Technologies, revolutions, and crisis

In March 2020 Antares went from an office-based organisation with managed IT in centralised locations to running over three hundred remote offices around the globe overnight. Although not seamless, the transition to an environment where business was done via virtual meetings, online synchronous collaboration and messaging replacing email, was quickly adopted alongside millions of other companies. The companies that provided the technologies that supported this global change poured money into development of the tools that help us run our business today.

The lessons learnt from that accelerated use of technology are now being applied throughout organisations and form the basis of our digital strategy. Our strategy aims to deliver operational excellence and the adoption of innovation, both through internal change and working with partners to extend our own capabilities. This global revolution focusing on operational excellence is driving the transformation of our internal processes using automation, artificial intelligence and data management technology.

The pace of innovation in our market such as real time flexible products or AI driven claims assessment, present additional opportunities if we can adopt and integrate them into our business efficiently. There is obvious value in using AI to make a claims assessment quickly and accurately, but the full value comes from automatically processing the data from the assessment, carrying out all the fraud checks and making payments for the claim as well as feeding and enhancing our risk and pricing models. This also results in changing the roles of our people to provide management and oversight of these processes and it is this change which must be managed to truly realise the value of digital transformation.

The ability of our IT functions to quickly integrate new innovations into our IT landscape has several challenges and solutions, both technological and people. By adopting a composite approach to solutions, we can make the most valuable components of our systems modular so they can be reused, as well as investing in API technology to support new services. The customer engagement model is changing, and these technologies will enable new digital products such as claims portals and chatbots that can hook into these modules.

The pace of change and opening of IT services also brings increased cyber risk and this will remain high on the CIO and Board’s agenda for the foreseeable future.

The pandemic also brought about a change in the IT workforce with many experienced IT professionals leaving the workforce at a time when demand is surging. This shortage of skilled IT resources is unlikely to be resolved in the short to medium term so we must look to attract, retain and train our IT teams to support the transformation of our business and we see this as an ongoing challenge.

Ultimately, successful digital transformation is a combination of people, process and technology and we believe this can only be achieved by using a combination of our own people and partnerships with other companies to benefit from their specialist expertise and systems.

Core Points

Ÿ The digital office has been adopted at an unprecedented rate due to Covid, we’re seeing ten years of evoluon in workplace technology over the last three years.

Ÿ New ways of working digitally with automaon, AI and data management is now driving operaonal excellence.

Ÿ The ability to adopt new innovaons, oen working with partners, into an ever-changing IT landscape demands a new approach to digital transformaon.

Ÿ he pace of change across all industries combined with the drain of experienced IT professionals leaving the workforce throughout Covid makes aracng and retaining talent a significant challenge.

Mr. Ahmed Zebeib Deputy Chief Executive Officer, QLM Qatar Life & Medical Insurance

Mr. Ahmed Zebeib Deputy Chief Executive Officer, QLM Qatar Life & Medical Insurance

Background: QLM Life and Medical Insurance is considered as the largest health insurance company in Qatar and the only specialised company that leads the health insurance sector through its advanced services and flexible insurance programs that suit all segments of society in Qatar.

W e live in a world that has become highly dependent on information technology in management, especially with managing a large volume of data as is the case in health insurance. Therefore, our vision in this field was to develop a system capable of absorbing any volume of data and managing it effectively in the most efficient way possible. This will in turn positively reflect on the speed of responding to the requirements of our customers and the requirements of medical service providers at the same time.

The advancement of technology benefit both insured members and insurance companies, QLM is no exception. QLM is constantly innovating and growing, we capitalized on the extensive data, experience, and technology advancement to build an outstanding insurtech to guarantee excellence in our services, and at the same time gives us a real time feedback on operations. The development of our solutions was highly sophisticated as it involved many parties internally as well as externally. We've invested in developing a highly sophisticated solution involving both internal and external parties.

We managed to build a system through an interactive electronic platform that automatically approves without the need for human intervention except in rare cases, which shortens the time for issuing approval to a record time where the patient experiences a seamless process. This electronic platform helps health centers communicate, get the right information, and make the whole transaction an easy journey for both parties. All this is in the interest of the client/patient who will feel that they are receiving prompt and a high standard service.

Today, our systems are all online and fully integrated with healthcare providers inside as well as outside Qatar, the provider can at a fingertip verify eligibility, obtain approval, and submit a claim all online without the need for any direct interaction with our team. The secret behind this is the claims autoapproval/auto-adjudication, our systems are equipped with all medical international coding that are mapped together in the back end of the system. Therefore, any coding the provider is using is mapped and auto adjudicated in the back end and the decision is communicated to the provider by the system.

The crown jewel of our IT platform is the Artificial intelligence (AI) that we have developed. Underwriting in health insurance is always seen as risky and needs extra attention, our AI module analyzes the data provided by the client and at same time analyzes the existing QLM data measuring behavior, trend, frequency, etc. Thus, suggesting an appropriate premium with prediction of loss ratio based on the suggested premium. Our AI is constantly monitoring behavior of providers in real time and alerting our team of any abnormal behavior that is taking place, it is monitoring the auto-adjudication module and correcting any errors that may exist during the process.

We are constantly evolving and growing as the leading Medical and Life insurer in Qatar, as we rely heavily on tech, we will continue investing where appropriate to maximize the satisfaction of all our partners. In QLM we believe that insurtech is the present and future. We will continue playing our role and assessing the markets worldwide while simultaneously be at the forefront when it comes to tech and for others to follow.