Asia InsurTech Podcast enjoyed having Evan Tanotogono, a co-Founder and the CEO of Rey back on the show.
Some of the topics Evan covered included:
- The integration of curative and preventive health care with its financing
- Changing people’s habits and starting with hydration
- Behavioral economics and the power of rewards
- Optimizing clinical pathways
- The importance of primary care and where tele-health fits in
- Member centricity versus policy centricity
Please read the best efforts transcript below:
Michael Waitze 0:10
Hi, this is Michael Waitze. And welcome back the Asia InsurTech Podcast. Today we are joined by Evan Tanotogono, a co founder and the CEO at Rey. Evan was one of our earliest guests on the Asia InsurTech podcast. And actually the last time you were on the show was in November 2021, it was a completely different world, then. It’s great to have you back on the show. How are you doing, by the way?
Evan Tanotogono 0:34
I’m doing great. So yeah, I’ve been on the show for a couple of times. And last time, I promised to come back to you again, you know, back then I started re as new breed of InsurTech. And then we just launched seven months ago, in July 2022, for the individual memberships, and for the group, which we call array for pieces, which are slash one month old. So yeah, a lot of learnings that I’m happy to share today to you, and to all the listeners.
Michael Waitze 1:04
So awesome. Let’s catch up a little bit. I mean, tell me where do you want to start? Where do you want to start?
Evan Tanotogono 1:08
One One exciting thing that I want to share to you today, Mike is, you know, I started looking at again, you know, how, and you know, what problems to be solved in Indonesia? And, and I think, you know, when when I look into our health and life protection, in general, it’s way larger than just the pain point of insurance. You know, it’s it’s, you know, covering the major health problems that we have in Indonesia, because at the end of the day, what we want is healthier Indonesians, right and productive Indonesian. So I started looking at at this facts and you know, we have three top issues, right, and it’s all correlated, we want to know the right. First is that, I see that Indonesians have very high health risks. And you know, the the healthcare spending per capita is really high right now. And it’s moving very, very fast. If I’m not mistaken, it’s like 10 to 12% CAGR. So it’s really, really a frightening rate of increasing healthcare spending. And mostly is driven by, you know, people are being distant with their health care to health care advocacy is pretty low, people have high profile leads to chronic disease as well. So that’s the first one, right, so people have very high health care risks to, you know, when they are having this health risk, they are financially impacted as well, they are financially vulnerable. Because, again, this goes into the penetration of health life insurance, where people are not protected. And again, I said as well that 100 100 20 million people in Indonesia don’t have access to an optimal protections. And lastly, which is very interesting, for me, combining the two facts together, people have very high health risks, and they’re financially vulnerable. The third one is, even though they are being protected their peers today, you know, talking about both insurers and public insurance scheme as well. They are not running sustainably, right. So this is really, really frightening for me, because again, like, we know that there are some risks, and people are being impacted financially, and they’re trying to get some protections, but even the parties that are protecting them is not running sustainable, and are struggling to make profit.
Michael Waitze 3:24
So can we can we break this down into those three components? And just dig a little bit deeper? What is it about, like, what’s changed? Or what’s developing over time? That’s make that’s giving Indonesian? So Thai health risks, right?
Evan Tanotogono 3:36
Yeah, I can name a couple of points. Right. The first one is that, you know, people are being distant or far with their healthcare. And there are a couple of reasons for that, right. One is on the habit itself, in which basically, when when people are are sick, they’re trying to, you know, access their health care, not not in a good way, right. So sometimes they just hear what the friend say, or just, you know, like doing something or I just take this take that I buy medicine on our own and, you know, basically, all these things that’s not making the efficacy of healthcare really high, right? And then sometimes when they are sick already, or they go to the doctor’s, they got antibiotics, for example, right? And then their adherence to take the medication is actually low. And then the next time they are sick again, if there is different illness, etc, then they feel they already know Oh, yeah, it’s antibiotics. You know, I just take antibiotics on my own, I just purchase it and done right. So that’s the first factor that I’m seeing, you know, healthcare efficacy is is is not really there. And then too, we also see that Indonesians as usual, have not very high awareness towards this chronic disease right and wellness. So as a result, you know, you see that the stats, you know, diabetics, hypertension people are are increasing in Indonesia is access
Michael Waitze 4:57
to health care driven a little bit by Just the structure of Indonesia as a country itself, right multiple model, even multiple 18,017 and a half 1000 islands? Does it get harder to get health care? As you get out of the main cities? And is there anything that you can learn? Like, is there a telehealth issue that needs to get solved? Or is it just that you need to have representatives in all these places to be able to give people better access to health care? And also better information for it as well? Yeah.
