Medical Health Insurance Underwriting Software

“With Newgen, we achieved a 60% reduction in policy issuance time through streamlined digital processing and a 25% increase in STP rate by automating risk assessments, significantly reducing manual intervention.”

Chief Operations Officer, Top Health Insurance Company

Learn what Newgen’s Digital Onboarding & Underwriting Solution can do for you

Digital Processing with Dynamic Journeys

Streamline the submission process—from data capture to application completion—while creating personalized onboarding experiences that adapt to user input, product needs, and past behaviors.

Automated Risk Assessment

Accelerate decision-making by enabling instant approvals for low-risk applicants through an AI-driven triage process, while routing complex cases to underwriters for detailed evaluation. Use predictive analytics for real-time risk scoring based on predefined rules.

Compliance Automation

Ensure adherence to local regulations and standards through automated compliance checks, audits, and reporting features, safeguarding data privacy and improving regulatory compliance.

Data Analytics and Reporting Dashboards

Gain comprehensive insights into the entire onboarding and underwriting process with analytics dashboards that track key performance indicators (KPIs), enabling continuous workflow optimization.

Digital Processing with Dynamic Journeys

Streamline the submission process—from data capture to application completion—while creating personalized onboarding experiences that adapt to user input, product needs, and past behaviors.

Automated Risk Assessment

Accelerate decision-making by enabling instant approvals for low-risk applicants through an AI-driven triage process, while routing complex cases to underwriters for detailed evaluation. Use predictive analytics for real-time risk scoring based on predefined rules.

Compliance Automation

Ensure adherence to local regulations and standards through automated compliance checks, audits, and reporting features, safeguarding data privacy and improving regulatory compliance.

Data Analytics and Reporting Dashboards

Gain comprehensive insights into the entire onboarding and underwriting process with analytics dashboards that track key performance indicators (KPIs), enabling continuous workflow optimization.

Learn what Newgen’s Digital Onboarding & Underwriting Solution can do for you

Digital Processing with Dynamic Journeys

Streamline the submission process—from data capture to application completion—while creating personalized onboarding experiences that adapt to user input, product needs, and past behaviors. Integrate with Yakeen for identity verification and auto-populate data, ensuring faster and more accurate data capture.

Automated Risk Assessment

Accelerate decision-making by enabling instant approvals for low-risk applicants through an AI-driven triage process while routing complex cases to underwriters for detailed evaluation. Leverage predictive analytics for real-time risk scoring based on predefined rules and integrate with Wathaq for document verification to streamline risk evaluation.

Compliance Automation

Ensure adherence to local regulations and standards through automated compliance checks, audits, and reporting features, safeguarding data privacy and improving regulatory compliance. Integrations with systems like CCHI help ensure compliance with health insurance regulations.

Data Analytics and Reporting Dashboards

Gain comprehensive insights into the onboarding and underwriting process with analytics dashboards that track key performance indicators (KPIs), enabling continuous workflow optimization. Integrate payment gateways like MADA, UR Pay, STC Pay, and SADAD for seamless premium collection and real-time monitoring of payment status.

Digital Processing with Dynamic Journeys

Streamline the submission process—from data capture to application completion—while creating personalized onboarding experiences that adapt to user input, product needs, and past behaviors. Integrate with Yakeen for identity verification and auto-populate data, ensuring faster and more accurate data capture.

Automated Risk Assessment

Accelerate decision-making by enabling instant approvals for low-risk applicants through an AI-driven triage process while routing complex cases to underwriters for detailed evaluation. Leverage predictive analytics for real-time risk scoring based on predefined rules and integrate with Wathaq for document verification to streamline risk evaluation.

Compliance Automation

Ensure adherence to local regulations and standards through automated compliance checks, audits, and reporting features, safeguarding data privacy and improving regulatory compliance. Integrations with systems like CCHI help ensure compliance with health insurance regulations.

Data Analytics and Reporting Dashboards

Gain comprehensive insights into the onboarding and underwriting process with analytics dashboards that track key performance indicators (KPIs), enabling continuous workflow optimization. Integrate payment gateways like MADA, UR Pay, STC Pay, and SADAD for seamless premium collection and real-time monitoring of payment status.

