The cure: innovation and empathy

The cure: innovation and empathy

Science, artificial intelligence and a fresh approach are helping QBE make a difference for injured customers

By Bernice Han

Firefighters had to cut Jane Black (not her real name) out of the wreckage of her car after a road accident, but just hours later she was discharged from hospital. She thought she’d been lucky to get off so lightly, but that changed when the extent of her whiplash injury made itself clear.

What followed was a long period of constant severe pain that called an end to her favourite outdoor activities, long walks and cycling. The pain and discomfort meant she could only dream of taking up those pursuits again. All Jane wanted was for her nightmare to end.

Thanks to a project QBE started two years ago, the nightmare did end. The Sydney resident has recently resumed walking and riding her bike, free from pain.

Jane’s recovery is an example of the ways science and technology can be used by insurers to achieve dramatic results for injured customers.

The case manager at QBE who was handling Jane’s compulsory third party (CTP) claim referred her for treatment with Active Recovery Clinics, an injury rehabilitation specialist.

At her first consultation a clinical team – which included an orthopaedic surgeon, a psychologist and a physiotherapist – ran medical checks and recommended her for the company’s whiplash treatment plan.

Patients in the recovery program engage in customised home-based exercises, which are supervised remotely via a computer program that tracks their progress using motion sensors and tablets.

David Bacon, QBE’s General Manager for People Risk Claims, tells Insurance News Jane’s program was “a combination of bio-sensors to monitor her exercise program and a psychological monitoring program to ensure that she was recovering well”.

The whiplash program is part of the QBE project that Mr Bacon has been overseeing since its launch two years ago.

Improving innovation in claims practices through the application of science, artificial intelligence (AI), analytics and other hi-tech variants is the over-arching aim of the exercise.

Its development stems from the “Brilliant Basics” program that QBE Group Chief Executive Pat Regan introduced when he took up the role at the start of 2018.

Underwriting, pricing and claims, the three pillars of an insurer’s business, form the focus of the Brilliant Basics program. In People Risk Claims, it was clear to Mr Bacon and his team where they should be directing their efforts.

“The approach we chose to take was to significantly enhance the application of the science and analytics in our business to be able to work towards helping people get their lives back together,” he says.

The initiative wasn’t just about cost savings for QBE, but also about working more closely with the injured customer.

“We observed that a lot of the academic work around injury recovery was very well established and very well researched, but really there was no effectively practical application of that in workers’ compensation or CTP.”

There also was also a motivation to add something Mr Bacon believes was missing from the handling of personal injury claims: empathy.

“One of the things we observe often in the industry is a very strong focus on process compliance rather than finding scalable ways to work with injured people – to actually help them recover while using science and analytics to guide us on that path,” he says.

“Empathy is really, really important. “

So we set out to change that. We arranged a series of partnerships with different healthcare organisations and academic organisations, as well as data analytics partners to help us work towards taking the science of injury recovery forward.”

One strength of the approach his team took is fundamental. If a pilot program produces less than satisfactory results, walk away from it.

James Hay, Head of People Risk Claims Strategy and Performance at the insurer, says this principle “has really served to guide us in what we implement and what we don’t”.

“We wanted to really understand the problems that we saw in workers’ comp and CTP schemes and test different things. So it wasn’t just about coming up with solutions and forcing them through.

“This is really about ‘test and learn’. We’re trying things, implementing them into our business, seeing how they work, determining the results and deciding if they are positive or neutral or not having the effects that we expected.”

The results from the project, which applies nationwide to CTP and workers’ compensation claimants, have so far have been very positive.

The whiplash recovery program, for example, has resulted in recovery rates for QBE-funded patients that are about 20% better than traditional rehabilitation treatment achievement rates.

QBE has so far paid about $10 million to put claimants through various injury recovery programs with external partners.

Apart from Active Recovery Clinics, the project’s other partners include US-based artificial intelligence specialist Clara Analytics and BehaviourWorks Australia, a research group affiliated with Monash University in Victoria.

QBE first worked with Clara Analytics in 2017. The insurer at that time was keen to apply artificial intelligence to help its workers’ compensation frontline staff manage claims.

Buoyed by the results, the insurer announced in December 2018 that it will adopt the California company’s knowhow for its CTP business.

Jayant Lakshmikanthan, founder and Chief Product Officer of Clara Analytics, tells Insurance News his company strongly believes “the best way for an insurance company to compete is by providing a highly differentiated, claimant-centric service”.

“QBE leads the charge on that front with a clear and unwavering focus on providing a compassionate service at scale to each injured employee.

Innovators: James Hay, left, and David Bacon

“We absolutely will continue to work with different types of healthcare organisations to bring in solutions that enable people to make a better recovery.”

“They are doing this by having a culture of doing the right thing for the injured person, coupled with AIpowered systems that help focus the team on the right claims.”

BehaviourWorks Australia trained four handpicked QBE employees over 18 months in the field of behavioural insights and ways to apply it in the claims process.

The initial results have been encouraging. The response times from treating doctors have improved 26%, with more important claims information provided. During the trial period, employers saved about $400,000 as claimants returned to work one week earlier through better engagement.

Liam Smith, director and co-founder of BehaviourWorks Australia, tells Insurance News that what has pleased him most about the collaboration with QBE was the team’s “ability to understand problems in new ways, focus on target behaviours, make better decisions about behaviour change interventions and test them”.

Looking ahead, QBE intends to continue with the project. The insurer believes that more good work could still be mined from the initiative.

“We certainly see this whole thing as being a continuous improvement program,” Mr Bacon tells Insurance News. “

We are not intending at all to get to the end and say, ‘well congratulations, we did well’. It’s really about what are the further types of services that we can bring for injured people to enable them to get better healthcare and recovery outcomes.

“We see that concept as being very broad – far more broad than has traditionally been the case – so we absolutely will continue to work with different types of healthcare organisations to bring in solutions that enable people to make a better recovery.”

Project partners

For now, the QBE initiative applies to the compulsory third party and workers’ compensation business lines nationally.

Here are some of the program partners and what they bring to the table.

Active Recovery Clinic and the whiplash recovery program

The program uses advanced rehabilitation technology such as wearable bio-mechanic sensors to help injured people through their customised recovery programs. The technology allows medical professionals to remotely monitor, support and guide patients through exercises at home.

Clara Analytics and artificial intelligence

QBE has an exclusive partnership in Australia with Californian company Clara Analytics to use its AI and machine learning models throughout the claims journey. The end results are improved risk identification, claims allocation and understanding the impact stakeholders have in the recovery and claims outcomes.

BehaviourWorks Australia and behavioural insights

QBE has teamed up with the research arm of Monash University to develop a behavioural insights unit in people risk claims. The behavioural insights team is charged with understanding how stakeholders interact in the insurance journey to deliver a better experience for injured people.