About
Presenting CARA, a revolutionary Claims AI Reasoning Assistant by Irish Life, a game-changer in the insurance industry. With its cutting-edge generative AI and advanced medical reasoning capability, CARA is transforming how we process customer claims
Innovation presentation
Background
At Irish Life, we are honoured to support the physical, mental, and financial wellbeing of our 1.6 million customers throughout Ireland, touching the lives of half of Ireland's workforce.
Recognising the pivotal moment a claim is made, we understand the profound impact it holds for individuals facing health challenges or loss. While we cannot prevent illness, we stand committed to providing swift and meaningful assistance where we can during these vulnerable times. While there is an industry wide challenge in the speed at which these customer claims are assessed - our dedication to streamlining the claims process reflects our unwavering commitment to enhancing the wellbeing of our customers.
What is CARA?
To elevate customer experience and streamline operations, Irish Life proudly introduced CARA, a cutting-edge multimodal AI system. CARA's groundbreaking use of generative AI and advanced medical reasoning represents a paradigm shift in claims processing technology. Leveraging an intelligent document recognition platform, CARA seamlessly validates and transcribes claim documents, while its integration with Azure Cognitive Services' fine-tuned Large Language Models enables precise evaluation of medical criteria. By analysing illness correspondence, treatment history, symptom records, and risk factors, CARA ensures accurate and efficient claims processing, marking a significant advancement in the industry.
CARA delivers outcomes to assessors through an interactive platform, fostering commentary, monitoring audit trails, and fuelling continuous improvement. It adeptly handles multilingual data and draws insights from Irish Life's experienced claims assessors. When any uncertainty arises, CARA seamlessly follows the human-in-the-loop approach, engaging human expertise ensuring precise claims assessment, a hallmark of Irish Life's commitment to excellence.
CARA has empowered us to enhance the claims journey for over 1.6 million customers. Processing all 2024 Death and Serious Illness Cover claims (+3,000 annually) with 98.8% automation, CARA's success sets the stage for scaling to cover over a million claims annually in the future. This achievement underscores our dedication to innovation and customer-centric excellence.
Early Results & Potential
CARA stands as a pioneering system within the claims industry, exemplifying Irish Life's commitment to innovation excellence.
1. In Q1 of this year, CARA delivered an unparalleled claims experience to over 450 Irish Life customers.
2. Its initial phase, encompassing all Protection Claims, addresses an estimated +3,000 claims annually, valued at over €300 million.
3. The time from initial claim submission to payment has drastically decreased by over 90%, from weeks to now averaging just half a day.
4. Notably, employee satisfaction has surged, with assessors reporting positive experiences, aligning with our trajectory to exceed a targeted employee NPS of +3.
5. Looking ahead, CARA is poised to drive remarkable efficiencies, equivalent to the workload of 30 Full Time Employees (FTE), translating to an estimated cost saving of €2 million by 2025.
Uniqueness of the project
CARA pioneers a multi-modal generative AI system, a first-of-its-kind innovation in the Irish market. It seamlessly processes diverse inputs and outputs including text, images, speech, and structured data, revolutionising and automating the claims assessment process.
• With a relentless focus on customer satisfaction, CARA accelerates and simplifies the claims journey, reducing processing times from weeks or months to less than a day. By enhancing employee productivity, CARA reshapes the landscape for claims assessors, driving efficiency and effectiveness. Leveraging business rules and predictive machine learning, CARA intelligently assigns claims to assessors based on complexity and experience, ensuring swift resolution with the right expertise.
• As a scalable solution, CARA will extend beyond its current application to health and to other claim types and underwriting processes. Its potential also reaches beyond claims, with opportunities to optimise additional customer journeys and business operations.
