological innovation and providing protection for more and more people.”
About the underwriting process, Simone explains in steps:
“An extensive list of pathologies is made, each topic undergoes bibliographic research, content and review, medical area advice, manual team, and IT,” says the doctor. “Coming out of underwriting, the content still goes through layers of other involved teams, such as taxonomy, translation, and others before integrating the s.360 system. It’s a very robust process. Still, we work with levels of authority to release medical opinions, with layers of permission and double-checking from the point of view of case complexity.”
The implementation of technological solutions in medical underwriting manuals provides greater efficiency, agility, and accuracy in risk assessment, identifying patterns that may influence underwriting decisions. Simone also adds that remote work was a challenge because underwriting deals with sensitive information traffic. “All of our systems were already prepared for LGPD, and the platforms ensure security.”
A Look Toward the Future of Risk Analysis
“Just like in medicine, technology will increasingly be incorporated as an ally in the underwriting process,” says Simone. “We will have a closer look at the increase in population longevity and, consequently, changes in risk decision-making.”
In this scenario, innovation in medical insurance arises from the dynamic interaction between these data sources, where machine learning algorithms are used to analyze and extract valuable insights. This approach allows insurers to identify patterns, trends, and correlations that can improve risk assessment, personalize insurance offerings, and enhance healthcare services for policyholders.
Simone also sees integration between life and health areas, focusing on disease prevention, which is advantageous for all involved.
“The use of data will become increasingly prevalent in the underwriting field as well as in the medical field. There will be opportunities for improvement, for increasingly personalized new products, which will also help identify patterns of behavior, deviations, frauds. All of this, of course, without ever abandoning the characteristic humanized care of Samplemed.”
More about Samplemed:
Samplemed is a Medical Group, the Holding offers Medical Services for Life Insurance and Underwriting as well as technology, as predictive models and the s.360 SaaS. Get to know more about the s.360 and see the life underwriting websemantics writing to mailto: info@s360.lifeÂ