Adoption of Technologies for Claims Management in the Health Insurance Sector

Technology is increasingly affecting every area of our lives and the insurance sector is no exception, especially health insurance. Efficient claims management is extremely important for insurance companies as it can significantly affect the insurer’s costs, it can eat up to 80% of the revenue earned from premiums. Therefore, digitizing every step of the way can increase the efficiency and accuracy of claims management. Let us look into some of the technologies adopted for claims management in the health insurance sector.

  • Artificial Intelligence: Nowadays, AI is assisting the health insurance sector in claim processing, this not only cuts down human intervention but also cuts down the time. This allows customers to have a better user experience, AI helps to capture damage and audit payout & quickens the settlement process. It also helps customers to check their claims history and stay updated on the payment.

  • Internet of Things (IoT): With the potential to offer real-time customer data, IoT is transforming the insurance industry with active loss-prevention techniques. A study by the Boston Consultancy Group estimates that US insurers could reduce annual claims by 40 to 60 percent, just with the real-time data smart devices provided.

  • Blockchain: Blockchain holds a lot of opportunities under it, it is found that the main use of blockchain technology is in fraud detection, risk prevention, and ultra-safe cross-border payments. Speaking of fraud detection, Forbes states that an estimated 5 to 10 percent of all claims, in general, are fraudulent which, according to the FBI, costs US health insurers more than $40 billion per year.

  • Application Programming Interface: API’s are crucial for claims management. Health insurers need efficient integration when it comes to patients eligibility, health data, digital claims management etc. and APIs are ideal for these.

  • Wearables: Wearables are technological innovations that help insurers. Connected devices such as wearables, nearables, hearables, and ingestables will aid digital insurers in the following:

  • Identify customer segments and categorize products and services accordingly

  • Offer customized premium pricing and flexible rates based on a wealth of location, health, and environment data

  • Recognize and update the latest information on a policy holder’s database

  • Detect fraudulent activities using photos, audio, video or any other form of qualified data

  • Generate real-time claims management by an adjuster

Digitization or technological innovations are the answer to most of the claims management issues. And, Insurtech has already become a mandate for survival.