Buy Health Insurance Policy

Exclusive

Wellness Benefits

24*7 Claims

Support

Tax Savings

u/s 80D

9000+ Cashless Hospitals PAN India

Pincode

+91 Enter Mobile Number

Try agian later

I agree to the Terms & Conditions

Port My Policy

Download Policy

(Incl 18% GST)

How Does Artificial Intelligence Play a Role in Health Insurance?

Artificial intelligence (AI) has been transforming both businesses and the healthcare sector around the world. In case you need a reminder, AI is a computer or system that is programmed to simulate intelligence and perform tasks like data analysis, decision-making, and problem-solving.

In healthcare, it can help by predicting and diagnosing illness at a faster rate, and it also has the potential to revolutionize health insurance by ensuring efficient and error-free experiences. Let’s look at understanding the role of AI in health insurance:

Team Digit

How Artificial Intelligence Impacts Health Insurance?

Artificial intelligence (or AI) is helping insurance companies provide better and more simplified health insurance services to customers. It can help improve many aspects of the insurance process, from calculating premiums, to settling cashless claims. Here’s how:

1. Faster Claims

Insurance claims are one of the major aspects of any policy; yet settling health insurance claims manually can be a long process, due to the large number of factors and documents involved. But AI can help to reduce this turnaround time for claims.

By automating the claims process, insurers can quickly detect fraudulent claims and verify genuine ones, as the AI can efficiently analyze data and provide reports based on a set of decided rules faster than any human could!

2. Easy Fraud Detection

As we have seen above, AI can make it easier to detect fraudulent claims by quickly analyzing data and learning to sort it into categories. This can result in large savings for insurers, as their decision-making and insights will be greatly improved, and will also help them to settle genuine claims much quicker.

3. Personalized Health Insurance Policies

AI can help you identify the best policy for you based on your own historical data and current health conditions. It can even help insurers create tailor-made health insurance plans for customers. This way, you can opt for an effective health plan that suits your needs, without paying for any services that you might not need to utilize.

4. Use of Chatbots

Artificial intelligence systems can help power chatbots, which makes it easy for users to interact with insurers. They can generate instant responses to a number of queries and solve various common problems related to insurance claims, documentation, products, and more. Thus, AI helps to provide better customer service management that can be available 24x7. This in turn can help insurers save administrative costs.

5. Accurate Underwriting

Underwriting is how an insurance company evaluates the risk in offering a policy to any individual, which can affect the premium. With health insurance this can be based on many factors, like age, medical condition, pre-existing diseases, and more.

When done manually, this process can be time-consuming and involve numerous medical tests and procedures. But, with technology, AI can accelerate the processes and make faster decisions based on pre-existing data, as well as data from healthcare devices like fitness trackers.

6. Cost Efficient

AI systems can streamline many insurance processes, such as fraud detection or underwriting, and automating repetitive administrative processes. This way, insurers can ensure more efficient operations, and better utilize their resources and expenses.

Additionally, machine learning can create deeper insights into the medical cost of claims, which can help insurers adjust their pricing and risk management. All of the above can make insurance more cost effective for both insurers and policyholders.

Drawbacks of Artificial Intelligence in Health Insurance

Despite all the benefits of the use of artificial intelligence in health insurance, it must be noted that it also comes with a few drawbacks:

Data Privacy – for AI algorithms to work efficiently, it needs to be able to access a large amount of data and healthcare information about policyholders, and some of this information may be sensitive, raising the issue of how insurers will make the data remain secure.
Security Challenges – as above, storing large amounts of data in a single place can make it easier for that information to be targeted by hackers and used in criminal acts, which makes it important to secure this data
Ethical Problems – because AI might make life-altering decisions regarding a person’s healthcare or finances, it is essential to check how those decisions are made and ensure that it is free from any biases or mistakes.

Conclusion:

The use of AI in health insurance is an important innovation, and one that is quickly driving improvements and changing the relationship between insurer and policyholder. It helps to enhance and streamline the user experience, and to make operations easier. While there is still plenty of scope for improvement, it is clear that artificial intelligence will continue to help health insurance provide enhanced customer services.

Frequently asked questions

All

What is artificial intelligence?

Artificial intelligence (or AI) is a term used to describe a form of programmed machine intelligence that copies human intelligence. It is employed in computer systems to automate time-consuming tasks like detecting patterns, problem solving, and making predictions, by analyzing data in ways that humans sometimes can’t.

How can AI make the health insurance claim process smarter?

Artificial intelligence can quickly analyze data and learn how to verify genuine claims and detect fraudulent ones. This can help to streamline the long turnaround time of settling health insurance claims.

How can machine learning be used by insurers in health insurance?

Insurers can use machine learning and AI to more accurately assess the risks involved in underwriting a policy, and thus predict premiums and losses. It can also help detect fraudulent claims, and automate administrative processes to give insurers a competitive advantage.

What is the role of AI in healthcare apart from health insurance?

