Read this article about MetLife, one of our finalists, in the category Best Achievement in Data Analytics enabling Operational Excellence, selected by the independent judging panel, for the 2019 Business Transformation & Operational Excellence Industry Awards program. Click here to read articles on other finalists.

MetLife’s digital strategy aims to unlock the potential created by the shifting landscape of the digital age, where customers are highly empowered. As a part of this strategy, the company is in the midst of a multi-year transformational effort to enhance claims processes through new digital solutions that increase efficiency and simplify the employee and customer experiences.

MetLife is harnessing the power of data by incorporating data analytics into its processes across the claims lifecycle, enabling quicker and more accurate decisions and improved clinical outcomes for customers.

Improving customer interactions

MetLife is helping its U.S. claims professionals become more empathetic and trusted partners for its customers with Cogito®, an artificial intelligence technology that acts as a coach – providing real-time alerts to help employees speak faster, slower or listen more – regardless of language or dialect.

Results from roll-out are promising, including:

• 13% improvement in customer satisfaction scores month-over-month
• 10% decrease in average claim handling time
• 15% increase in customer engagement scores

MetLife has rolled out Cogito® to approximately 800 associates and estimates approximately 1,300 associates using Cogito® by Q3 2019. Teams are assessing whether to leverage this solution for its Mexico and Japan claims groups.

Simplifying the process for how we route claims

MetLife’s long-term disability (LTD) business processes more than 26,000 claims each year. Assigning the appropriate likely claim progression (LCP) to a new claim is a complex and lengthy task, which requires claims specialists to manually access and validate medical and other relevant data in order to make their decision.

To make the LCP identification process more efficient and consistent for customers and claims employees, the claims organization’s advanced analytics team introduced a machine learning solution that uses available data (e.g. medical data) to assign a LCP to each new claim shortly after it is received. Once the LCP is identified by the model, a claims specialist validates the data collected throughout the process, checks the customer’s eligibility, and makes a claim decision.

Early adoption of the LCP model has helped reduce the average time needed to make a claims decision by approximately 10%, which decreased the length of the overall process from approximately 38 to 34 days.

Reassessing our special handling unit for claims

The disability special handling unit (SHU) within MetLife reviews and manages approximately 48,000 long-duration LTD claims which typically have durations greater than 24 months. There are 24 case managers working these claims, with an estimated caseload of 2,000 claims per person.

Leveraging a data model, an analytics engine using AI, text analysis and Qlikview visualization techniques, the team was able to deliver a solution that provided “at-a-glance” views of variances and anomaly patterns within the data in one central dashboard. 

While it historically took a case manager approximately 45 minutes to complete a claim review, the new analytics-enabled solution produces the variance analysis in approximately three seconds. We’ve seen improved accuracy of variance detection and more accurate referrals from the SHU unit based on variances and the need for additional investigation.