Evan Tanotogono 5:25
Yeah, I feel, you know, it’s a combination of all of the issues, right, because again, like, geographies is one of the big factor there, like people are living far, far away. While telemedicine will help, telehealth will help people in getting their Euro consultation getting their medications. And, you know, having the right offline setup is also quite important. And, you know, how do we connect both is also also quite important. So you know, like, people don’t need to go and walk to the to the offline facilities, they can go to the telemedicine company, get having some access there. And then whenever needed, can be triaged to an offline facilities get their treatments there. And also the connection with the financing as well. So I think that’s, that’s one of the things that Ray starts from, and we really want to make this integration between, you know, the payer financing facilities that that people will have with their health care,
Michael Waitze 6:26
right? Because there’s a little bit of a, what’s the right word? There’s a little bit of a vicious circle here, right? In other words, if I’m a little bit concerned about access to health care, but even if I’m not feeling well, if I feel like I’m going to be financially vulnerable, as well, but also if the payers you said, whether it’s the insurers or the public, public providers of insurance as well, aren’t making a profit or aren’t profitable, their incentive as well to provide the proper insurance coverage for these people that are that are unhealthy. Isn’t there either? So how do you solve that problem on the flip side of the profitability of the insurers or the payers, to then be able to provide the proper health care to the people that are at risk?
Evan Tanotogono 7:06
Right, so yeah, that’s a good point, right. And this is where actually we we kind of going together. And in Ray, we we start having, you know, we expand our approach, not only just coming as a health insurer tech on its own, and we have all this emphasis, but it’s all about the integration. So, you know, basically, what we have in race is actually three pillars, right? to healthcare, first one curative health care in which bringing people to their health condition in the most efficient way possible, in the most efficient clinical pathways, and etc. And then we have the second pillar, which is the preventive health care. So if you’re not sick, then obviously we don’t want you to be sick. And there are some features that you can use. If you’re not sick, right. And then there’s the third pillar, which is the financing now insurance is the backbone of it, to make it you know, predictable to make it more certain in terms of how much membership fees unit to unit to pay. But there are other things inside of the of the financings as well. So you know, by combining these three pillars, and they’re working together, not just bundled, but integrating, right, so what it means is that, we tell you that a mike there is this membership, that covers all you need in your life, in terms of your health protection, right, there are features, if you’re getting sick, there’s somebody to take care of you, there are features to you know, give you unlimited access to the primary care give you medications, if you need to go to offline, then it’s very, very seamless, it’s very convenient, you just go there, somebody takes care of the payment already, don’t worry. And if you are not sick, right, there are features that you can use the you know, like the nutrition, diet, plan, the activities, etc. And again, everything is financed. But again, you know, all of the things that curative and preventive are, they’re working in unison to optimize the risk covered by the financing part. So that’s the that’s the integration that I’m talking about. And I believe that when we create something like this, it’s not only bringing, you know, the convenience for the people, but also, you know, it’s bringing efficacy on the health care, because you can give personalized care wherever they are, you can optimize the long term risks as well. And then you know, the payer here is also involved in one platform. So we built this since day one and giving benefits for everyone.
Michael Waitze 9:37
At the at the end of last year, is that true? Not the beginning of 2022. I kind of gave in and I bought myself this thing. Yeah, because I really wanted to track my heart rate, my sleep and other sort of health related data. And I’m indifferent to whether it’s a Fitbit and ordering an Apple Watch. Like I really don’t care. But everybody doesn’t I have access to this. But I do feel like if I do go to get medical care, and I have some of this data, even if it’s just like a constant tracking of my heart rate that there’s some interesting information here. How do you get these 120 million people? Which is almost half of the population in Indonesia, right? Maybe a little bit less. But how do you get enough data for them personally, because it all starts with prevent preventive, right? In other words, insurance costs gonna be way lower if everybody’s just healthier. And that starts with preventive better diet, you said better exercise, all this type of stuff. And I feel like having this data with me, just me personally, helps me do things. I’m like, oh, no, why did that happen? Oh, I get it because I ate that thing, or because I didn’t do that exercise, because I didn’t sleep enough. But how do we get enough data for everybody else that maybe doesn’t have access to that type of technology, so that they can get the preventive health care at the beginning, before they need to get to curative and then actually need to actually access to health care so that they can use the insurance?
