By Layak Singh, Co-founder & CEO of Artivatic.AI
In the health insurance sector, technological advancements and regulatory shifts are driving an evolution. Insurers are embracing cutting-edge technologies, positioning themselves for a future that prioritizes efficiency and sustainability. The overarching aim of these transformative changes is to democratize health insurance, improve service standards for beneficiaries, enhance well-being of the consumers and ultimately reduce overall costs. From automated claims processing to personalized products, InsurTech solutions are driving a systemic overhaul.
Automation in claim processing:
Using tech like Optical Character Recognition (OCR), Artificial Intelligence (AI) / Machine Learning (ML), GenAI (General Artificial Intelligence) Robotic Process Automation (RPA), insurers are witnessing faster claim settlements. IRDAI regulations suggest that health insurance claims should be settled within 30-45 days, and without error; leaving insurers and third-party administrators to turn towards automation for streamlining claim processes in a faster and effective way.
Enhancing Risk Assessment &Profiling:
AI and ML algorithms are leveraged to assess the risk profile of potential consumers, by analysing multiple data points, such as age,occupation, medical history, and lifestyle choices. These algorithms can calculate the likelihood of an individual, making a claim or engaging in risky behaviour.
Providing more affordable insurance products:
The highly competitive Indian health insurance market is tapping into telemedicine and home healthcare to prevent expensive hospital stays and emergency visits. Using micro-data analytics, insurers are crafting tailor- made healthcare coverage, aligning with individuals & financial capabilities and needs, especially for those residing in Tier 2, 3 cities, and beyond. This will be transformational in the healthcare industry in the years to come.
Fraud, Waste & Abuse Intelligence (FWA):
Healthcare insurance frauds lead to people paying more for their coverage, facing increased out-of-pocket expenses, and receiving fewer benefits. AI-powered investigations can be game-changer in this category, by tapping into various data sources like financial records and digital communications. Its advanced algorithms uncover hidden connections and trends, drastically cutting down the time needed for investigations.
The insurance industry is undergoing a seismic transformation driven by technology, and This momentum is set to surge even further in the next two years. With continuous innovations and swift technological progress in health insurance, the Insurtech landscape is poised for significant disruptions.