Remove Bottlenecks, Accelerate Decisions

In case you’re new here, we’ll start by reintroducing ourselves. Sixfold is the first purpose-built AI for insurance underwriting, designed to help insurance underwriters reduce their manual workload. We work with global and innovative insurance carriers like AXIS, Zurich Insurance Group, and Generali.

This year has been full of milestones—we’ve processed over 150,000 submissions, responded to more than 250,000 custom underwriting queries, and gathered 3,200+ hours of underwriter feedback.

So, how did we get here? We sat down with our engineering and product teams to give you an inside look at what we built, how we did it, and the technology behind it all.

The result? Nine of our top product achievements this year, picked by the folks who built them from the ground up, all focused on improving accuracy, efficiency, and transparency for underwriters around the world.

1. Improved Accuracy through Advanced Data Extraction & Risk Matching

What is it? ​​💡 

Accuracy is one of the key elements at Sixfold and this time we’ve improved our models to deliver:

• Better data extraction from complex insurance documents
• Faster and more accurate matching of insurer risk appetites to key signals within cases

How did we build this? ⚙️

Our AI team focused on these key areas:

1. Addressing variability in LLM responses
2. Developing accuracy metrics and ensuring targeted output
3. Quantitative testing for basic accuracy

“Working with LLMs is unique because they don’t always give the same answer to the same question. To handle that variability, we created metrics to assess how well we extract the necessary information, the precision of our responses, and our performance on key tasks."

- Ian Cook, Head of AI

What’s the impact? 🚀

Boosting accuracy for underwriters is one of our core missions. With our latest models, we’ve seen a 40% improvement in data extraction accuracy compared to six months ago — even from the most difficult-to-read documents.

“General methods to pull text from a PDF don’t go far enough to meet the rigor we demand. By focusing on the specific documents and information underwriters need, we deliver a more targeted, efficient system than off-the-shelf data extraction services.”

- Ian Cook, Head of AI

2. ​​Transparency in One Click Through
In-line Citations 

What is it? ​​💡 

With this feature, underwriters can find the source of any information Sixfold is showcasing –with just one click. It’ll show which documents and websites the facts came from. Need to know the exact page? No problem we got you!

In-line citations don’t just build trust in our platform; they also give underwriters context on certain risks and provide full traceability for every piece of risk analysis.

“One of the most important things for an underwriter is not only seeing the pertinent risk signals or questionnaire responses we surface as part of the Sixfold risk analysis but also being able to dig deeper or understand the broader concept behind that information.”

- Lana Jovanovic , Head of Product

How did we build this? ⚙️

In simple terms, we associate each extracted fact with a page number to surface the most relevant information. So, what was the underwriting need behind this development?

1. Building trust and confidence in the results
2. To quickly locate information without having to read through many documents

“Certain information surfaced as part of that analysis may even trigger additional add-on questions or thoughts that they may have about it, so they can really rapidly be able to dig in further”

- Lana Jovanovic, Head of Product

What’s the impact? 🚀

We’re bringing transparency, speed, and confidence for underwriters—making it that much easier to make informed decisions.

3. Quicker Decisions With Reduced Case Processing Time

What is it? ​​💡

With our commitment to making underwriters' lives easier, this improvement was an absolute must! Our engineers rolled up their sleeves and worked hard to bring our case processing time down by 61%!

So, what happens during that processing time? Sixfold analyzes aggregated information, searches the web for publicly available information company data, and decides the right NAICS/SIC code classification.   

How did we build this? ⚙️

“It started by reviewing our analysis pipeline step-by-step. We measured the processing time and the size of the data payload for each step of our pipeline to see where we could identify any bottlenecks.”

- Ian Hirschfeld, Senior Engineering Manager

Here are the steps we took:

1. Broke large data processing tasks into smaller and faster units that could run concurrently
2. Reconfigured the pipeline to allow multiple analysis steps to run in parallel

What’s the impact? 🚀

A 61% reduction in processing time—and hopefully, a lot more happy underwriters!

4. Closer Alignment With Your Risk Appetite Through Weighted Risk Signals 

What is it? ​​💡

This feature will show underwriters all the risk criteria they’ve defined as important and classify those risks as either positive, really positive, negative, or really negative. And yes, the weighted risk signals are tailored to each customer’s unique risk guidelines and definitions.