Evan Tanotogono 10:59
Right? So I have an interesting story to share with you on that. Right. So yeah, in Ray writer, we realized that not everyone will have wearables, even though we can connect with any brand of wearables of your choice. And you know, we start realizing that Okay, what if this guy’s ad, by the way, our members going from very easy to very rest of Indonesia, and we understand, okay, some people might not have this verbal. So we have also a feature called diary. So dire is basically something that, you know, we just want to change the mindset and the habit of people, right, so the first day I read that we created is the hydration diary, in which basically, you go there, and then you set a reminder for your drinks, because that’s also one of the biggest factors of driving someone’s health, right? Other than walking and activities, you know, drinking is something that that’s gonna make an impact. So that we have those features. And it’s based on your honesty, right? You go there and then set the reminder and you drink water, you click on a nice glass of water, and then you get points. And then you exchanged we had something. One day, my friend talked to me and said, Okay, are you sure you’re gonna make this features because people will abuse it? Right? It’s based on people honesty, and then there are rewards, etc. So I’ll try to abuse it. So I said to him,
Michael Waitze 12:22
hold your thought. You know, my grandfather once said to me, when you’re when you’re lying to other people, you’re not actually lying to them, you’re lying to yourself. And it’s so obvious when you go because you used to, I used to go to the doctor when I worked at Goldman Sachs, right. And unfortunately, when you work in the financial services industry, like Goldman or Morgan, every night, you’re out drinking with your clients. And I’m talking like, almost every night, right? It’s bad for you, and no one should be proud of us. But you go to the doctor for your annual checkup, and the doctor would say, how much would you say you drink every week and you just be like, one or two glasses of wine, and the doctor would look at you and just be like, That’s a complete lie. And it’s obvious from your like, physical physicality. That it can’t be true. Your eyes are bloodshot, you know what I mean? Like you don’t look well. So it comes out anyway. So how can you encourage people because it’s a good finish your story but then just ended with like, how can you encourage people not to lie to themselves and to not to lie to their physical care people? Yeah, sorry. Go ahead. Right.
Evan Tanotogono 13:20
Yeah, so the funny story about this, I think, in sync with what you what you told us is, you know, like this guy, my friend tried to abuse the system, right? So I said, Okay, go try it. Right. So so he downloaded he becomes a member. He starts paying at okay, let me do this feature. You know, like first day, he told me it’s easy, I’m just gonna click it nine times in a day and then I gotta get the coins. I said, Okay, sure. So he tried and then you know, like the third or the fourth or fifth class he forgot to click it and he was like, oh, no, I forgot Okay, tomorrow I’ll try again right and then like the next day he try again and then and then he forget about it again. His kid maybe in like one or two weeks maybe he he just you know successful for one time. Yeah, and then and then along the way what happened was this guy he said that Okay, wait, wait, did I do this right? Might as well I drink waters while waiting so
Michael Waitze 14:19
it’s so stupid right? Like yeah, instead of clicking the thing want to do the thing?
Evan Tanotogono 14:25
Yeah, like the real thing right so that what happens is that okay, you in order for for this guy to remember he take water and an actual sugar drink and so then he come to me and I say, oh, yeah, I ended up drinking waters now every day so I was like, see? So that’s how the you know this habit can actually you know, build the book and and we can we can give incentive to people Yes, maybe people would be a little bit corrupt in the beginning Oh, there’s rewards out as a store but where people try it chips a habit and when it becomes a habit like you wash your hands with hands sanitizer right now wear masks, it’s very hard for you to get rid of right. So I think that’s really something that we start getting traction as well. And a lot of people ask me, will, will actually use this because we see some insurers having, you know, an app with all this activity is nobody use it. But you know, what, what we have in Ray was, was amazing. So I think like, we are seven months old, after, after we launch, we got, I think 70 plus million steps, we got, I think, like, how many 1000s of liters of water that people locked in, and we start seeing impact as well. If I might to go, you know, into the impact side, right, we are seeing impact because people who are engaged with this, you know, wellness activities, they are twice as, as persisting as as those who don’t. So, you know, definitely something that that’s better for the payer side as well. Because, you know, when people engage with us wellness activities, they are more aware of their health, they’re actually, you know, improving their health and lifestyle, but at the same time, you know, they’re, they’re more likely to pay more and more in the platform.
