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Business Rule Engine for Insurance


InRule provides a window to look into the IT applications that support the business, allowing underwriters, claims managers and other business users to create and maintain the rules, calculations and logic that drive the competitive insurance business today.

     

What is a 'rule engine'?


InRule Technology helps improve business agility by externalising and automating complex decision logic and calculations. More simply, any IT application has complex rules often deeply embedded in the code. The InRule approach is to take these rules out of the application into a rule engine, where the logic and calculations are executed. Better still, these rules are then able to be modified by non-IT people.  


Why is it relevant to insurance?

  • Control costs through automating routine tasks
  • Reduce insurance risks by promoting consistency between rules and business conditions
  • Increase speed and flexibility by getting analysts, actuaries and underwriters closer to the rules that systems use
  • Provide a framework for rapidly developing  dynamic customer facing systems
  • Make the logic in calculation intensive applications easier to create, manage, and maintain
  • Expedite underwriting, rating, and claims management decisions

How does it work?


Developers and business analysts (underwriters, claims managers, etc.) share a common rule catalog and server. Developers code applications to execute the rules (eg; rating calculations) based on data that’s input by end users. Underwriters use the irAuthor tool to make changes to the rates, logic, or calculation methods, and test the rules using the in-built irVerify tool.

 


  

Some Examples?

Quoting and Underwriting

The rules involved in underwriting books of the business are easily expressed in the InRule Business Language tool. The ability to easily modify, test, and execute these rules helps insurance companies triage quote requests to enable straight-through processing.

 

Rating

InRule is well suited for calculation-intensive rating development and maintenance processes, to alleviate the backlog and reliance on programmers for making rating logic changes. With InRule’s Excel-like syntax, actuaries and underwriters are immediately productive, writing complex rules and expressions that drive the rating process. In addition, they can make use of over 100 built-in functions including the use of aggregate functions over collections, such as summing up the premium at various levels such as exposures, locations, and policies.

InRule’s data functions make it possible to load and lookup data points in various rating tables for base exposure costs, factors, etc. Finally, InRule’s irVerify provides a complete testing environment to verify the calculations and rules are correct without programmer involvement. InRule has been used to provide quotes for over 40 lines of insurance coverage in both the US and Europe.

 

Medical Claim
Bill Re-pricing

Insurance companies that have needs to manage medical claim bill pricing have harnessed InRule to reduce their overall losses. By using rules, high volumes of medical claim bill transactions can be scrutinised to assist with adjudication of overbilled or fraudulent records thereby protecting the insurance company from making incorrect payments. Complex rules for cascading payouts on line items on a medical bill can be added as adjudications rules, reducing development and maintenance costs.

 

Commission Calculation and Document Composition

The rules behind commissions can change frequently and sometimes require customisation. By exposing the logic behind commission calculations to brokers, one-off and ad-hoc situations can be handled with ease. Likewise, special situations may arise which dictate custom behaviour for how documents are generated for an insurance company. Risk managers and counsel need the ability to change the rules for how documents are composed in their systems without entering a restrictive development/testing lifecycle.

 

Data Transformation

Because of regulatory reporting requirements, Insurance companies are often tasked to capture and deliver reports because of the legacy systems that are used for claim aggregation. Further, third parties involved in administration of claims may utilise reporting systems that are different in layout or format than the insuring company's system. InRule can be used to create transformation rules between systems leading to streamlined consolidation of claims storage and reporting.


Who Uses InRule?

aon

Aon provides innovative solutions in insurance and risk management, human capital consulting, and insurance underwriting. Each industry has unique requirements.

To manage those requirements, Aon built Winbroker – a .NET application that handles accounting, policy management and issuance, reporting, underwriting, rating, and claims for the insurance programs they underwrite. Rules authored in InRule are used extensively in WinBroker for complex rating calculations and underwriting and policy form selection logic.

"For one of our insurance coverages, it took an experienced programmer 120-160 hours to develop the logic [without InRule] for the rating program. An actuary, using InRule, was able to build and test the same logic in 14 hours." In addition, they used the tool to express their requirements instead of having to write up a huge Word document."

Underwriter, Aon Corporation


UK insurance brokerInRule provides business logic automation for a large UK niche market insurance broker.

InRule automates various aspects of this full cycle, multi-provider, award-winning insurance management system including:

  • comparative insurance quotations
  • policy issue
  • mid-term adjustments
  • renewal, cancellation and payment processing
  • compliance management

Doctors Company 

The Doctors Company is the leading physician-owned medical malpractice carrier in the USA. As an organisation founded, owned, and led by physicians, it is fiercely committed to protecting, defending, and rewarding its members. The company has $2.2 billion in assets and insures more than 32,000 physicians.

The Doctors Company uses InRule business rules software for components such as:

    • Creation of Electronic Document Routing Rules
    • Automation of Underwriter Assignment
    • Evaluation of Underwriting Rules and Flags
    • Automation of Coverage and Form Attachment

 


download free trial

Try it yourself

Download the software. It's simple to install and you can try the example applications including a simple rate calculation program.

 


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