For example, a cyber company might consider it a “really positive” signal if a prospect has implemented a Multi-Factor Authentication (MFA) process, while not having a backup in place might be something really negative.

How did we build this? ⚙️

Our product team envisioned this feature as something that could easily adapt to each carrier’s unique needs and got close support from our Lloyd's mentors during our 10-week Lloyd’s Lab Program, to refine and improve this feature. 

Some of the core elements to figure out when building this feature included:

1. Creating a scoring model that’s detailed enough to handle different signals without becoming too complex
2. Balancing positive, negative, and neutral signals to accurately reflect real-world underwriting decisions
3. Making sure the system could adapt smoothly to each carrier’s existing workflows

Because every carrier and industry interprets risk signals differently, we needed a solution that was both flexible and adaptable.

“The biggest challenge in designing this feature was addressing the diverse UW guidelines across various sectors.”

- Leonardo Momente, Senior Software Engineer 

What’s the impact? 🚀

‍
This feature is a great improvement in accuracy in appetite match scoring. This not only saves time but also improves underwriting precision.

“Frequent iteration and testing allowed us to refine the scoring criteria and user interface based on user feedback, ensuring the system was both effective and intuitive.”

- Leonardo Momente, Senior Software Engineer 

5. Reliable Evaluations Thanks to Detailed Medical & Lifestyle Insights

What is it? 💡

Life and disability underwriters have to go through hundreds of pages of medical documents, alongside lifestyle details, hobbies, and family medical histories. Sounds like a lot, right? Some might even compare it to detective work.

With our Life and Disability customers in mind, our product and engineering team built the Lifestyle & Medical History Analysis from scratch. This feature analyzes all the documents provided for a case and brings back a summary of all relevant risk information, helping underwriters quote cases more efficiently and quickly.

Sixfold takes care of the heavy lifting so that underwriters can focus on decision-making and relationship-building!

How did we build this? ⚙️

This feature was designed in different phases:

1. Sixfold ingests all the documents underwriters upload for a particular case, extracting the relevant text from each file
2. We analyze both the structured and unstructured data extracted, summarizing key information for the underwriter
3. To make it even easier, we provide a chronological narrative of each case or condition

But, that’s not all! We also flag specific conditions predefined by the carrier and deduplicate repetitive information.

“One challenge was the fact that these medical histories can have a lot of repetitive information. For example, the history of a diagnosis or condition can appear many times across different types of documents.”

- Omeed Fallahi, Software Engineer

What’s the impact? 🚀

This feature dramatically reduces the manual work for underwriters, cutting down processing time for each case.

“You might have a negative risk signal for diabetes, for example. What the AI can do is identify a medication for diabetes that doesn’t explicitly mention the word ‘diabetes’ and flag it as a risk signal. This means the underwriter doesn’t have to constantly check what each medication is and what it treats.”

– Drew Das, Senior AI Engineer

6. Robust Security Through SOC2 Type II Certification + HIPAA Compliance

What is it? 💡

Our main goal is to make underwriters' lives easier – that’s at the core of everything we do – making sure our platform plays a huge part in that.

So, what does it mean for Sixfold to be SOC 2 compliant? This means that a neutral, expert third party has evaluated our platform to confirm we meet strict security controls, data protection, and availability standards. With SOC 2, we’ve gone the extra mile to prove these controls work consistently and effectively over time.

And what about HIPAA? HIPAA protects patient health information (PHI), and being HIPAA compliant means we’ve passed an audit confirming that our platform meets the privacy and security requirements needed to serve the life insurance industry.

How did we build this? ⚙️

Over several months, our engineering team addressed a series of steps to align with these regulations:

1. Implementing strong access controls, user authentication, and data encryption
2. Creating detailed incident response and disaster recovery plans
3. Setting up continuous security monitoring, logging, and comprehensive documentation

"Team coordination and implementation proved to be a challenge. We needed to ensure all staff members were properly trained and fully understood our security protocols and compliance requirements. "

-  Ryan Garver, Staff Software Engineer

What’s the impact? 🚀

By meeting these standards, we’ve put ourselves in a stronger position to help our customers meet their compliance needs in the insurance industry. It’s all about making Sixfold a trusted, reliable partner for carriers.

“For our platform, SOC 2 Type II and HIPAA compliance are fundamental business necessities, not just regulatory requirements”

- Ryan Garver, Staff Software Engineer

7. Establishing a Responsible AI Framework

What is it? 💡

We love helping underwriters improve their quoting process with AI—that’s our main goal—but we also want to do it in a responsible way and set the benchmark for Responsible AI. With that in mind, we created our Responsible AI Report.

