The pandemic is over, but modern health insurance demand is rising in India. The Indian health insurance market is expected to grow to US$96.62bn by 2025. This growth is mainly due to technology integration into the insurance industry. The insurers now use AI, machine learning, and automation to speed up their processes. IRDAI support efforts for cost reduction, and the growth of telemedicine further fuel this growth. Let’s explore how technology can improve consumers’ health insurance policy experience.
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Advances in Modern Health Insurance Technology
Health insurance and customer experience have improved through digital tools, like AI for claims processing and wearable devices tracking your health. Some of the latest health insurance technology trends include:
Automation in Claims Processing
Healthcare claims processing places a huge burden on the part of the insurers. IRDAI has also specified that the claim must be settled between 30 to 45 days, leaving less time for insurers to attend to each request. Hence, such work cannot be managed by manual efforts alone, and therefore, insurers and TPAs look for automation solutions.
In integration with real-time processing, Optical Character Recognition (OCR), Artificial Intelligence (AI), Machine Learning (ML), rule-based engines, and Robotic Process Automation (RPA), insurers quickly do the claims approval process with reduced errors.
Automation ensures accuracy, and the settlement happens much faster. Speedy approvals ensure a quicker cycle of payments for hospitals, provided claims are well-documented and presented.
Cloud and AI/ML for Scalability
The insurers are upscaling their infrastructures to compete with each other and adopting cloud-based solutions to heighten the scope of scalability and efficiency. Cloud providers such as Amazon Web Services (AWS), Google Cloud Platform (GCP), etc, offer custom solutions for the insurance industry.
Insurers use AI analytics to give recommendations tailored for their customers when issuing policies, further improving customer engagement. AI/ML technologies aid in preventing fraud and improving customer experience.
Digital Tools to Control Costs
IRDAI proposed capping Expenses of Management (EOM) at 35%, forcing insurers to consider cost-efficient strategies. Now, companies are optimizing all the digital channel distribution and using direct sales to generate leads at a lower cost.
Telemedicine and home health care services are also gaining speed, thus averting costly hospitalizations for insurers. Companies are making operational cost-reducing decisions by adopting blockchain, RPA, AI-based chatbots, and WhatsApp support. Such technological advancements would help India achieve Universal Health Coverage by 2030 as India moves ahead towards making health care cheaper and accessible.
Wearable Technology for Wellbeing Programs
Non-communicable diseases (NCDs) constitute 65% of deaths in India, increasing OOP medical expenses. In response to this need, insurers partner with wearable technology vendors to promote wellness-based habits.
Wearables, connected sensors, and monitoring devices are part of Remote Patient Monitoring (RPM), which helps monitor the patient’s vital health parameters in real-time. These help in managing chronic ailments with fewer hospital visits. Importantly, companies offering health insurance policies can collaborate with the digital wellness platform to offer help with smoking cessation, stress management, and lifestyle interventions. With this, a new, innovative version of day-to-day wellbeing can be achieved.
Unified Modern Health Management
The healthcare industry is at a point where technology has improved, but fragmentation is still prominent because of the absence of standards in data-sharing protocols. Working towards this, India is moving closer to an interoperable digital health ecosystem through the Unified Health Interface (UHI) under the Ayushman Bharat Digital Mission (ABDM).
Digital storage and access to patient’s medical histories via the ABHA card lead to hassle-free transitions between healthcare providers. This digital infrastructure can potentially revolutionize healthcare in India, just like UPI changed the payment landscape.
All concerned parties must adopt standardized code and data exchange frameworks for this change. A few insurance companies are adopting the API-driven model to speed up data exchange, although companies like Google and Microsoft design solutions that further interoperability.
Conclusion
Health insurance is now becoming a personalized, technology-based service that encourages modern health management. As automated claims settlements and digital data access become more common, policyholders must know which insurance company can use these technologies. Digitalization is opening doors for insurers and customers to develop a healthier, smarter, and more efficient way of healthcare. The technology-enabling insurer would bring about a decrease in cost, faster service, and added wellness benefits.
