Strategy and Solutions
The client was a large North American health insurance provider serving millions of members across employer-sponsored plans, individual policies, and government-backed programs. Over years of growth through acquisitions and expansion, the insurer accumulated a complex landscape of legacy policy administration and claims systems. While these systems were reliable, they were slow to adapt to evolving regulatory requirements, rising customer expectations, and increasing operational costs.
As digital-first healthtech and insurtech platforms raised the bar for speed, transparency, and self-service, the insurer recognized that incremental system upgrades would not be sufficient. Policy issuance was slow, underwriting depended heavily on manual reviews, and claims processing required significant human intervention. To modernize its core operations without disrupting ongoing business or regulatory compliance, the insurer partnered with Zymr to build a modular, cloud-native insurance platform on Microsoft Azure.
Despite its scale and market presence, the insurer struggled to operate with agility. Core policy administration systems were tightly coupled and difficult to modify, making new product launches or regulatory updates slow and costly. Underwriting processes relied on manual data reviews and rigid rules, resulting in application turnaround times of up to 10 days.
Claims processing was heavily manual, with inconsistent data formats and limited automation forcing adjusters to spend time on repetitive tasks instead of complex cases. Digital engagement was also limited, as existing customer portals offered only basic functionality and little real-time visibility into policy or claims status.
All modernization efforts had to operate within strict regulatory, audit, and data privacy requirements, making large-scale transformation particularly complex.
The insurer needed a solution that could modernize core operations, improve speed and transparency, and reduce costs without compromising compliance or service continuity.
Zymr helped the global health insurer transition from rigid, legacy systems to a modern, AI-enabled insurance platform. By accelerating underwriting, automating claims, and improving digital engagement, the insurer reduced operational friction, improved customer satisfaction, and gained the agility required to compete in an increasingly digital healthcare insurance market—all while maintaining strict regulatory compliance.
This case demonstrates how cloud-native architecture and applied AI can modernize insurance operations at scale, turning legacy constraints into long-term competitive advantages.
Zymr designed and implemented a modular, Azure-based insurance platform that decoupled core functions, introduced AI-driven automation, and enabled rapid innovation across policy, underwriting, and claims operations.
Security, Governance, and Compliance Controls
Embedded role-based access, audit trails, encryption, and compliance-ready reporting to meet regulatory requirements across jurisdictions.
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