Features of Underwriting Solution For Health Insurance

Omnichannel Request Initiation and Data Capture

Enable omnichannel case initiation and proposal registration via portal, mobile, and email. Initiate new business requirements via portal and easily capture all proposal data and member details. Provide customer-specific product recommendations for insurance solutions.

Core Underwriting Engine

Determine risk levels through underwriting rules management. Enable member-wise underwriting and business rules execution at the back end. Facilitate straight-through processing of low complexity submission with dynamic rules and automate key underwriting tasks.

Easy Configurability and Integration

The solution offers configurable user interface to define i-forms for handling different products and plans, such as floater plans, fixed health plans, etc. Seamlessly integrate with core system, third party administrators (TPA) for getting medical tests conducted, and legacy applications such as policy administration and CRM for data push.

Rule-based Case Routing & AI/ML-led Decisioning

Automatically assign cases based on the defined authority matrix, restrict access rights based on users, groups, etc., and enable ad-hoc referral of cases to multiple departments. Improve agility and accuracy in the decisions to identify defaulters with AI-based data models. Predict morbidity over a 15-year period using data from different sources by analyzing patterns.

Automated Checks and Validations

Conduct application screenings with KYC, AML, and Dedupe for customer verification and risk assessment. Utilize color-coded risk scoring to categorize different risks identified by the system. Gain access to comprehensive case details, preexisting medical conditions, and customer behavior to ensure informed decision-making. Perform quotation validations with the help of rules configured in the back end.

Extensive Underwriting Evaluation

Deliver counteroffers to members with revised policy rates. Automate policy evaluation to maximize the percentage of straight-through pass cases for quick policy issuance. Auto-classify non-straight-through cases and route to underwriters based on authority limit. Analyze medical test report data and execute business rules to identify the pass vs. fail cases. Easily raise member-specific medical and non-medical requirements by the customer. Leverage the MDM module to auto-populate exclusion details and capture member-level exclusions along with ICD code mapping, underwriting remarks, and additional clauses. Utilize sophisticated dashboards for in-depth data analysis and report generation and 360-degree visibility of the policy application to evaluate and reduce risk.

Omnichannel Request Initiation and Data Capture

Enable omnichannel case initiation and proposal registration via portal, mobile, and email. Initiate new business requirements via portal and easily capture all proposal data and member details. Provide customer-specific product recommendations for insurance solutions.

Core Underwriting Engine

Determine risk levels through underwriting rules management. Enable member-wise underwriting and business rules execution at the back end. Facilitate straight-through processing of low complexity submission with dynamic rules and automate key underwriting tasks.

Easy Configurability and Integration

The solution offers configurable user interface to define i-forms for handling different products and plans, such as floater plans, fixed health plans, etc. Seamlessly integrate with core system, third party administrators (TPA) for getting medical tests conducted, and legacy applications such as policy administration and CRM for data push.

Rule-based Case Routing & AI/ML-led Decisioning

Automatically assign cases based on the defined authority matrix, restrict access rights based on users, groups, etc., and enable ad-hoc referral of cases to multiple departments. Improve agility and accuracy in the decisions to identify defaulters with AI-based data models. Predict morbidity over a 15-year period using data from different sources by analyzing patterns.

Automated Checks and Validations

Conduct application screenings with KYC, AML, and Dedupe for customer verification and risk assessment. Utilize color-coded risk scoring to categorize different risks identified by the system. Gain access to comprehensive case details, preexisting medical conditions, and customer behavior to ensure informed decision-making. Perform quotation validations with the help of rules configured in the back end.

Extensive Underwriting Evaluation

Deliver counteroffers to members with revised policy rates. Automate policy evaluation to maximize the percentage of straight-through pass cases for quick policy issuance. Auto-classify non-straight-through cases and route to underwriters based on authority limit. Analyze medical test report data and execute business rules to identify the pass vs. fail cases. Easily raise member-specific medical and non-medical requirements by the customer. Leverage the MDM module to auto-populate exclusion details and capture member-level exclusions along with ICD code mapping, underwriting remarks, and additional clauses. Utilize sophisticated dashboards for in-depth data analysis and report generation and 360-degree visibility of the policy application to evaluate and reduce risk.