Amit Bhandari, Chief Technical Officer at Magma HDI General Insurance
The integration of technology in the insurance claims process is not just a trend, it’s evolution. With the combined efforts of insurers, regulator, and government bodies like the National Health Authority, the future of claims processing looks brighter, faster, and more customer- friendly than ever before
In today’s fast-paced world, Quick commerce and UPI payments are shaping up Indian customer expectations for on-demand services, instant gratification and ease of fulfilment. With a single tap on our mobile phones, household items are delivered within minutes, offering unparalleled convenience and speed. This shift is also being felt in the insurance industry, which is rapidly adapting newer technologies to meet the changing customer expectations for quick, seamless service.
COVID-19 era necessitated a lot of change in the way customers dealt with physical interactions. For Insurance, it saw the rise of the DIY (Do-It-Yourself) claims processing models where Insurers moved from paper heavy, lengthy claim processes to tech driven solutions.
Customers were empowered to scan or click photos and upload claim documents via apps, enabling a move towards a paperless claim process. Further, enhancements were made to digitize uploaded claims documents, tackled via technologies like Optical Character Recognition (OCR).
Whether it’s reading the Hospital
Discharge card or real-time assessment of damaged vehicles, AI tools have significantly reduced turnaround time (TAT). The survey process in Motor insurance has also been simplified through video streaming, making it completely touchless and efficient process, with no need for physical intervention.
The final aspect of claim processing is adjudication. With the help of AI, we now have software capable of accurately assessing losses and providing a complete end-to-end solution.
However, fraud and non-disclosure of pre-existing conditions remain top reasons for claim repudiation, presenting an area that insurers still need to address through human intelligence.
One of the most exciting developments in this space is the National Health Claims Exchange (NHCX), an initiative by the National Health Authority (NHA) aimed at streamlining India’s fragmented health ecosystem. NHCX will create a standardized, interoperable platform powered by AI and blockchain, allowing all stakeholders—hospitals, insurers, and patients—to interact more efficiently.
The impact of NHCX is poised to be transformative. With NHCX, patients will be able to access and share their medical history digitally, with consent, to the Insurers. This will help curb non- disclosures and fraudulent claims, through machine learning (ML), boosting the ability of insurance companies to offer seamless claims experience.
Admission times, which currently average around two hours, could be reduced to under 15 minutes. Discharge times, typically a cumbersome three hours or more, could be brought down to just 30 minutes. This will also significantly help improve hospital bed utilization, which is crucial for a country like ours.
For end customers, a seamless and efficient claims experience means being able to track their claims in real-time, receive timely updates, and benefit from faster settlements. AI-powered chatbots could assist policyholders in filing claims, answering queries, and providing real-time updates on claim status.
The integration of technology in the insurance claims process is not just a trend, it’s evolution. With the combined efforts of insurers, regulator, and government bodies like the NHA, the future of claims processing looks brighter, faster, and more customer- friendly than ever before.