Michael Waitze 16:09
So one of the things you said, and you kind of pass over it really quickly was if they do this activity, or if they even pretend the activity, they get the coins, what does that mean? Get the coins?
Evan Tanotogono 16:20
So we give a reward, right? It’s, it’s behavioral economics. So when you do something that, that I want you to do, we give you a reward. Right? And, you know, like, I had some debates with some colleagues back then, um, you know, because some people feel that, okay, this needs to be intrinsically coming from you, and you want to be healthy. But you know, Indonesia, you know, the market is, okay, maybe I need to give a little bit of push, right. And, again, because some some of the solutions or startups or software out there, they become really, really pure and being really intrinsic is because, you know, you just get that feature on its own right for us. Because it’s an integration, again, with all the healthcare and the payer side. Together. We know what economics we want to try, right? So that we feel that okay, we can share some economics to this people. They got some incentive, and from that coins they can, they can use for anything that they want, they can exchange with electricity bills, they can get iPhone, if you walk long enough, right? You can’t get an iPhone. To be honest,
Michael Waitze 17:28
I would walk from Bangkok to Jakarta to get an iPhone, I’m sure, I’d like to get a new one. But do you do you also find that when people start getting rewards, but also when people start getting healthier, that they start encouraging not just their family members, but their friends to also become healthier? Right? Is there a community aspect to this to where it’s like, I don’t have to proselytize other people, but they see me getting healthier and just think I could do that too.
Evan Tanotogono 17:54
Hypothetically, yes. I think now, it’s very early for us to say so. But that’s definitely the direction that we want to go together. Especially, you know, because I think, you know, again, there’s some community factor as well, in that, you know, if you stop doing so, for example, if you go to gym with some of your friends, and you stop doing it, right, and your friends will push you out, like, come on, like, let’s go, we did this together and cetera.
Michael Waitze 18:22
Yeah, I mean, to be fair, the only reason why I joined a gym 20 something years ago, it’s at 330 something years ago, because all my buddies were doing it before we went out to dinner, they’re like, let’s go to the gym first. And I started going to the gym when I was 24, almost 25 years old. And now I just go all the time. You also said something else. You know, it’s true that everybody can’t have access to a wearable. But the and we can talk about that in a moment. But let’s say you do have access to it. You said you meaning Ray itself as a platform connects to all the wearables. So how does that work? Like does it if I have an Apple Watch, how do I connect it to the platform? And then what is the what’s the feedback loop that happens there?
Evan Tanotogono 19:01
So first in array, for instance, right? So for example, right? You have, you have a device, and then you connect to the Google Fit. So we work with Google Fit today. So that you, you can give authority to Google Fit to share the data to rate. So that’s how it works. And then yeah, and then we got your data from from Google feet. What we utilize right now is taps and water but we are expanding it towards distress sleep and etc. And then we have this module to actually calculate how much healthier you versus onto pupil right? And that converts into the economies of the coin.
Michael Waitze 19:40
I would love to see a situation where insurers and even public insurers, and I’m just picking a random device right or giving everybody like an aura ring. I know it gets a little bit expensive, but at $329 or whatever it is for the cheapest one it just feels like that could be a great investment for companies to give out. I know people who’ve tried this before there was this big fight of like giving up Fitbit. Or like, you know, if you worked at a fancy company that maybe they gave you an Apple Watch, if you read some incentives, is there any reason to do that? Or is there any data on whether that actually works? You can say no, like, I don’t know the answer to that question. I’m just curious.
Evan Tanotogono 20:16
Yeah, I think right now, like $300, for four ring are wearables still probably too expensive, right? Especially because like race is making a product for middle class, middle and upper class. So lower fluid class. So basically, we are still talking about, in average, 150 to $200 per year. So I think, like $300, for a wearable still too expensive.
