The health insurance market in India is expected to reach $23.8 billion by 2028. As the country’s digital economy approaches the $1 trillion target, the insurance sector is rapidly digitalizing , moving away from traditional sales methods. It adopts a “phygital” model, combining physical and digital services to enrich the customer experience. Key insurance processes, such as policy issuance, claims settlement and pre-medical checks, are being digitized, providing customers with a smooth and faster experience. Technologies such as machine learning, artificial intelligence, automation and data analytics are revolutionizing the industry, transforming operations to better serve customers.
Personalized Health Insurance Plans
Today’s insurance companies leverage technologies such as artificial intelligence and data analytics to collect and analyze vast amounts of customer data, from medical history to current illnesses and habits. lifestyle such as diet and exercise. The data is used to create health insurance plans tailored to each individual’s needs. . Customers pay premiums based on their risk profile through personalized risk assessments enabled by AI and data analytics. With personalization now possible, users feel like their needs are being met, leading to greater customer satisfaction.
Automation of claims processing
AI has significantly reduced the need for manual work by digitalizing various insurance processes, from claims processing to data entry and evaluation. This also helped minimize manual errors and improve the accuracy of claims processing. Customers receive their refunds faster, making the entire process more efficient and error-free than before.
Early fraud detection
India is facing a surge in digital insurance fraud, with cases increasing by 212% in 2023 compared to the previous year. To combat this, insurance companies are using AI systems to analyze claims data and detect suspicious trends that may indicate fraud. These algorithms learn from historical data, continually increasing their ability to detect potential fraud and saving insurers money. According to the recent Deloitte Insurance Fraud Report, 40% of insurance organizations are prioritizing the use of AI for fraud management.
AI-powered customer support
Insurance companies are using AI and data analytics to provide round-the-clock support to their customers through AI chatbots. Without any human assistance, these chatbots answer frequently asked queries by guiding users through policy details and helping them submit a claim. Customers can get help immediately when needed, making interactions with insurance companies more accessible and convenient, and promoting satisfaction and trust.
Real-time monitoring
AI enables real-time claims monitoring, ensuring continuous supervision and instantly identifying any questionable data. Rather than relying on recurring assessments, this real-time monitoring allows businesses to identify abnormal patterns or behaviors as they occur, saving time and money by preventing fraudulent claims.
Health Outlook for India
Using artificial intelligence and data analytics, insurers examine vast volumes of population health data. AI can easily identify patterns and trends, such as the frequency of particular diseases or medical conditions within specific demographics or regions. The insurance industry and government use this information to create solutions for common health problems, such as policies to manage chronic conditions such as diabetes or heart disease. This strategy helps develop better products that meet customer needs and improve overall health outcomes.
The road to follow
In conclusion, the Indian insurance industry will continue to leverage machine learning algorithms as the system becomes increasingly sophisticated and capable of handling complex data sets. Here, it is important to note that with the increasing use of AI in the insurance sector, compliance with Indian rules regarding data protection, security and ethical use of AI will become more vital. Insurance companies must adhere to laws and regulations framed by regulatory bodies such as the Insurance Regulatory and Development Authority of India on the use of AI and its implementation.
The insurance industry must also consider ethical implications when deploying AI technologies. They must ensure that AI systems are fair, transparent and impartial. This includes creating strict security standards to protect customer data and avoid discrimination. By implementing these advancements responsibly, the insurance industry can position itself as an innovator, offering secure and innovative services that meet the evolving needs of policyholders across the country.
Sumeet Aggarwal
Sumeet Aggarwal is the Chief Technology Officer at Manipal Cigna Health Insurance Company, a joint venture between Manipal Group and US-based Cigna Corporation.
