Business News: CLARA Analytics, IICF, Lemonade

CLARA analytics, a division of LeanTaaS, a Silicon Valley healthcare SaaS provider, announced the commercial availability of PUMA, a search engine that helps insurance carriers and their claims adjusters rapidly connect the injured worker to the right providers.

To date, early adopters have achieved significant improvements in operational performance:

• Reduction of more than 10 percent in average workers’ compensation claim costs;
• Reduction of 5-15 percent in temporary disability duration;
• Reduction in attorney involvement;
• Increased compliance with evidence-based guidelines for drugs and procedures.

The scoring engine from CLARA analytics rates providers not only based on operational outcomes like cost and duration but also on adherence to evidence-based guidelines. The results are then delivered to claims adjusters in a familiar search engine user interface and can be seamlessly integrated into existing workflows.

PUMA uses adaptive machine learning techniques to automate checks on excessive opioid administration by scanning through the bill lines of a claim and detecting evidence of non-compliance to drug and opioid guidelines. Providers are scored on an “A” (best) through “E” (worst) scale based on the level and extent of non-compliance of their prescriptions. These guideline-compliance scores can then be combined with the other scores to create a configurable, composite score for each provider.

Claims adjusters can access these scores for the providers through a search engine that gives a ranked list of providers, much like Google shows a ranked list of websites. Adjusters can immediately suggest the providers or package the suggestions in a text message to the injured worker. The result is a highly accurate, outcomes-based recommendation of providers in seconds.

A scalable product, it can handle any amount of data and any number of customers. It is offered as a secure, HIPAA-compliant, cloud-based application.

Deployment is completed in three phases:

Pricing for PUMA is based on the size of the customer, including volumes of new claims being received every year. Visit http://www.claraanalytics.com/products/puma to learn more and to schedule a demo.

The Insurance Industry Charitable Foundation (IICF) Western Division announced the establishment of its new Washington Chapter, which will broaden the division’s mission of providing grants, leadership and volunteer support to local community organizations in the greater Seattle area that focus on child abuse prevention, disaster preparedness, education and health and human services. This marks the introduction of the division’s third chapter, following the successful launch of its Colorado and Arizona Chapters in 2011 and 2012, respectively.

The Washington Chapter will be led by a board of senior industry leaders from prominent insurance companies across the region, with Molly Hunter, senior vice president, global relationship leader of Zurich Insurance, and Jacob Decker, vice president, drector of Financial Institutions of Woodruff-Sawyer & Co., serving as Chapter co-chairs.

Nearly 200 volunteers across the Pacific Northwest participated this year in the IICF’s annual Week of Giving, which brings insurance industry professionals together for a week-long series of volunteer projects to serve local nonprofits and community organizations. In total, the Western Division drove participation of 2,933 volunteers October 8 – 15 during the 2016 Week of Giving.

The inaugural IICF Washington Board comprises 11 senior industry leaders from across the state, representing companies including AIG, AFM, Berkshire Hathaway Specialty Insurance, Chubb, CNA, Great American Insurance Group, The Hartford, Swiss Re, Woodruff-Sawyer & Co. and Zurich.

Lemonade, the insurance company powered by artificial intelligence and behavioral economics, announced a $34 million B round. The funding was led by General Catalyst with participation from GV (formerly Google Ventures), Thrive Capital and Tusk Ventures, as well as existing investors Aleph, Sequoia, and XL Innovate.

This brings Lemonade’s total funding to date to $60 million. The investment comes less than two months after the insurtech company launched in New York, and less than a year after announcing its seed round.

Lemonade uses bots to deliver insurance to consumers through its app and at lemonade.com. Consumers chat with the AI to file claims too, and the bot is authorized to pay claims instantly and without human intervention. This creates an insurance experience that is fast, simple, and delightful.

Lemonade was licensed as an insurance carrier in the State of New York on September 15th, 2016 and filed for a license in California within hours. The company plans a broad expansion in 2017.

Unlike traditional insurance companies, Lemonade takes a flat fee, and gives back unclaimed money to causes policyholders care about. Lemonade’s ‘Giveback’ program derives from studies by Lemonade’s Chief Behavioral Officer, Professor Dan Ariely, and earned Lemonade a B-Corp certification.