FICO Helps British Insurance Provider Vitality Deliver Personalised Healthcare Journeys

Unique fully digital journey increases operational efficiency with 69% reduction in claims started over the phone, improving customer engagement and loyalty

LONDON--(BUSINESS WIRE)--Vitality, a leading health and life insurance provider, is working with global analytics software leader FICO to deliver personalised experiences for its 1 million members.

Unique in the health insurance market, the Vitality Care Hub powered by FICO^® Platform offers a fully digital journey including instant authorisation, online consultant booking and integration with a GP referral. Since its implementation, fewer than 28% of Vitality member claims are now started over the phone, compared to over 90% in 2019. Consequently, Vitality’s specialist claims teams have more time to provide personal support for complex claims.

More information: https://www.fico.com/en/fico-platform

Vitality has integrated a range of FICO tools to make data-driven decisions based on real-time insights, reducing the need for manual intervention by agents and improving the efficiency of claims processing. The Care Hub offers a fully digital journey for members to access healthcare, from GP services to physiotherapy, mental health and onward specialist treatment. As a result, Vitality has been able to lower operational costs and minimise the risk of human error during assessment and processing, while increasing its ability to scale and manage increasing volumes of complex claims, such as chemotherapy treatments.

Annabel Simmons, head of Healthcare Programs at Vitality, commented: “At Vitality we understand that no two patients are the same. Some members prefer a no-nonsense, straightforward, and self-managed approach to healthcare, while others require more handholding and empathy. We wanted to offer personalised healthcare journeys that cater to these individual preferences.

“Upgrading our system wasn’t just about moving to the cloud — it was about unlocking the potential for growth by allowing our teams to focus on what they do best: providing excellent healthcare services and improving patient outcomes. We realised we were limiting our possibilities by staying with our old system. Our upgrade with FICO is already paying for itself and will continue to drive value for years to come."

Adopting a cloud-based microservices architecture that integrates seamlessly across its various services, from life insurance to reward schemes, Vitality ensures customers benefit from tailored journeys that match their needs with full traceability of decisions made and consistent decisioning.

Care Hub complements the work of Vitality’s specialist claims teams, who are on hand to provide personal support for members, particularly when they are going through complex claims. The availability of fast, digital pathways helps manage demand, enabling Vitality to deliver strong customer satisfaction whilst driving significantly reduced operational costs when it comes to managing claims, costs that can be reinvested in other key services.

Vitality is also using the FICO^® Business Outcome Simulator to preview the outcomes of rule changes in real-time. This has been particularly crucial in understanding the impact that rule and operational changes will have on all aspects of the business and its members.

“The collaboration between FICO and Vitality has enabled the kind of personalised digital-first approach that is transforming healthcare services,” said Nikhil Behl, president, Software at FICO. “By focusing on personalisation, automation, and operational efficiency, Vitality is building a future-proof system that meets the diverse needs of its members while driving sustainable growth.”

FICO^® Platform provides an open architecture and an integrated set of composable capabilities that span the applied intelligence value chain — from organizing your data to discovering deep new insights — putting this into motion with actions to achieve the desired outcomes. FICO was recently named as a Leader in the IDC MarketScape: Worldwide Decision Intelligence Platforms 2024 Vendor Assessment (doc #US51047423, August 2024).

About FICO

FICO (NYSE: FICO) powers decisions that help people and businesses around the world prosper. Founded in 1956, the company is a pioneer in the use of predictive analytics and data science to improve operational decisions. FICO holds more than 200 US and foreign patents on technologies that increase profitability, customer satisfaction and growth for businesses in financial services, insurance, telecommunications, health care, retail and many other industries. Using FICO solutions, businesses in more than 80 countries do everything from protecting 4 billion payment cards from fraud, to improving financial inclusion, to increasing supply chain resiliency. The FICO® Score, used by 90% of top US lenders, is the standard measure of consumer credit risk in the US and has been made available in over 40 other countries, improving risk management, credit access and transparency. Learn more at www.fico.com.

FICO is a registered trademark of Fair Isaac Corporation in the U.S. and other countries.