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Our Expertise

AMSTAT Consulting has become nationally recognized for helping insurance companies turn data into value without the hassle of managing complex infrastructure, systems, and tools. From implementation to data migration to tuning and optimization to data engineering and advanced analytics, the AMSTAT Consulting Professional Services team will work with you every step of the way. Our clients cite these reasons for choosing to work with us:

  • AMSTAT Consulting has a strong leadership team with Ph.D. in statistics at leading universities including Harvard, Stanford, and Columbia.
  • We are experts in advanced analytics.
  • We possess deep expertise in delivering actuarial services, adjudication, subrogation and other complex high-value processes that can help accelerate companies on the path to outperformance.
  • Our professionals are equipped with A1CPCU (IIA) / IF of CII / CPA / CFP and AAPC certifications a, and possess expertise across the insurance value chain.
  • Our mid-level and senior management is certified on CII’s CF1, FA1, and F2 certifications.
  • Our customer-centric approach, deep insurance domain expertise, global delivery network and the strong focus on operational excellence, combined with innovative analytics solutions, enable us to help our clients differentiate in the insurance market.
    • Serving more than 30 clients ranging from insurers, brokers, loss assessors, self-insured auto fleet owners fraternity
    • A rich talent pool possessing deep domain expertise, managing core industry-specific processes, besides actuarial and analytics

Nationally Recognized Leadership Team with Ph.D. in Statistics at Leading Universities Including Harvard, Stanford, and Columbia

Nationally Recognized Leadership Team with Ph.D. in Statistics at Leading Universities Including Harvard, Stanford, and Columbia

Expertise in Delivering Actuarial Services, Adjudication, & Subrogation

Expertise in Delivering Actuarial Services, Adjudication, & Subrogation

Deep Insurance Domain Expertise

Deep Insurance Domain Expertise

Health insurance providers seek to control fraud perpetrated by healthcare providers, pharmacists, and patients and manage investigations from detection to prosecution. Payers confront significant data challenges that block them from realizing optimal outcomes. The relevant information is typically locked in data silos and rigid data warehouses that cannot adapt quickly to new data sources.

Analysis is frequently inaccessible to key decision makers within the enterprise. Researchers are often unable to investigate specific procedures, diagnoses, and patient profiles that contribute to macro-trends. Amidst these technical challenges, payers attempt to develop and refine predictive algorithms to eliminate waste, fraud, and abuse. They execute comparative effectiveness analyses and design and back-test plans through regression and strategy modeling. AMSTAT Consulting Insurance Analytics provides a unified solution for these workflows that overcomes technical obstacles and promotes better outcomes.

We can:

  • Integrate all relevant data sources
    • Fuse disparate data sources, structured and unstructured, for unified search and analysis
    • Integrate medical coding, drug codes, claims formats, approved drug attributes, prescription transactions, and comparative hospital data
  • Configure HIPAA-Compliant access controls
    • Handle many kinds of sensitive data
    • Provide unmatched data protection capabilities
    • Secure integrated data at the level of source records and implement regulations to ensure that investigators see only the data objects and attributes they are authorized to examine.
  • Iterative dashboards and second-order analysis applications
    • Provide comprehensive top-down views into integrated data
    • Quickly iterate on complex hypotheses with customizable interactive dashboards to examine aggregate data from multiple perspectives, and drill down into data subsets for in-depth contextual investigation with specialized analytical instruments

We can implement data-driven innovations for better plan design, proactive care management, and pay-for-performance initiatives which lead to increased market share. We can help you with:

  • Healthcare Reform
  • Enterprise Decision Support
  • Provider Partnerships
  • Acquisition Marketing
  • Membership Management
  • Health Plan Trends
  • Payment Integrity for Health Plans

Our Data Analytics offerings help insurance companies address their challenges such as:

  • How to optimize sales & revenue by focusing on target groups with the highest probable outcome?
  • How to improve campaign execution?
  • How to enhance returns from initiatives to boost sales through agents and brokers?
  • How to maximize returns from marketing investments?

