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A Predictive Model for a Health High Cost Insurance Product in Colombia
At our independent consultant firm, we work for Insurance Companies (ICs), they hire us because they need agility, an independent point of view, an adequate speech for different audiences (actuary, finances, commercial, product development and even underwriting, legal, IT and auditory) or a combination among them.
Being an external party allows us to have the perspective that the day-to-day duties sometimes do not allow the IC to answer questions that go beyond product or reserve compliance, maintenance, or development.
Using data from the “Claims File Book” (CFB) for “Health High Cost” (HHC), I developed a Predictive Model that answers the question: How much will I pay for a received claim? The answer to this question would allow the IC to estimate optimal opening reserves, support finance planning among other business objectives. In other words, we may use modern approaches to answer business questions that seem simple, but fundamental.
In this paper, the predictive model is described and some of the implications of using data science approaches for ICs in Colombia and undeveloped markets are discussed.
Final remarks: The paper that I am submitting was written for the “Captstone” course of the “Data Science Professional Certificate” that I finished last year (https://www.edx.org/certificates/professional-certificate/harvardx-data-science). I am adapting the document for this event, in the next few weeks, I will submit the final document.
September 26, 2024