The Data Layer

One structured profile per life. Owned by you.

Your richest data on every policyholder isn't in your database — it's trapped in documents. Every claim and underwriting file we process is read, structured, and laid onto one longitudinal profile per life. The automation is the means; this layer is the asset that compounds.

Policyholder record

POL-2026-01184 · already in your system

enriched

+ from AI Underwriting

BMI 27.4BP 148/94HbA1c 6.1Non-smoker

+ from AI Claims

ICD E11.9 · T2 diabetesMetformin 500mgCardiac stent · ฿285k

Every run writes typed, cited fields onto the record.

0M+

Documents structured

0–98%

Field-level accuracy

0

Profile per life

0

APAC markets

The longitudinal profile

Every claim and UW file is a medical event.

Captured and structured, they form one health history per customer — laid on a single timeline. That timeline is the raw material for cross-sell, proactive care, and sharper pricing, and it only deepens with every interaction.

One life · one profile

2021 → 2026
2021UW

Life cover underwritten — medical exam + labs

2022CLAIM

Hypertension diagnosed, medicated

2023CLAIM

Annual health check — HbA1c trending up

2024CLAIM

Type 2 diabetes — metformin started

2024UW

CI cover added — priced on richer history

2025CLAIM

Cardiac stent — inpatient + surgery

2026CARE

Managed & monitored — statin, proactive care

How the layer forms

No new database. It accrues on the records you already hold.

The insured is already in your system. Every claim and underwriting case enriches that record with structured, typed, cited data — the profile compounds as you work, not as a separate data project.

Start from the record you hold

The policyholder already exists in your core systems. We enrich the record you already have — no identity project, no parallel database to stand up.

Structured on every run

Every AI Claims and AI Underwriting case extracts typed, schema-bound fields — diagnoses, procedures, labs, costs — each cited back to the source document.

Compounds event by event

Each case writes a new structured event onto the profile. The more you run, the richer the layer — and the sharper every downstream decision.

What it unlocks

Grow. Care. Protect. On data only you hold.

Grow

Cross-sell & upsell on a real view of each life

Offers grounded in real health history, not a demographic guess.

Care

Proactive engagement on actual health events

Reach members before the next claim — care triggered by real events.

Protect

Catch fraud, waste & abuse; underwrite sharper

Longitudinal history sharpens detection and prices on what really happened.

Healthcare cost benchmark

What care actually costs — benchmarked, only by you.

Every claim and underwriting file is structured into line-item cost data — procedure, provider, diagnosis, amount. Aggregated across your book, it becomes a benchmark of what each episode of care truly costs: by provider, by region, over time. No public dataset holds this. No competitor can rebuild it. Only the insurer paying the claims sits on the raw material — and Papaya turns it into a live benchmark you can act on.

Cost per episode

your book vs. market

Cardiac stent฿285k

above benchmark → renegotiate

Chemo cycle฿120k

above benchmark → renegotiate

Knee replacement฿142k
C-section฿85k
Appendectomy฿62k
your book market benchmark

Manage providers

Negotiate on real cost, not list price. Spot the provider billing 3× peers for the same procedure and renegotiate from evidence.

Sharper pricing

Price to the actual cost trends in your own book — not a stale industry table that never saw your members.

Better product design

Design cover that fits how care is really used — benefits and limits that match real episodes and real costs.

Only the insurer paying the claims sits on this data. It compounds with every episode.

The business case

Four levers — six points off the combined ratio.

Illustrative for a Life & Health book, phased over 24–36 months. Indicative — to be modelled on yours.

−2.0

FWA & leakage

loss ratio

−1.5

Claims & UW opex

expense ratio

−1.5

Sharper underwriting

loss ratio

−1.0

Retention & scale

expense ratio

−6.0 ptscombined-ratio improvement — a step-change for a Life & Health book.

Governance & security

Your data. Your decisions. Your borders.

In-country data residency

Deployed in the AWS Region for each market — a country's data never leaves its borders.

No training, no retention

Every LLM call runs through AWS Bedrock or GCP Vertex — no training on your data, secured in your cloud boundary.

PII encrypted at the row level

Sensitive fields encrypted per database row, on top of encryption in transit and at rest — with a replayable audit trail.

The automation pays for itself. The data layer compounds.

Start with one workflow in weeks — and watch the profiles, benchmarks, and triggers accumulate.