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Expertise in high-value complex processes

  • We possess deep expertise in delivering actuarial services, adjudication, subrogation and other complex high-value processes that can help accelerate companies on the path to outperformance.

Insurance-in-a-Box

  • We offer back-office support and end-to-end capabilities for new product introductions, new sales channels, and new geographies.
  • We enable ‘shell’ companies to enter niche markets or provide niche products.

Embedded Analytics

  • We embed analytics in client processes to provide insurance companies actionable insights to translate trends and opportunities into profitable growth, beyond efficiency gains.

Flexible commercial models

  • Our commercial models are flexible in every aspect—from the scope, pricing, to scale and involve risk sharing.
  • We customize solutions to fit the needs of insurance clients.
 

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Deep Domain Expertise

  • Our professionals are equipped with AICPU (US) and CII (US) certifications, and possess expertise across the insurance value chain.
  • Our capabilities include end-to-end operations management, research and analytics, investment accounting, and actuarial services.
  • We deliver process transformation through a combination of insurance domain expertise, Fix-Shift-Transform methodology, and Lean and Six Sigma initiatives.

Embedded Analytics

  • With best-in-class embedded analytics offerings, we provide actionable insights to translate trends and opportunities into profitable growth, beyond efficiency gains.
  • We have pioneered the use of ‘on the floor’ analytics to identify potential benefits and agile process frameworks to quickly test, refine and deliver innovation to our clients.

Flexible Commercial Models

  • Our pricing models are flexible and aligned to deliver the client’s desired business outcomes. As the services are priced on a per transaction basis, clients only pay for what they use.

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Deep Domain Expertise

  • AMSTAT Consulting professionals are equipped with A1CPCU (IIA) / IF of CII / CPA / CFP and AAPC certifications and possess expertise across the insurance value chain. Our mid-level and senior management is certified on CII’s CF1, FA1, and F2 certifications.
  • Our employees hold FINRA Series 6, 7, and 24 licenses.
  • Our capabilities include end-to-end operations management, research and analytics, investment accounting, and actuarial services.
  • We deliver process transformation through a combination of insurance domain expertise, Fix-Shift-Transform methodology, and Lean and Six Sigma initiatives.

Comprehensive Closed-block Processing Capabilities

  • AMSTAT Consulting offers full support for all elements of closed-block processing, including technology, conversion, actuarial services, distribution management and embedded analytics.

Insurance-in-a-Box

  • AMSTAT Consulting offers back-office support and end-to-end capabilities for product launches, new sales channels, and new geographies. We enable “shell” companies to enter niche markets or provide niche products.

Embedded Analytics

  • We embed analytics, both operational and strategic, into our life and annuity engagements to ensure that clients benefit from actionable insights.
  • With best-in-class embedded analytics offerings, we provide actionable insights to translate trends and opportunities into profitable growth, beyond efficiency gains.
  • We have pioneered the use of ‘on the floor’ analytics to identify potential benefits and agile process frameworks to quickly test, refine and deliver innovation to our clients.

Flexible Commercial Models

  • Our pricing models are flexible and aligned to deliver the client’s desired business outcomes. As the services are priced on a per transaction basis, clients only pay for what they use.

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Largest Actuarial Practice in the BPM Industry

  • AMSTAT Consulting has developed a highly skilled actuarial team with significant experience of delivering core actuarial processes on a regular basis for multiple clients.
  • The team has become an integral and vital part of the Actuarial function for many clients and has helped clients address the ever-increasing resourcing and capability challenges in this area.
  • We work with many insurers across the globe and have in-depth experience across the entire value chain.

Rich Domain Experience

  • The AMSTAT Actuarial team possesses the experience and deep expertise in delivering superior outcomes spanning a wide spectrum of actuarial tasks, including pricing, reserving, Solvency II and capital management, asset liability model valuations/projection sections, asset management, and experience studies, among others.

