Saturday, June 22, 2024

Exclusive: ‘Ahealthyoutlook’ – Cristiano Bezerra, SulAmérica Seguros in “The Insurtech Magazine”

SulAmérica Seguros used API technology to connect with startups, healthtechs, fintechs and banks as it set about expanding its telemedicine and other digital channels during the pandemic. And now that it’s begun the API journey, there’s no stopping it, says Enterprise Architect Manager, Cristiano Bezerra

Brazil’s publicly-funded healthcare system SUS (Sistema Único de Saúde) has been under pressure since its ambitious and well-intentioned roll-out in 1990 – principally due to fiscal austerity measures that eventually led to the government freezing health service expenses for a period of 20 years.

Unsurprisingly, buying private health insurance became a life goal for most Brazilians – behind getting a good education and having your own home. Indeed, in March 2019, there were approximately 47 million private health plan (PHP) beneficiaries in the country,  roughly a fifth of the population, according to the National Regulatory Agency for Private Health Insurance and Plans. Corporate health insurance plans, managed by an operator or insurer and offered to individual employees, accounted for the bulk (approximately 70 per cent) of those PHP beneficiaries.

As the dynamics of the public-v-private healthcare market evolved, SulAmérica Seguros, Brazil’s largest non-bank owned insurer – with more than seven million customers – developed its own, holistic approach to health cover. It entered a joint venture with leading US healthcare provider, Healthways, in 2015 to promote wellbeing, established wellness coaching programmes and monitoring programmes for patients with chronic diseases and complex conditions. In 2018, it launched a telemedicine service, although regulation at the time prevented it from including video consultations. And, in 2019, it rolled out SulAmérica Direto, a new line of regional health plans, giving brokers an opportunity to sell a low-cost product to companies in areas of the country where coverage was poor.

But 2020, saw SulAmérica Seguros push health to the top of its agenda. It divested itself of its auto and P&C (property and casualty) business lines and purchased Paraná Clínicas, a well-established specialist in corporate healthcare plans, adding more than 90,000 to its membership base in the south of Brazil.

Announcing the company’s most recent Q3 results, SulAmérica Seguros CEO, Gabriel Portella, described health management and the company’s Coordinated Care programme as being the two strategic pillars of its operations, noting the importance of tracking beneficiaries’ journeys ever more closely; primarily through advanced technology.

The pandemic gave the insurer fresh impetus to adopt and upgrade digital health tools for beneficiaries, as well as physicians and therapists. Its app allows policyholders to schedule virtual appointments with general practitioners as well as specialists, including psychologists, nutritionists and other therapists. It also enables drug prescriptions and examination requests to be implemented, all in a safely remote way via mobile phone, computer or tablet. Having its telemedicine platform in place before the pandemic meant that when government was forced to relax rules around video consultations, it was primed and ready to go with its in-app Physician on Screen feature, rolling it out over new channels, including WhatsApp, with remarkable results.

Virtual consultations jumped from 500 in February to 15,000 in April, reaching a peak of 60,000 in June. By May, its then- recently launched online screening feature for COVID-19 had clocked more than 280,000 access requests.

With almost 400,000 digital appointments made between March and November, SulAmérica Seguros and its partners were not only able to offer swifter assistance around COVID-19, but also for elective and non-COVID emergency appointments, as well as enabling ongoing treatments – something other countries found hard to maintain. For SulAmérica Seguros, the digital direction of travel was clear.

It’s now planning a similar ‘financial doctor’ virtual service for its life and pension divisions.

“We need to open our markets and I believe APIs, as well as microservices, will be key for that,” says its enterprise architect manager, Cristiano Bezerra.

“We started our journey with APIs a few years ago and even though we didn’t have the vision we have today, we knew that technology would play an important role. Today, the adoption of APIs is not a differentiator, as it may have been a while ago, but a vital lever to remain competitive in an ever-changing digital world.”

He argues that APIs are the gateway to the value chain, allowing business intelligence to be opened up ‘for consumption and interaction via new channels and interfaces that will impact the customer experience’.

