aYo, a provider of micro hospital and life insurance cover for underserved communities in Africa, has slashed claims processing time and costs thanks to claims automation built on Hyland’s Alfresco Process Automation platform.
Hyland is a leading content services provider that enables thousands of organisations to deliver better experiences to their customers.
aYo already has over fifteen million people enrolled on its system in Uganda, Ghana, Zambia, and Cote d’Ivoire. As an MTN subsidiary, aYo has ambitious goals to scale up across all the markets MTN operates in, taking low-cost life and hospital cover to over 100 million people via their mobile phones.
Insurance products are often the only safety net for families when breadwinners die or are hospitalised. “Without the cover aYo provides, families would be left without their daily income in the event that something should happen to the policy holder,” says aYo Group Chief Executive, Marius Botha.
To support financial inclusion and to reach a huge underserved market most effectively, aYo customers can sign up, engage, transact and claim using their mobile phones. “Historically, the vast geographies covered, and the low cost of each premium, meant that aYo had to make claims processing as efficient and cost effective as possible. We aimed to reduce the number of claims assessors needed in each country and slash claims processing time from the current average of between nine and eleven working days to as little as two to four hours from the time a claim is submitted,” he adds.
Heidi Badenhorst, Group Head of Operations and Client Experience at aYo Holdings, explains that aYo’s three-phase automation and modernisation project encompasses the following phases: Phase 1, to automate claims document submission via WhatsApp to the document store; Phase 2 will see indexing and building a predictive model and Phase 3 will involve implementing five predictive models to instantly assess and approve claims with minimal human involvement.
To achieve Phase 1, aYo had a challenging requirement – the solution deployed had to feature Optical Character Recognition (OCR) capable of reading hand-written medical documents and low-resolution images compressed for WhatsApp.
“OCR was key, but most solutions cannot read documents in 96 dpi resolution. We also needed something capable of managing the rules engine, content store, process orchestration, and security – which was also crucial as we are dealing with medical and health data. We compared around fifteen different solutions and Hyland’s Alfresco was the only one that ticked all the boxes,” says Badenhorst.
With Hyland’s Alfresco Process Automation platform, aYo can now allow clients to easily submit their claims and upload supporting documents using WhatsApp. A simple interface allows people to submit documents for themselves, or on behalf of someone else, using the policy holders cell phone number as the primary identifier. The documents are automatically indexed and create a task, eliminating previous manual processes in which a dedicated staff member had to download all uploaded documents at aYo claims offices. “Downloading documents was a full-time job, but the automated process takes just minutes,” Badenhorst adds.
Monique Williams, Hyland’s Regional Manager – Southern Africa, says Hyland is very proud to support the aYo Claims Automation project with its low-code automation studio that operates in Alfresco Cloud. “In just a few weeks the team has been able to integrate with WhatsApp Business, AWS Textract, and other cloud-based machine learning services facilitating an automated solution that ensures an improved customer experience at the point of claiming. Our mission with Alfresco Process Automation is to help any organisation orchestrate everything from simple document workflows to complex content-rich business operations,” she says.
Williams describes the aYo team as true visionaries pushing the boundaries of what is possible in insurance. “This is one of the most impressive projects we have seen in this sector.”
Botha confirms the Claims Automation project is helping future-proof aYo for sustainable growth. “Many companies give clients with low and irregular incomes a subpar service. We believe these clients deserve the experience of a world class service. Their need is often greater than that of higher income groups because they don’t necessarily have a backup or a safety net to tap into when unexpected events occur. aYo is working to fundamentally change and improve the lives of the clients we serve.”
He notes that aYo receives around 30,000 claims per month from the three countries where aYo is most active. “However, our experience over the past four years has shown that scaling up of claims tends to happen around two years after we enter a market. As we become more established and grow into more of MTN’s markets, we will see exponential growth in claims volumes. We had to automate and improve efficiencies to support the millions of claims we expect to manage in the years to come,” he concludes.