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FINEOS Actionable Data delivers embedded AI, GenAI and Reporting in the case managers’ core platform – FINEOS AdminSuite. Our AI-driven assistants seamlessly interact with FINEOS workflows and user interfaces. FINEOS Customers can tailor AI assisted automation and validation to meet their specific needs at any time.

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Generative AI

For many years, the unstructured nature of documents and notes has been a significant barrier to quick turnaround times and high automation in insurance processes. While the proliferation of APIs has reduced the number of documents in our ecosystems, many still remain. Generative AI (GenAI) offers a groundbreaking opportunity to work with document contents in unprecedented ways. With GenAI, we can assess documents, recommend actions, and enhance automation flows before human involvement.

FINEOS GenAI initiatives are guided by our AI Governance Policies, which prioritize transparency, decision ownership, and human-in-the-loop usage. FINEOS customers can adjust AI assistance and automation levels to align with their own AI policies and risk management approaches.

FINEOS GenAI solutions focus on assisting case managers in making high-quality decisions efficiently, including:  

  • Document Summary: Summarize all incoming documents for ease of review.
  • Form-Based Automation: Automate processes based on the content of forms.
  • Case Flags: Identify potentially impactful flags in case documents that need to be addressed.

Predictive Models

Machine learning helps an insurer make better decisions. Purpose-built machine learning predictive insurance models offer strong value out-of-the-box, avoiding a long specification and development process, providing a much shorter period of model maturation.  

The FINEOS Platform offers several predictive models relevant to your business.

  • FINEOS Claims Triage: Segment claims based on risk of crossing duration thresholds.
  • FINEOS Claims Transition: Identify short-term disability claims with a likelihood transition to long-term disability.
  • FINEOS Claims Duration: Predict  average claim duration based on a series of claim and related factors.
  • FINEOS Claims Settlement: Identify long-term disability claims with a likelihood to settle based on claim attributes.
  • FINEOS Census Standardization: Normalize census files using a standardized data model.
  • FINEOS Annuity Fraud Scoring: Assess annuity fraud likelihood based on application, distribution source, and employee connections.

Operational Intelligence

All FINEOS analytics capabilities are available to the operational teams in FINEOS AdminSuite, helping to drive smart operational decisions.  

Operational Intelligence is presented throughout FINEOS AdminSuite in purposeful contexts.

  • Supervisor Dashboards: Live visuals of team workloads and calendar of upcoming work. Drill down to view further details and reassign work as appropriate.
  • Operational Reports: Analyze trends in workflow across departments, teams, users, case and task types over as many years as you have data. Slice and dice data to identify bottlenecks and areas of attention. Save and export visuals for sharing with colleagues or partners.
  • IDAM Employer Reporting: Deliver up-to-date deep intelligence on employer experience across Claims, Absence and Accommodations. Embed reports into employer portals through API’s and view reports in context of the employer record on FINEOS AdminSuite. Allow employers or account leaders to slice and dice experience data across products and across the employer engagement since inception. 
  • Embedded Analytics: View predictive analytics scores on dashboards, on portfolio views, in case summaries and in great detail on the case record. Filter and prioritize portfolios based on analytical outcomes. 
  • Process Analysis: Review process flows for all processes across lines of business. Identify common paths, time on each step, frequency of visits for each step.   

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FINEOS Actionable Data – Frequently Asked Questions

Actionable Data is part of the FINEOS Platform that allows insurers to use customer-centric data models to gain real-time analytics data from multiple channels across their entire insurance digital ecosystem to inform operation decision making.

Yes. FINEOS uses embedded, real-time analytics to leverage platform data which helps insurers determine smart operational decisions.

Immediate insight into a given case, plan or policy provides accurate and efficient decision making for insurer staff, policy holders, and employers.

FINEOS Insight with real-time embedded analytics provides operational and product trending data to ensure your customers the best service experience. Identify key business trends and opportunities while also saving time and money.

The FINEOS AI program focuses on 3 different areas. The first is leveraging cloud AI platforms. The second is collecting data and presenting predictions to improve internal insurance models and providing decision assistance. The third is developing new Life, Accident & Health machine learning models. Learn more on FINEOS.com