Using Artifical Intelligence to improve health insurance – ITIJ
Healthcare services around the world are facing unprecedented strain due to the pressure brought on by the Covid-19 pandemic. Despite increased digitisation around us, healthcare services still rely greatly on manual processes, including writing medical reports, which is still done by hand.
Process lag
This lack of digitisation in the healthcare industry has a spillover effect in slowing down other sectors, including insurance. For every insurance claim, handlers have to go through and analyse 20 to 30 pages of documents which, in addition to medical reports, can include various receipts and bank statements. Of all the documents, only a third of them will be typed, the rest will be photographs, scanned documents or handwritten pieces into templates or on blank sheets of paper.
Additionally, some of the handwritten documents will be difficult for claims handlers to decipher, which adds to the amount of time they spend processing and reviewing each case. The average insurance claim is resolved in around 30 days, but it can take up to six months to reach a decision in complex cases.
Manually sorting documents is a very time consuming and inefficient process that drastically reduces the amount of time claims handlers have to engage with customers. The less time available to claims handlers to engage with customers, the longer the latter have to wait before hearing back on a claim. The process of filing an insurance claim is stressful and often has to be done at a time when customers are financially and emotionally vulnerable. Time becomes extra precious when facing an urgent physical or mental healthcare need. This is a particularly big issue in countries like the US, where most citizens depend on private insurers to cover medical procedures.
To date, the insurance industry has been more resistant to innovation than the wider financial services sector. This is slowly changing, as insurers look to improve customer experience throughout the value chain.