Michael Waitze 20:41
Look, you talked a lot about the health side of this and the data side of this, but what about the financial side of this, right? In other words, if we want to make insurers more profitable, or least profitable, right, meaning the loss ratios are low, or the claims ratio is a load, maybe you can explain the difference between a claim ratio, a loss ratio and a combined ratio. For people that may not know, most of our listeners probably will. But how do you affect that as well?
Evan Tanotogono 21:06
Right. So yeah, claim ratio is something that’s, you know, like, the lower Cape ratio, the more profitable the periods. Right? So you know, it’s, it’s still early in the game seven months old, but you may take a guess on how much claim ratio do I have right now, with right,
Michael Waitze 21:21
before we do that, is the claim ratio, the loss ratio? Is that just the number of the percentage of the claim that I get versus the the premium that I’m paying? Because that’s what the loss ratio is? Right?
Evan Tanotogono 21:32
Yeah. So So basically, it’s the, it’s the claim that that the payers need to pay versus the premium that the insurer state, and at that’s normalized, basically. So what should
Michael Waitze 21:43
it normally be 5060 70% is like a normal loss ratio, what should a claim ratio be?
Evan Tanotogono 21:50
Well, I think in Indonesia, you know, it could be as high as 8085 easily, right? And I mean, with free, we start off patient first strike. So outpatient became the first Euro forefront. And, you know, it’s it’s never been done before by insurance, because they feel that inpatient should be first right. Outpatient is more frequent. They don’t want to deal with that a lot of frauds and etc. Yeah, so they feel that, okay, Ray, like good luck. You’re doing outpatient first, you’re gonna be destroyed. Right. But yeah, I think that’s where we come differently. And, and, you know, I think differently, to be honest, right? Or outpatient is the most frequent, the most thing that people need is the most interaction. That’s the layer where you get most of the data, you kept most of the interaction, you see most of the behaviors. And I think they’re still there are things that we have to work on. Yes, like me, like healthcare, fraud detection, which we have, but you know, even we start with our patient first, right now, our claim ratio is below 20%.
Michael Waitze 22:52
What else up? How’s that even possible?
Evan Tanotogono 22:56
So there are two factors, right. One is the is the proper clinical pathways, so we optimize the clinical pathways, and two, is the fraud detector. Right? So I’ll go on, right. So clinical pathways is basically you know, when a member wants to pursue their health care, what was the most efficient way possible that balances between you getting healthy in the fastest way, convenient way possible, but at the same time, the causes is controlled. Right? Now in Indonesia, to be honest, there are a lot of cases where you know, people have limited knowledge on the health care and they you know, sometimes go to a specialist A, but meanwhile, you’re wrong, right? Then you need to go to specialist P. And then as a patient, you already spend like, three, four hours going to one doctor, and then it was not effective. And then you go to the second doctor for the payer, then definitely extra cost, right. So we re basically we we start with having a teleconsultation. But you know, this is where our teleconsultation is different. is, you know, we give it unlimited, right? So we have unlimited doctor from the platform, you can go check with your doctor, we don’t limit the session, 15 minutes or so, like the longest we had was people talking to our doctor for 13 hours. 13 hours, right? Because, outcast. Yeah, he just he just wants to understand, right? You know, like, can I eat this? Can I eat that and etc. But, you know, from my point of view, what we wanted to do is we want to build the habit of a unit to be close and you need to make friends with your doctor, doctors. And you know, when when people talk to their doctors, this is where you know, the process starts and the doctor sees right, okay, this is Evan, I know the history and I can make a personalized diagnosis. The doctor knows who I am, and giving me you know, recommendations to go to the right, doctors in the offline if needed, and some times is not needed. Most of the time, you know, the doctors can just give me prescription and take this pills for three days. And, and let’s see, right. And in most telehealth companies, it stops right there. But with us, you know, it’s a continuous care or, you know, the two days the doctor can reach out back to me and say, I give you this medication, how does it feel for you? And etc. So, you know, when when we have a proper primary care like that, that’s, that’s driving a lot of things, right. So that diverts people from going to the offline because they already feel convenient with all the process, even when they go into the offline, they go into the right doctors. And there is no you know, Miss medications and etc. So you know, all these things, right? I think people in the market, players start looking at the this integration between your telehealth and insurance, but I can tell you one thing, you know, why it’s not possible today. And while they are there, the claim ratio is a bit high still, is because, you know, the interest is not is not aligned, right. So we see that some