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    FWA Solution From Metamorphosys

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    MetaMorphoSys is an insurtech company that builds digital insurance platforms powered by AI/ML. It has deep domain expertise in Asia Pacific, UK, and US insurance markets. The company's digital insurance platform supports innovative life, P&C, health and other insurance products across the entire value chain from customer acquisition to claims processing. The platform consists of several modules including a product configurator, underwriting engine, customer acquisition and engagement platforms, claims and provider platforms, and a fraud, waste and abuse prevention solution.

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    FWA Solution From Metamorphosys

    Uploaded by

    haophantuan1
    29 views7 pages
    MetaMorphoSys is an insurtech company that builds digital insurance platforms powered by AI/ML. It has deep domain expertise in Asia Pacific, UK, and US insurance markets. The company's digital insurance platform supports innovative life, P&C, health and other insurance products across the entire value chain from customer acquisition to claims processing. The platform consists of several modules including a product configurator, underwriting engine, customer acquisition and engagement platforms, claims and provider platforms, and a fraud, waste and abuse prevention solution.

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    FWA Solution from Metamorphosys

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    MetaMorphoSys is an insurtech company that builds digital insurance platforms powered by AI/ML. It has deep domain expertise in Asia Pacific, UK, and US insurance markets. The company's digital insurance platform supports innovative life, P&C, health and other insurance products across the entire value chain from customer acquisition to claims processing. The platform consists of several modules including a product configurator, underwriting engine, customer acquisition and engagement platforms, claims and provider platforms, and a fraud, waste and abuse prevention solution.

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    29 views7 pages

    FWA Solution From Metamorphosys

    Uploaded by

    haophantuan1
    MetaMorphoSys is an insurtech company that builds digital insurance platforms powered by AI/ML. It has deep domain expertise in Asia Pacific, UK, and US insurance markets. The company's digital insurance platform supports innovative life, P&C, health and other insurance products across the entire value chain from customer acquisition to claims processing. The platform consists of several modules including a product configurator, underwriting engine, customer acquisition and engagement platforms, claims and provider platforms, and a fraud, waste and abuse prevention solution.

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    of 7

    MetaMorphoSys

    FWA Solution
    powered by AI/ML

    © MetaMorphoSys Technologies, 2023 | Page 1 08th Feb 2024


    MetaMorphoSys Corporate Overview

    An InsurTech focused on building innovative B2B cloud-based


    software products that optimizes the Insurance value chain from Customer
    Acquisition to Engagement

    MetaMorphoSys Digital Deep domain expertise in Asia Microservices based API On Demand/On
    Platform supports innovative Pacific (India, Singapore, enabled platform to launch Premise
    Life, P&C, Health, Personal Indonesia, Hong Kong, innovative products and MetaMorphoSys Digital
    Accident, Low Ticket & Vietnam), UK and US Insurance empower the sales and Insurance Platform
    Episodic insurance products Market services team

    On-Premise/On-Cloud/Pay As Team with experience in Delivery model focused on Flexible


    You Use architecting Intellectual Business Outcomes Implementation &
    Property/Products Commercial Models

    STRENGTHS

    Experience Insurance
    Team Years of
    in Man 200+ Size 100+ Operations 7+ Products 500+
    Years Configured

    © MetaMorphoSys Technologies, 2023 | Page 2


    MetaMorphoSys Digital Insurance Platform

    Product Configurator, Quotation & Rules Underwriting Engine


    Engine (ThUnderWrite)

    Launch Innovative Products using Existing Vocabulary, Rules & Templates Auto Underwriting & STP
    Unified Rating Engine to Support Omni Channel Underwriting Workbench

    Customer Acquisition Platform (Agent


    Buddy) Claims Platform

    Dashboard  Lead  Activity Quotations e-App Claims Intimation Registration  Auto Approval & STP
    e-Signature  Documents  Auto UW  Policy Issuance  Claims Servicing Sales Claims Workbench  Claims Adjudication & Settlement  Fraud Analytics
    Analytics

    Customer Engagement Platform (Customer New Business Platform


    Buddy) & Customer Workbench
    Dashboard  Profile Policy Management  Renewals End-to-End New Business & Renewal Platform
    Loyalty Rewards  Health & Wellness Telematics Claims  Renewals Customer 360 Workbench, Conversation Engine

    Fraud Waste & Abuse Platform Provider Platform

    Static rule & Anomaly based model Provider lifecycle management


    Fraud propensity score & Recommendation Frontend for All Provider types
    Close looping of all platforms

    METAMORPHOSYS DIGITAL INSURANCE PLATFORM


    www.metamorphtech.com

    © MetaMorphoSys Technologies, 2023 | Page 3 Module proposed


    MetaMorphoSys FWA Foundation

    FWA System foundation with 4 pillars

    • Rules based on • Define Clusters • Rich Fraud Repository


    • Line of Business • Line of Business • Activities being done during
    • Product type • Boundary level Rules • Product type repair of vehicle
    • Configured with dynamic • Grey areas to be defined • Each cluster to have • Pictures and Videos (Before,
    variables • Each Anomaly to weighted score Policy prior and Now)
    • Each rule mapped with score understand the • Logic within each cluster to • Financial standing & Track
    & category correlation factor undergo self learning mode record

    Social
    Network
    ML based
    analysis,
    Rules Anomalies Predictive
    Fraud
    modelling
    Database
    & KYC

    © MetaMorphoSys Technologies, 2023 | Page 4


    Fraud Analytics Engine

    Anomaly level analysis


    Fraudometer

    Rules failed

    Does Not need investigation Needs investigation Reasons of Fraud

    Mapping at the entity level

    True
    Positive

    Self learning Refine the rules/logic


    False
    Positives Close Looping System Checks, Controls &
    learnings of FWA

    Strong Investigation
    Report Submissions
    Flow

    © MetaMorphoSys Technologies, 2023 | Page 5


    MetaMorphoSys FWA Solution – how it works

    Cases with PII masked data


    in Excel
    Insurance MMS FWA solution
    company hosted on MS Azure
    Cases with FWA results

    No Case Details Fraud


    1 TXXXXXX8J6 N
    2 RXXXXXXMT9 Y
    3 GXXXXXX608 N
    4 KOXXXX63MN N
    . …… .
    . …….. .
    n CCXXXXKL589 Y
    © MetaMorphoSys Technologies, 2023 | Page 6
    Thank You

    © MetaMorphoSys Technologies, 2023 | Page 7

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