The Canadian insurance industry is entering the age of artificial intelligence with a project undertaken by Optima Global Health. This specialist in health and wellness at work has partnered with Ellipse Synergy to launch a fully digitized system based on algorithms.

The mission of this joint venture is to make life insurance forms more dynamic, and more truthful. The questions the system asks are aimed at making it easier for experts in health and wellness at work to intervene if employees need aid. Optima Global Health and Ellipse Synergy say that their system is specially designed to help people overcome reluctance to ask for help. 

Louis-Raphaël Tremblay engineered the project. With a background in education, he founded Ellipse Synergy following a project in the school system. Ten years ago, he designed a base with algorithms that helps students boost their motivation to succeed in school. It also encourages people to speak out against bullying, be they victims or witnesses. This project worked so well that Tremblay dropped out of teaching seven years ago to focus on marketing the application. His clientele includes five school boards. This number will likely climb this fall, he told The Insurance and Investment Journal.

Spurred by the success of his project in schools, Tremblay looked for a partner in the insurance sector, believing that his tool can improve disability management. He chose Optima Global Health.

His timing was good. When Tremblay approached Optima three years ago, the firm was rethinking its future strategy. The company was looking for new innovation to fuel its growth, says Jean-Claude Vaillancourt, associate and vice-president, Business Development and Customer Relations, at Optima.

Ellipse Synergy and Optima will offer three lines of services in their joint venture. The first, called Epsylio, is a suite of services aimed at businesses. The second line, Implicio, brings the same solutions to insurers, with a white labelling option. The general public version, called Psylio, is a free online approach that targets people who lack access to psychological help. Optima can then guide users to the appropriate resources, at a reasonable cost. 

Insurers are showing an interest in their project, the two project leaders say. They are currently negotiating with several large group insurers. The official launch is schedule to take place before the end of October. 

How does it work?

People who connect to one of the three interfaces meet ISA, which stands for assisted support interface. ISA guides users throughout the process. Everything said to ISA remains confidential. The system does not contact any other person until the user authorizes it to do so. If a person is truly in distress and contemplating suicide, there is a process to handle that situation. ISA actually replies to users in its own voice. It checks in on people who have not responded after a certain time, determined by the individual’s state of distress. 

As the user answers questions, ISA builds phrasing, generated by algorithms. “In schools, we can monitor people who are bullied and support them over the long term, while maintaining dialogue with them. We can also track the success of people with academic problems. We can measure young people’s metacognitive skills,” Tremblay explains.

The school experience inspired Tremblay to build a similar tool for psychological support. “No one goes to see a psychologist just for curiosity’s sake. Yet we all know that a large portion of the population who does not consult a psychologist could benefit from this service. That’s what we want to change,” Tremblay says.

Getting psychological help is often one step away: a phone call. “Someone who calls has already made progress. We are introducing a machine into the person’s isolation that can make contact with that person. If people don’t want to make the call for help, ISA can do it for them, as long as they give their consent,” Tremblay explains.

Vaillancourt confirms that the tool was not designed to help, but rather to detect problems and encourage people who need help to obtain it. “This way the therapist can see how the individual is progressing. It may take five or six sessions to build trust, but this is often all the help that an employee assistance program covers,” he points out. 

Implicio can help insurers shorten intervention time while reining in costs. “We have just closed the loop because we can detect cases more easily. We can act more quickly with more motivated people. We can avoid work stoppages because the workers themselves will click to ask for help,” he says.

Artificial intelligence is a major advance, Tremblay says. “We have taken the process further than anyone else. We think our model is unique in the world. The machine reacts to create a call to action. It asks questions, asks the client if they feel in distress, recapitulates what the person says and gives advice. It follows the standard process that psychologists use. It then notifies people at the right time. Once it accomplishes its mission, we pass the puck to the next player,” he explains.

Optima sees this notification as critical. “If a person agrees to start this process, it’s because he or she wants help. We can control the process from there on. The more people use the system, the more it understands the individual,” Vaillancourt points out.

Less cumbersome process

Vaillancourt adds that their program is a much more user-friendly process than going straight to an insurance form. “We are starting from the principle that people don’t like to fill out these forms. In fact, these people are already at maximum cognitive overload, so their desire to complete the form is at its lowest point. We lighten the burden. In addition, the client interacts with the system. If insurers can successfully forge relations with claimants this way, they will win. It doesn’t involve a form, but rather interaction,” he explains. 

ISA complements the skills of the financial advisor who sells the insurance coverage, Tremblay says. “Good advisors are those who enjoy selling this coverage and with whom clients enjoy working. Advisors may be good at nurturing these relations, but can they find out the truth about the client’s alcohol consumption? The client may not be at ease confiding this, especially during the first meeting. This way, advisors can focus on what they do best and let clients complete the form at home on their own,” Tremblay says. 

What about people who still hesitate to do business online? Tremblay thinks that this barrier to Epsylio’s reach is fading, because people are used to surfing the Internet. Vaillancourt mentions the recent CEFRIO study on Quebecers’ online habits. It found that people ages 55 to 70 now mainly look for information on Google as opposed to the phone book. 

Does the arrival of artificial intelligence mark one step closer to Big Brother in insurance? Not to the program founders. Tremblay says that his system produces disaggregated data. When people connect to Epsylio, ISA reassembles their data in three seconds. The public still needs to be more educated about the system, Vaillancourt says, but with use, this fear should dissipate. 

“Artificial intelligence will take whatever shape we give it. If we want it to do good, it will. If we want it to resemble what we see in the movies Blade Runner, 1984 or Terminator, it will. Over time, media coverage of artificial intelligence will improve. People’s mentalities will inevitably change,” Tremblay says.