The ecosystems they’re designed to function in are no less fundamental for the future of insurance, including that of SulAmérica Seguros.

“We have seen the digital journeys of insurers involving an increasing interconnection with a large community, not only of brokers but also banks and regulators. In our case, we have also connected with startups, healthtechs and fintechs, to accelerate the exposure of an improved offer, too,” adds Bezerra.

Companies would be foolish, then, not to repurpose and remodel their businesses for API exposure, he says, even in cases where there is lack of demand at present. “Because this is an accelerator for what will come, be it a connection with a telemedicine healthtech – as in our case  – or when it comes to entering the ecosystems of others to offer, for example, some of our intelligence as a service.

Particularly in health – where exposing data siloed among doctors, healthcare record companies, healthcare providers and insurers has been a barrier to improved services – liberating APIs allow for personalised suggestions to improve customer wellbeing. APIs also allow for the adoption of automated services, such as chatbots and IVRs (interactive voice response systems), that can greatly improve customer experience. They also make customer requests much faster and less costly to process, says Bezerra. APIs can be used to establish rules and routines for automatic approval, as well as to spot and notify insurers of attempted fraud.

“For each of these scenarios, there will be an API capable of ensuring your company delivers a rich experience to your customer,” says Bezerra. That said, there is still a question over how standardised APIs can best be developed for sharing information with partners, while also maintaining customer security, all the while having to meet regulatory/data privacy requirements across the globe.

“Inevitably, more disruptive digital experiences demand more data, so in this case transparency is key,” says Bezerra. “It is necessary to explain to customers what data is demanded and, at each stage, ask for their permission to use it.”

SulAmérica Seguros recently launched a web application that allows policyholders to not only see how their data is being used and where, but facilitates them asking for it to be deleted.

“Portals like this that use APIs, as well as the business’ own APIs, must have additional layers of obfuscation, encryption, unifying databases and so on, that allow companies to simplify the governance of this data,” says Bezerra.

An iot opportunity

Over the course of 2021, SulAmérica Seguros will be leaning even further into the tech by leveraging the Internet of Things (IoT). The potential is already clear.

“We already have transactional data and talk with our customers through our Coordinated Care programme, but if we can observe the client, we can further help influence their behaviour to improve their health and wellbeing,” he says. 

We need to continue to surprise and add value for customers. To achieve this, digital interactions must be smarter. We can enrich the processes with artificial intelligence and machine learning, creating new ways to interact with wearables and home assistance devices. That’s a great opportunity for the financial services industry, not just insurance.

“Connecting these IoT devices requires mature models of technology that not only support traffic, but also maintain data privacy. Once again, APIs will be crucial.”

For now, though, Bezerra’s priority is making sure existing systems are fit for purpose both now and when it comes to handling more distributed and granularised data in the future.

“We need to ensure the experiences we want to deliver with APIs, web applications, mobile apps etc, are as good as possible. Because if our clients run our app, click a button, and it takes more seconds than it should, we are going to be (seen as) untrustworthy,” he says.

There’s no room for complacency, especially when the competition is not necessarily another insurer, but a tech company whose DNA is data-based customer service that doesn’t miss a beat.

In the UK, GlobalData noted in a 2018 report that more than 30 per cent of UK consumers would consider switching their insurance to a Google, Amazon, Facebook or Apple (GAFA) product. Some of those have already expanded into pharmacies, diagnostics, wearables and insurance. Meanwhile, venture capital is pouring into digital health startups – a record $8.4billion in the third quarter of 2020, according to CB Insights.

“Big techs expect to enter our market, and it will be an interesting challenge for us. But we don’t have to be afraid of it; we need to learn from them,” says Bezerra.  “We use their services, like Cloud and APIs, to build the ecosystem, so I believe we can bring these forces together with our experience as a 100-year-old insurer to create something new that ensures our longevity.”


This article was published in The Insurtech Magazine #05, Page 21-22

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