A Differentiated Practice

  • AMSTAT Consulting acts as a true extension of our clients business.
  • AMSTAT Consulting has established a highly capable actuarial team to support our clients in a variety of areas.

Great Depth of Offerings in the Insurance Domain

  • We have built a large pool of actuarial resources, and constantly endeavor to provide more value-added services to the insurance and re-insurance organizations globally
  • We deliver actuarial services and end-to-end solutions across the entire spectrum of actuarial functional towers
  • We supplement our actuarial resources with analytics, technology, black belt, quality and business analyst resources to automate and / or re-design actuarial processes

Understanding Geographical and Regulatory Environments

  • We operate in North America, the UK / Europe, and Australia regions
  • We have a strong understanding of both the geographical and the regulatory landscapes – we support various regulatory requirements across the globe, especially the Solvency II programs for our clients

Innovative Engagement Model

  • We operate in North America, the UK / Europe, and Australia regions
  • Our ‘team extension’ engagement model, coupled with our actuarial work control cycle, creates a suitable environment to help augment and perform actuarial tasks offshore

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Domain Expertise

  • We have highly skilled resources who perform various brokerage operations.
  • In fiduciary, we handle cash applications, carrier and client payments and customer helpdesk functions.
  • We also manage private client services for high net worth individuals. In accounts receivable, our operations cover billing, invoicing, month-end support and reconciliation.

Embedded Analytics

  • The services we offer are based on our strong business analytics capabilities.
  • This gives our customers a competitive edge while shaping their business strategies.
  • It also provides insights for the better business outcome.
  • Our expertise in the ever-evolving analytics space enables us to provide in-depth analysis of brokerage revenues.

Business Impact

  • Our solutions have had a major impact on our customers’ brokerage operations.
  • We have brought down the cash on an account by 30 percent within a span of one year.
  • We have produced compelling statistics for the onshore controller to make quick decisions on refunds and write-offs.
  • We have also enabled faster resolutions and decreased the time lag for processing invoices.

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Domain Expertise

  • Our pool of CAMS-certified AML professionals has a strong and deep knowledge of the AML landscape across geographies and extensive experience in managing diverse work in this domain.
  • Our capabilities span the entire spectrum of customer screening and due diligence, and transaction monitoring and investigation services.

Regulatory Knowledge

  • We have well-defined internal practices and structured processes to ensure all our AML professionals are updated with the latest regulatory information and changes.
  • Our teams are certified on the latest regulatory requirements. This ensures that our clients are compliant with the latest regulatory requirements at all times.

Automation and Analytics

  • Our real-time automation ensures comprehensive risk profiling, with minimal human intervention.
  • This combined with analytics-driven decision processes across the customer lifecycle ensures total customer risk management and due diligence.
  • Such efficiency results in minimizing false positive rates and improved productivity.

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Property and Casualty Claims Management

  • We provide end-to-end services across the claims value chain for personal and commercial lines of businesses including specialty lines.
  • From First Notification of Loss (FNOL) to assessment, claims adjudication, subrogation, reserve management and payments, we manage annual claims spend of more than USD 2 Billion.
  • Our clients include top insurance carriers and intermediaries in the U.S., U.K., Europe, Australasia, Gulf Cooperation Council (GCC) and Asia regions, players in Lloyd’s market as well as reinsurance companies.
  • Here’s a list of the business processes we service:
    • FNOL and Claims Setup from all customer interaction channels
    • Fraud Identification and Investigation
    • Assessment — Physical and Desktop
    • Adjudication
    • Subrogation
    • Third Party Capture and Settlement
    • Payments and Supplier Chain Management
    • Portfolio Management and File Closure
  • Products we service are:
    • Motor Insurance
    • Home Insurance — Building and Content
    • Commercial Fleet
    • Commercial Property
    • Workers Compensation
    • Compulsory Third Party/Bodily Injury
    • Marine
    • Engineering
    • Liability
    • Strata