insurance, okay, they have an app in the app, they have, you know, telehealth teleconsultations. But, you know, at the end of the day work, this help provide the company in this case, Valley how this is want to get as much as revenue from from the payers, right, so they charge the surfaces to the payers. And, you know, the payers have have no control of what it is right. So then what happens, we see some cases that, you know, the telephone consultation, not properly done not based on data, giving more prescription than it should because you know, to maximize the revenue, sometimes not giving triage properly to the offline because, you know, they will reduce revenue, if the guy’s going to the offline rather than finishing it with a lot of prescriptions. And at the end of the day, you know, the, the members are still not taking care of taken care of properly, and they go to offline still, right. So they say, Okay, I am not comfortable with this, even though is provided for free in my app, but it’s not personalized for me, I’m not happy with this, I will still go to the offline. So that is going to be double cost, right? So the profile chart, the healthcare charge to ensure that the member goes and then claim again to the insurance. And that’s why you’re in the market, we start seeing people asking, Okay, I’m, I’m using this telehealth services, I’m putting it in my app, but my claim ratio is not going down. It’s going up. That’s, that’s because that’s what happened.
Michael Waitze 27:26
So it sounds to me like there’s, there’s a big ecosystem play here, right? And let’s just, let’s just use three big categories and tell me where I’m wrong. It’s individuals or people that need health care, right? It’s the insurers and the health care providers. And they’re all kind of together, but they feel sort of misaligned to me. Right? How do you create this ecosystem where everybody’s interests are aligned, where the health care providers are getting paid enough? The insurers loss ratio, or the combined ratio where their claim ratio is low enough where they can be profitable enough. And people still remain both healthy and you remove their financial vulnerability. Like this is the big trick, right is how do you get all of these things aligned inside that ecosystem? Right, and you said something that’s super interesting, because you keep using this word over and over again. And I think it’s purposeful on your part. You keep saying members, yeah, right. So you haven’t said like customers, you haven’t said like users, you haven’t done that at all? You keep saying our members. So just explain this to me, these members pay a subscription, where it’s just every month they pay, I’m gonna use the thought 2000 3000 baht, whatever it is, or whatever the equivalent number is in Indonesia? Or are they still paying upfront? You know, every time they have to renew their insurance, they have to pay the whatever that number is? And is there some benefit for this subscription type model? So that part of that subscription can then go to enhance the revenue that each one of these Ecosystm members get and remove some of the financial vulnerability for the people that are members? How does that work?
Evan Tanotogono 29:12
Yeah, I think you summarized that correctly. Like, so why we call this members is because, you know, our philosophy, Unlike typical insurance, right? When you see the database of insurance, usually they are policy centric, or case centric, right? So you start seeing a unique ID like policy ID and then they start from there. For us, we are implementing 360 degrees member centric, right? So it’s individual centric, it’s Michael or it’s Evan. And, you know, this people might have different faiths in his or her lifetime right. So I can for example, first going, you know, as an employee, my company purchase rate for me, and then you know, and then later So on, I leave the company, and then I decided to purchase Ray for myself as an individual. And then I will get married, and then I will bring my my spouse into the membership, I will add more protections along the way. So this is, you know, the first philosophy of why we are different. And, you know, we start seeing that, you know, this creates a lot of impact by seeing this way. We haven’t talked about fraud detection yet. But this also relates with this, when you start seeing individual as who they are, you start seeing the medical patterns, you start seeing the electronic health records, you start seeing activities, and their personalized health risk towards the pool. So this is where we start from. Now, you’re right, that, you know, when when we create this into a subscription, we become like a new layer that you know, orchestrates between the peers, the healthcare and the members. And I think, you know, that’s, that’s why, you know, I spoke with you, probably 15 months ago, and we just launched several months ago. So those are the time where we actually create this system, right. So everybody needs to come to the same table, and get out of their comfort zone. And you know, people from the healthcare claims adjudication, the insurance, people from the broker side, and we are as a technology platform, and we start with a blank paper, how do we do this? Right. And I think that’s, that’s really the key, because, you know, we have the right team to understand pain points from each. And we also have the right partners, supporting us and committing with us to solve this problem together.
