ProductsTruRisk helps underwriters set premium rates with clinical statistical models to accurately forecast group life, long term disability (LTD) and medical stop loss claims. Historical medical claims and eligibility are required to apply our clinical statistical models. Life and Disability:
TruRisk Life and LTD clinical factors can lower your loss ratios. Maximize your ROI while minimizing risk. We use a patented Bayesian approach for estimating Life and LTD claims that does not require linked person-level data. We have large pools of Life and LTD data that, when combined with your medical data, allow us to predict person-casetype, person, and group costs. At the group level, these estimates are accurate enough and robust enough to be used as clinical factors in underwriting decisions. To minimize your purchasing risk, we can first demonstrate the efficacy of our models using back-testing on your insured population. If you are not satisfied with the results, your only cost will be in extracting the necessary member and claim data from your data warehouse. The clinical factors for each product are normalized to your experience rates and can be combined with other standard underwriting factors for better informed pricing decisions. The incidence and cost models are generated from your experience and medical data, so the clinical estimates are specific to your population. TruRisk regularly updates the estimates to track changing group populations and incorporate new comorbid conditions. Stop Loss:
TruRisk Predictive Analytic Models generate estimates based on exact clinical conditions. These estimates are more precise than those based on conventional models as different medical conditions lead to widely different risks, e.g. chronic hypertension versus a recent serious heart attack. For the self-insured employer (target employee population: 100-10,000), these models enable CFO's to make more informed decisions on whether or not to purchase Aggregate Stop Loss insurance to insulate the balance sheet from unanticipated aggregate claims costs. For the insurer/reinsurer writing Aggregate Stop Loss insurance, this will better enable underwriters to establish and propose appropriate risk transfer thresholds and to price their product. As the ability to accurately forecast claims cost is the most critical factor for both self-insured employers and organizations providing risk transfer solutions, we believe that utilization of our models will yield distinct advantages. The broker/consultant organization utilizing our methodologies on a proprietary basis will be better equipped to develop effective solutions for its clients and prospects. The provider of Aggregate Stop Loss products will enjoy a distinct advantage as compared to its competitors as it will have better developed data on which to base underwriting decisions.
TruRisk clients have included insurers, reinsurers, MGUs, brokers and employers. The varying client perspectives have allowed us to develop decision support tools which are designed to help clients optimize their choices. Decision support tools help the client select the best type of risk transfer or insurance coverage, amount or terms of coverage or set optimal prices for quoting insurance coverage. Off-the-shelf models can be provided for these products. However, the client's data is frequently used to recalibrate these models to the client's experience, thereby producing more accurate forecasts. TruRisk can efficiently build custom designed models using the client's data and adapt the modeling approach and processes to the specific idiosyncrasies of the client's data and the models intended use. All TruRisk Clinical factors are product-specific. The benefit products require different models since different medical conditions account for greater or lesser portions of claims cost for the different product lines. For example, pregnancy and delivery are clinical categories that account for a large portion of medical expenses and short-term disability claims cost. Yet, pregnancy and delivery are inconsequential for long term disability (LTD) and life claims cost. Additionally, different data elements are available in different claims files and the linkage across claims and eligibility files varies by benefit line. These factors require alternative modeling strategies and statistical techniques, different definitions of clinical case types and varied risk factors by benefit line.
Presentation
Download
this MS Powerpoint presentation for more information on TruRisk Life and LTD Products.
|
|
|