The report gives an overview of Sixfold’s approach to safe AI usage and answers common questions about the topic.

With Sixfold, you can have peace of mind knowing that your data is:

1. Never stored or used for training our base model 
2. Isolated and separated from others
3. Locked up tight for ultimate security

How did we build this? ⚙️

Our AI team is constantly working on:

1. Evaluating and re-evaluating our workflows and pipelines
2. Reviewing data that enters our system and assessing it for appropriateness and consistency to ensure it aligns with our Responsible AI principles
3. Refining code, LLM-based interactions, and data governance to ensure no protected class information is inserted or surfaced

“While we always want to make sure we’re aligned with the latest research on Responsible AI, the principles themselves don’t change as often as the tools. Our focus is on applying those principles every time we evaluate new tools and techniques.”

— Ian Cook, Head of AI

What’s the impact? 🚀

The Responsible AI Report reinforces our security standards and compliance commitments, building trust with our customers.

“As someone once said, focus is choosing what not to do. The framework helps us keep focus by making it clear what we should not be doing.”
‍
— Ian Cook, Head of AI

8. Boosting Speed and Accuracy with Fewer Tabs via API

What is it? 💡

You may not even notice, but you’re probably using APIs – Application Programming Interfaces –every day. An API allows different software to communicate while keeping the user on the same interface they’re familiar with. Think about online shopping—you don’t need to leave the site to process your payment through the credit card company, right? That’s an API working behind the scenes! 

For Sixfold, launching our API was a big step because it brings simplicity and efficiency to underwriters using our system. Underwriting teams often work across multiple platforms during the quoting process, so we made it easy for our customers’ tech teams to integrate Sixfold’s AI capabilities directly into the tools they’re already using.

How did we build this? ⚙️

Our engineering team focused on:

1. Identifying the most critical information to expose through the API and how this information might differ from what is presented in the Sixfold Web UI
2. Highlighting the most relevant data, supported by auditable sources
3. Minimizing exposure to behind-the-scenes complexity

What’s the impact? 🚀

Sixfold’s API makes it easier for our customers to process a high volume of cases daily.

“One of our customers submits approximately 1,000 cases per day, with an average processing time of 31 seconds per case.”

- Ian Hirschfeld, Senior Engineering Manager

9. Streamlining Workflow Efficiency with SSO Integration

What is it? ​​💡 

Yes, SSO stands for Single Sign-On. But what does that actually mean? We like to think of it as a way to simplify the way users log into applications.

For our customers, that basically means using their corporate email address to securely access Sixfold’s platform. And trust us, implementing SSO isn’t easy—there are plenty of security considerations, and the first thing that comes to mind is compliance!

How did we build this? ⚙️

This feature was a top request from our customers and with a diverse client base, our platform team had a lot of boxes to check:

1. Different configurations across different clients
2. Which Identity Provider do they use? Microsoft Azure or PingFederate, for example?
3. How does user authentication happen—and how do we map users correctly?

“If you have a team of different underwriters, maybe they have different permissions—maybe they can see one case that fits certain criteria but not another.

And when new underwriters join, you want them seamlessly authenticated and authorized the same way as your existing underwriters.”

- Mike Rooney, Principal Software Engineer

What’s the impact? 🚀

No more handling a bunch of passwords! SSO is simply a better way to log in, reducing the chance of leaked credentials.

“Very soon, we’ll just be able to send a link to new customers who want to set up SSO with us. They can go through a detailed onboarding guide at their own pace. Once they’re done and happy with the setup, it turns green on our dashboard and we’re good to go.” 
‍
– Mike Rooney, Principal Software Engineer

That’s a 2024 Wrap

Looking back at these product developments and improvements, a few key themes stand out— efficiency, accuracy, and transparency. These are the key elements Sixfold is committed to bringing to underwriters every step of the risk assessment process. 

Want to see how we’re making a difference in underwriting today? Check out how AXIS reduced submission time from 30 minutes to just 60 seconds, and how Zurich’s underwriters saved an average of 90 minutes per submission.

Thanks for sticking with us until the end of this post, and we’ll see you in the next one!