Michael Waitze 31:37
Yeah, I mean, it’s a great conversation to have. And the reason why I’m thinking about this is because I’m in the process of renewing my own insurance. Right? So this is a real thing that I’m thinking about. It’s like, do I pay boom, all that at once? Or should I just pay a little bit month to month, just like I would do for anything else that I subscribe to, right? So it’s so much easier for people. And I’m not, I’m not as financially challenged as the rest of the world. But even if I’m not, for me to be able to plan, do my financial planning, like a financial planner would say to me, don’t spend $100,000 In January, right, spend eight and a half $1,000 Every month, or whatever it is, right? So that’s what I would want to do. That’s what I would want to do for my insurance as well. And you’re right, if everybody’s aligned, it just becomes a lot easier that way. You said we haven’t spoken yet about fraud detection and fraud control and fraud protection. So talk to me a little bit about that, and, and how we’ve become so good at this.
Evan Tanotogono 32:32
Right. So again, this is where our philosophy is a bit different than typical insurance. And I feel that this philosophy alone contributes on your how we deal with fraud, etc. So we don’t believe in fraud. We believe in fraudsters, right? So no, there is no fraud on its own, it’s somebody bad making it right. So, yeah, so that’s why, you know, when we start looking from policy I see or, you know, claim case ID we start moving towards, you know, a member centric database and interaction we start seeing all that right, typically ensures, you know, when when they review a claim, they know, it’s a fraud by the time the case is submitted, or it’s post mortem, oh, we’ve just got fraud, right? For us, it’s pretty much different because again, we start with with the one that has most interaction, which is the outpatient, we give the primary care for free unlimited, which is something that you know, typically insurers will say oh, if I do that, it’s a cost for me and I need to think about the cost and blah, blah, but you know, like this is all the interactions we got the details, etc. So our philosophy is that okay, find the bad guys, how do we do that? You know, imagine you’re an airport right? And you have a series of X ray machines there but what actually catch people you know, from bringing bad stuff into the into the aircraft is not the X ray machine on its own right, right. It’s is basically you know, a lot of things happening and the guards there will start looking at how you interact with each of the steps if you’re innocent people you will just walk through very fast and if if you are bringing something that you start parsing you start sweating and that’s where the guy will say, Okay, come over here I’ll do random checks on you and most likely when they do random checks, they find something So believe it or not, you know, when you when you track all this interactions and behaviors, you know, we have everything working in unison from from the doctor chair, we have the you know, care team chats, we have the KYC and etc in in play, then you start seeing even something very, very simple like linguistics. That’s that’s something that we learn along the way is that okay, if people are trying to do fruits, the way they interact the first time to wait, they try to explore what benefits they have on the app, what they’re looking for in the app the way they try to explore the world. The polls, the way they try to talk and speak with the doctors is different than than the innocent people. So that’s what we are start, you know, looking at. And again, because there are some costs that we are taking in and we reshape it into one membership, etc. The interests and appears don’t need to worry about this, right, they just see the end results. This is the protection that I’m giving as as the backbone of this membership, and I’m getting, you know, of free of fraud. Right. So that’s, that’s what we do we identify that people from the good people. And the idea is we do a personalized surface as well, on the clips. If you’re with insurance today, insurance, most likely will think of everybody as as bad guys. Right? But they scrutinize all your claims, where the documents etc. But for us, if we know that you’re a good, innocent guy, then why should we make your life difficult? We just spent 510 minutes on you and you know, everything is done. But if you are your potential fraudsters with very bad scores, then then we know who to scrutinize. And, you know, we had some cases, right when I think like couple months back when we having like 1500 members or so I can pinpoint in that these, these two people did this guy, they will fraud us, right? So it’s pretty important. So I know that if this guy will look fraud us I don’t know when I don’t know how but cable. And that happened, right? So they go into the hospitals. And we we test our hypothesis, we start doing the checks, and we find out that something’s something were fishy. And then we were you know, we were happy, not because we we have a fraudster. But but we can identify before it happens.