Life Claims Management

  • Our life offerings are extensive and spread across functions including specialized new business, underwriting and issue, contract and policy administration, customer support, agency management and claims solutions.
  • It covers multiple product lines such as Life Insurance, Retirement Solutions, Annuities and Investments.
  • We service over 20 Million transactions and handle more than 2 Million customer transactions with over 2.5 Million calls through the end-to-end value chain.
  • We process over USD 6.8 Billion worth of business annually across various clients and geographies. 
  • Our clients include top insurance carriers and intermediaries in the U.S., U.K., Europe, Australia, GCC and Asia regions, players in Lloyd’s market as well as reinsurance companies.
  • Following are the business processes we service:
    • New Business
    • Underwriting and Issue
    • Contract and Policy Administration
    • Billing Center
    • Agency Management
    • Claims Center
    • Customer Support
  • The products we service include:
    • Life Insurance
    • Retirement Solutions
    • Annuities
    • Investments
    • Life Protections and Long Term Care

Transformation Model

  • We understand the industry challenges and partner with clients in their transformation journey by deploying our ‘value creation framework’ to address specific business problems.

Domain Expertise

  • We have a pool of highly qualified employees in claims operations who cater to various lines of business within the claims management cycle.
  • Our in-depth knowledge of regulatory requirements and business nuances across multiple geographies, coupled with our experience in working on leading industry platforms such as Guidewire and Exceed, has been key to our exceptional service standards.
  • Our operations’ teams are complemented by Lean-Six Sigma experts who use industry-leading practices to drive process improvements.

Claims Center of Excellence

  • We have established a Claims Center of Excellence where we imbibe best practices across the globe and use our value creation framework to offer customized solutions for clients’ business problems.
  • We use our process maturity models to benchmark and create a transformation roadmap for our clients.

Embedded Analytics

  • Through our embedded analytics framework, we offer a suite of solutions which can help reduce the indemnity spend, improve customer experience and provide models for quick claims settlement. Our services include:
    • Claims Life Cycle Management
    • Claims Reserving and Case Estimate Accuracy
    • Claims Subrogated Recoveries
    • Claims Supply Chain Optimization
    • Claims Best Offer
    • Claims Litigation Behavior
    • Claims Fraud Propensity
    • Cat/Event Loss Modeling
    • Single Touch Claims

Technology Enablement

  • We have an array of solutions that are underpinned by our technology expertise.
  • Some of the technology rooted in our claims management solutions include BaseNet, FleetNet, InsureNet, RepairNet, and MotorGuard.
  • We have assisted clients to automate and digitize solutions while also developing mobile applications to simplify their processes. We have the capability to integrate multiple channels in the ecosystem and provide superior services to our clients.

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Claims Analytics

  • The claim process is a critical component to achieve operational efficiency and provide better customer experience.
  • Improving claims has become important for insurers to protect revenue and profitability.
  • Though fast-tracking of claims process improves the customer experience, it can increase the risk of fraud.
  • AMSTAT Consulting provides end-to-end claim analytics solutions to accelerate the processing of claims and reduce the risk of fraud.

Subrogation Analytics

  • Insurers are using predictive analytics to identify subrogation opportunities and turn to arbitration as the means to resolve disputes.
  • AMSTAT Consulting’ subrogation analytics solution increases the yield through the use of advanced text analytics and predictive modeling.
  • Predictive modeling identifies factors that drive successful subrogation recovery based on the data, patterns, business rules and other related characteristics.

Fraud Analytics

  • Early detection of fraud is a key challenge for the insurance organizations.
  • Leakages arising out of fraudulent claims and underwriting impact margins.
  • AMSTAT Consulting’ comprehensive fraud analytics solution increases the detection rate and accuracy.
  • Our solutions leverage text mining to tap both structured and unstructured data, including claim notes, call center notes, medical reports, police reports, e-mails, and web-based content.

Customer Analytics

  • AMSTAT Consulting’ customer analytics solutions help clients acquire new customers, enhance customer engagement with a particular product or service through cross-sell/up-sell propositions.

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