Today, life & disability carriers have access to more data from more data sources than ever, but the processing of all that data has paradoxically decreased efficiency and limited underwriting capacity. The industry has wisely turned to gen AI to help it reap the rewards of the modern data abundance while minimizing the cost.

In our view, gen-AI-powered underwriting isn’t about conversing with chatbots, it’s about collaborating with a platform that understands exactly what you need and exactly how to get it. But how should a platform like that function? What would it even look like? We started the process of answering those questions by interviewing dozens of underwriters to understand their frustrations, goals, and how other tools have failed them in the past. This input has guided our approach to design built around simplicity, context, trust, and fun. 

Simplicity

Many L&D carriers rely on automated extraction tools and/or offshore teams for their data-processing needs. These result in long multi-page reports, which are typically just ordered lists of data. Underwriters are left to rifle through these tomes to pull out relevant info. Sixfold eliminates these overly manual tasks by injecting AI throughout the underwriting process.

We use cutting-edge AI to independently build a virtual model of carriers’ unique risk appetites, so the platform can understand what constitutes negative or positive risk signals for that carrier. The platform taps a different set of purpose-built AI models to process ingested data and gracefully surface precisely what information underwriters need — and nothing else.

How does this AI wonder translate into design? We’ve leaned hard into “inconspicuously helpful.” The best AI is one that doesn’t make a show of itself, but can be depended upon to solve problems when called into action. More old-school British butler, and less Robin Williams’ genie from Aladdin. From a design perspective, that means elevating minimalism and simplicity.

Underwriters never see the AI hard at work ingesting data from disparate sources (APS files, MIB reports, labs, etc.). And they shouldn’t have to. All they want to see are easily scannable bits of appetite-aligned information in a unified dashboard experience. Leave the sausage-making to us, enjoy your hotdog.

This effortless minimalism extends to every part of the platform. On the case list page, underwriters can peruse a list of applicants with clear visual cues signifying which cases are closely aligned with underwriting criteria and which aren’t. In a previous technological era, underwriters had to invest time in scrutinizing each and every applicant with limited ability to triage, leading to reduced productivity. With Sixfold, they can focus their efforts on the biggest impact.

Context

Traditional data processing & ingestion treats all information equally. Taking a daily multivitamin is, for example, given with the same “weight” as immunosuppressants taken after an organ transplant. “Flattened” data reports, no matter how thorough, require underwriter intermediation to pick out the relevant through lines. 

We can do better in 2024.

Sixfold taps a medley of nine AI models to identify relevant data points from disparate sources and “connect the dots” between them. It’s the difference between, say, mentioning an applicant has diabetes versus summarizing how it’s being managed, e.g., “applicant was diagnosed with diabetes in 2015, but it is being adequately managed through diet and insulin.”

We haven’t merely replaced one form of summarization with an AI-powered one. We use gen AI prudently and solely in service of accelerating decision-making. Our goal is to present underwriters with as little information as possible (or, rather, just the right information) so they can focus their energies on making informed decisions. 

Concise auto-generated explanations are placed front and center, but underwriters can always dive deeper into specific information as needed (e.g., the platform may let you know that recent cholesterol readings were acceptable, but you have the option to dive into the readings from the last few labs).

‍Trust

The best underwriters are detail-oriented, and they deserve tools that meet (or better yet, exceed) their standards of thoroughness. Underwriters using Sixfold should be confident that everything has been scrutinized as thoroughly as if they did it themselves—if not more!

We accomplish this by showing our work. Transparency is baked into the Sixfold UX. We provide sourcing of all surfaced risk factors and conclusions, right down to the source and page so underwriters know precisely where a conclusion came from, and why it was arrived at.

And a little bit of fun

We want engagements with our platform to feel like working with your favorite coworker. You know the one we’re talking about right? The one that gets things done, but throws in a little light-hearted banter and joking around to improve your day just a bit.

Going through medical records isn’t what most people consider enjoyable. So we injected some moments of surprise and delight that can bring the joy back to underwriting. Our platform includes small flourishes that we hope provide a little levity.

Throughout the site, we’ve included illustrations of friendly robots collaborating with humans and empowering the humans to do more. The overriding theme of this aesthetic? Clay. Why clay? It feels deeply human, handmade with little imperfections that add character. We believe that AI can liberate humans from rote work (which is better handled by machines anyway) so they can emphasize their uniquely human qualities. The machines aren’t going to take over our jobs – they’re going to free us to bring humanity back to the work we do.