Michael Waitze 36:41
So I want to I want to be a supporter of behavioral science, I really do. And that’s kind of what you’re saying. It’s behavioral science at scale. It’s gathering all this data and watching the way people behave. And you’re right. The guy or the gal at the airport is kind of looking around, and I’m exaggerating, right to make a point. But the guy and gals looking around trying to see if anybody’s watching them, checking their pockets or doing kind of shifty things, is probably going to try to sneak a knife onto the plane. Right? And even if the even if the radar, whatever it is, doesn’t catch it. Right? The X rays doesn’t catch it. Okay, fair enough. That’s not the only interdiction point. And I’m saying this because it’s so close to home to me, not only was I not only was Am I trying to renew my insurance, which is a separate context. But somebody tried to scam me this year. And I think for the first time in my life, not on the insurance side and something else. I’m very concerned about my fitness, right. So this gets back to why I have the watch. And while I’m thinking about the aura ring and stuff like that, so somebody has this thing where they watch people on LinkedIn or on YouTube that are watching things that are related to fitness, I want to be fit. And actually in the last year between January 6 2022, and today, I’ve lost about 15 kilos. Well, yeah, and that gets me just wrapped back down to my regular weight, the pandemic ate too much drink too much. That’s why I’m thinking about all this stuff anyway, but that’s a side issue. But somebody saw that it was like, Okay, I’m gonna try to scam this guy for fitness. And the more the he spoke, the more obvious it became that this was not legit. Right? And it would there were certain behavioral patterns that I saw. And again, I’m not a computer, I don’t have a big data set and all this stuff, but you could kind of feel it. But I’m a real believer in this behavioral science. Because the more went on, the longer went on the more obvious it was this is a scam. And again, you can you can feel it when it happens. And sure there are edge conditions where people that have behaved this way may just be like super enthusiastic about something. And yeah, you may be wrong. And that’s okay, because that can get fixed. But I’d rather fix that than have way too many frauds and then try to fix that after it happens. does. Does that make sense?
Evan Tanotogono 38:47
Yep. Yep. I hope you you’re still seeing how the integration, you know, comes into play, right? Because you know, when the payer is integrating with the healthcare and the healthcare has a lot of interactions, we shouldn’t think just, you know, typically, people think that, Oh, that’s a cost. That’s a cost. That’s a cost, right? There’s a lot more richness to the interactions, and we start seeing more behavior, start seeing more data, we start seeing more patterns and long time. You know, risk can be feasible as well, you know, it’s still early in the game. But I think that’s that’s where we are going towards as well.
Michael Waitze 39:22
Yeah. And I think you made a really good point. You’re not trying to you’re just trying to catch the fraudsters, right. And if you can identify those individuals that are trying to do it, you actually benefit everybody else, because my premium should go down if if the fraud gets removed, right, or at least it gets a minimum. I want to do this. If there’s anything else you want to talk about today. That’s great. You’ve launched seven months ago. So that’s good. There’s some data there. But now instead of coming back 15 months later, I’m going to leave it to you to remind me six months from now to find out how member growth is going how your fraud protection is going. Is your claim ratio still saying stable or maybe rising a little bit as you get more members coming? then, and then what’s changed? And what new stuff is getting built over time? Is there anything else you want to bring up? Or should we just wait until the next time we chat up to you?
Evan Tanotogono 40:07
Well, yeah, I think I think for today, I’ve shared enough. But yeah, I would like to use your platform and thank you so much. I really appreciate her doing the Isha InsurTech podcast. But yeah, I would love to, you know, use this platform as a learning for the industry as well. And for people who are who are trying to change the world, right? Because I realized it’s, you know, it’s a big problem. It takes more than array and, you know, it’s it should inform everybody in the healthcare side, in the AI machine learning insurance side, the way they see risk, you know, I think people should be able to refresh their minds some belief might not be relevant today. So yeah, I would love to update you and all the listeners as well, how we learn certainly can make a better world together.
Michael Waitze 40:54
Yeah, let’s do that. I mean, we talked about ecosystems before, we want to be an integral part of that ecosystem so we can help people share knowledge and share new ideas. Evan Tanotogono, a co founder and the CEO of Ray, thank you again, so much for doing this today.
Evan Tanotogono 41:05
Thanks for having me.
Podcast: Play in new window | Download
Subscribe: Google Podcasts | RSS
