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African insurance company utilizes cloud-based Hyland solutions to provide insurance via cell phones.

Heidi Badenhorst explains how aYo utilizes Hyland solutions to bring its cost of claims and service down.

aYo, a provider of micro hospital and life insurance coverage for underserved communities in Africa, has slashed claims processing time and costs thanks to claims automation built on Hyland’s Alfresco Process Automation.

aYo already has over 15 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.

Changing lives

Insurance products are often the only safety net for families when breadwinners die or are hospitalized. Without the cover aYo provides, families would be left without their daily income in the event that something should happen to the policyholder. 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. aYo premiums are also priced to be affordable for low-income and irregular-income earners alike.

Unique challenges

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. aYo’s aim is to reduce the number of claims assessors needed in each country and slash claims processing time from weeks and days to just hours. aYo’s three-phase automation and modernization project encompasses the following phases:

  • Phase 1: Automate claims document submission via WhatsApp to the document store.
  • Phase 2: Index and build a predictive model.
  • Phase 3: Implement five predictive models to instantly assess and approve claims with minimal human involvement.

Heidi Badenhorst, group head of strategy and special projects at aYo Holdings, said the dream is to reduce the time it takes to pay out claims from between nine and 11 working days, to as little as two to four hours from the time a claim is submitted. 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," Badenhorst said. 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 15 different solutions and Hyland’s Alfresco was the only one that ticked all the boxes.”

Downloading documents was a full-time job, but the automated process takes just minutes.

— Heidi Badenhorst, Group Head of Strategy and Special Projects, aYo

Claims made easy

With Hyland’s Alfresco Process Automation platform, aYo can now 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 policyholder's 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,” says Badenhorst.

Raphael Allegre, senior product manager at Hyland, said: “We are very proud to support the aYo claims automation project with our low-code automation studio that operates in the 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 organization orchestrate everything from simple document workflows to complex, content-rich business operations.”

Future-proof for growth

aYo Group CEO Marius Botha said the claims automation project is helping future-proof the company for sustainable growth.

“We receive 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 hundreds of millions of claims we expect to manage in the years to come.”

Monique Williams, Hyland’s regional manager of Southern Africa, describes the aYo team as true visionaries.

“They are pushing the boundaries of what is possible in insurance. This is one of the most impressive projects we have seen in this sector,” she said.

Added Botha: “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.”