Want to see the platform in action? Watch our on-demand product demo for a live walkthrough of Sixfold’s Life & Disability offerings.

With our latest product update, we’ve sharpened our focus on Life & Disability via a suite of AI-powered features that overcome common underwriting challenges.

Sixfold’s number one superpower is to easily–and quickly–ingest carriers’ unique underwriting guidelines and automatically surface the submissions that match the carrier’s unique risk appetite. Moreover, the platform empowers Life & Disability carriers to streamline the underwriting process by:

🔘 Ingesting data from multiple disparate sources in an instant

🔘 Generating a comprehensive summarization of the applicant's health history and lifestyle within minutes

🔘 Surfacing positive & negative risk signals aligning with the unique risk appetite of each carrier 

🔘 Triaging submissions with an underwriter-facing dashboard for improved resource allocation

We've significantly broadened our Life & Disability offerings by expanding into six key areas, facilitating us to quickly create a comprehensive 360-degree applicant profile in just minutes by: 

✔️ Reducing manual workload through improved document ingestion 

Our technology has been significantly enhanced to process and analyze an extensive history of lab results, diagnoses, and medication records, covering years or even decades.

The platform is proficient in ingesting data from various sources including APS files, MIB reports, labs, applications, supplementals, Electronic Health Records (EHR), and Fast Healthcare Interoperability Resources (FHIR) files. By automating the ingestion of these diverse data types, Sixfold eliminates the need for manual document handling by underwriters.

✔️ Refining risk evaluation with a holistic view of medications, treatments, lifestyle choices, and family history

The platform leverages advanced synthesis of adjacent applicant history information, including pertinent family medical histories and lifestyle attributes, to offer a comprehensive understanding of their broader health habits and disease predispositions.

By integrating details from submitted records—such as family diagnoses ("father was diagnosed with melanoma at 63, but was successfully treated")—with insights into exercise routines ("engages in moderate-intensity aerobic exercise and weight lifting"), hobbies ("applicant scuba dives several times per year"), and substance use ("consumes a few beers every few days"), Sixfold provides a holistic view of an applicant's health.

This comprehensive approach enhances the precision of assessments, enabling more informed decisions regarding risk.

✔️ Improving risk decision precision with in-depth analysis of health condition progression 

We are now able to aggregate data related to a condition, including adjacent factors like medication, to chronologically track the comprehensive progression of the condition across multiple data sources. By utilizing detailed health data and its evolution over time, we enable more informed and accurate underwriting decisions.

This approach provides a unique layer of detail, incorporating crucial health information over time, allowing underwriters to quickly grasp risk with relevant context, thereby informing more precise rating and pricing.

✔️ Enhancing fraud detection by identifying inconsistencies across sources

Underwriters are tasked with synthesizing and managing a vast amount of information from lengthy documents, including Attending Physician Statements (APS), self-reported data, laboratory results, and more. An important aspect of analyzing these documents is to identify inconsistencies or discrepancies that could arise from oversight or fraud. Instead of solely relying on underwriters to detect irregularities across diverse documents, Sixfold proactively identifies and flags these discrepancies to the underwriter.

The platform's automated capability to identify problematic areas empowers underwriters to make informed decisions, leading to more accurate pricing of premiums and greater reliability of applicant information, safeguarding both insurers and applicants.

✔️ Expanding traceability with full document and page number sourcing

Our recent achievement of SOC 2 Type 2 certification underscores our commitment to being a responsible AI solution.

In this release, we've taken traceability to the next level by ensuring underwriters have access to complete information sourcing, pinpointing the exact document and page for increased transparency and accuracy.

✔️ Boosting underwriting capacity with upgraded triaging functionality 

Sixfold's latest update introduces a streamlined dashboard experience, designed specifically to empower underwriters to efficiently prioritize applicants who meet their risk tolerance and gracefully set aside those who do not. This effectively addresses the common 'front door issue' in Life & Disability underwriting, which involves managing an overwhelming influx of submissions by automating the pre-processing of applications. Within minutes, Sixfold accurately identifies and aligns applicants with the carrier’s risk criteria, significantly easing the burden of manual sorting and enabling underwriters to focus on the most suitable cases.

Our newest updates equip life & disability underwriters with a complete, clear and accurate health snapshot for every applicant, pinpointing key data points without sacrificing our commitment to compliance and data privacy.‍

Curious to see it all live? 👉 Watch our 20-minute product demo.