AI can be instrumental in using data to predict diseases, or detect them early on, thus potentially improving the effectiveness of treatments. It can also help develop personalized treatments, monitor disease management, and provide cost-effective diagnostic services through the use of chatbots.

Can AI detect fraud in health or life insurance claims?

Absolutely. AI spots patterns in claims, like mismatches in death certificates or treatment history. This helps insurers avoid fake health and life insurance policy claims and ensures honest customers are paid faster. It's like having a super-smart detective checking each claim instantly.

How does AI help me choose the proper health and term insurance policy?

While choosing the right health and term insurance policy, AI-powered platforms analyse your income, dependents, age, and future needs to suggest the best-fit policy. Instead of pushing random products, they personalise suggestions, like a financial advisor using real-time logic.

Important Tips Related to Health Insurance

Health Tips for Women

How to Choose a Health Insurance Policy in India?

Right Age to Buy a Health Insurance Policy

Benefits of Group Health Insurance

Right Time to Buy a Health Insurance Policy

How to Choose the Best Health Policy for Senior Citizens?

Staying healthy during the quarantine

Risks of Not Buying a Health Insurance Plan

Factors That Affect Health Insurance Premium

How Does Age Affect Your Health Insurance Premium?

What Happens if You Don’t Renew Your Health Insurance Policy on Time

Common Mistakes to Avoid While Purchasing Health Insurance

Myths About Health Insurance for Senior Citizens

Why Do Women Need to Buy a Separate Health Insurance?

Important Terms to Know Before Buying Health Insurance

Role of Artificial Intelligence in Health Insurance

What to Check When Porting Your Health Insurance Policy?

Do's and Don'ts of Buying a Health Insurance Policy

Pros & Cons of Having Multiple Health Insurance Policies

Secure Your Savings by Investing in Health Insurance

Can You Renew Expired Health Insurance Policy Online?

Why Is Health Insurance Important for Low and Middle-Income Groups?

How to Increase Your Health Insurance Cover Without Paying a Higher Premium?

How to Review Health Insurance Policy Document?

Benefits of Upgrading Your Health Insurance Policy

Important Changes to Make in Your Health Insurance Plan After Marriage

What to do When Your Health Insurance Claim is Rejected?

Medical Inflation in India

What to Keep in Mind When Adding Your Children to Health Insurance?

How to Choose Between Long-Term and Short-Term Health Insurance?

Pros & Cons of Family Floater Health Insurance

Benefits of Porting Health Insurance Policy

More articles related to Health Insurance

Domiciliary Hospitalization Cover

Group COVID Insurance for SME's Industries & Companies | Digit

Health Insurance Tax Benefits for Senior Citizens

Mental Health Insurance

Air Ambulance Cover in Health Insurance

Benefits of Critical Illness Cover

Health Insurance Glossary India: Terminology, Terms and Definitions

Senior Citizen Health Insurance

GMC and GPA in Health Insurance Policy

Coinsurance vs Copay vs Deductible

Myths about Health Insurance

Increase of Health Insurance Premium on Renewal

What is ABHA Card

What is Health Insurance?

Difference between Mediclaim and Health Insurance

Copay in Health Insurance

Pre & Post Hospitalization Expenses in Health Insurance

Health Insurance with Cancer Cover

Health Insurance for Vector Borne Diseases & COVID-19 Online

Life Insurance vs Health Insurance

Health Insurance for Vector Borne Diseases & COVID-19 Online

Indemnity Health Insurance

Health Insurance Plans for Family

Cooling-off Period in Health Insurance

Add-Ons in Health Insurance Policy

Consumables Cover in Health Insurance

Waiting Period vs Survival Period in Health Insurance

TPA in Health Insurance

Types of Health Insurance Plans

Health Insurance for Parents

Reimbursement Claims in Health Insurance

What to do if you are tested Positive for COVID-19?

Health Insurance Non-Medical Expenses

Critical Illness Health Insurance Cover

Grace Period in Health Insurance

Waiting Period in Health Insurance

Road Ambulance Health Insurance

Nominee in Health Insurance

Health Tips & Guides

Anywhere Cashless Hospitals - Hassle Free Hospitalization Anywhere in India

Day Care Treatment in Health Insurance

Health Insurance Premium Calculator

Health Insurance for Disabled Person

Yoga Asanas & Exercises for Better Lifestyle

Is Dental Covered in Health Insurance?

Zone Based Health Insurance in India

Health Insurance for Government Employees

Health Insurance for Smokers

Restoration Benefit in Health Insurance

Check Health Claim Status Online Instantly

Comprehensive Health Insurance

Compare Health Insurance

Coronavirus Cover: Health Insurance for Coronavirus Treatment

Healthy Lifestyle

Health Insurance for Self Employed/Freelancer

Types of Health Insurance Claims

Benefits of Health Insurance

Reason to Buy Seperate Health Insurance for Parents

Daily Hospital Cash Benefit in Health Insurance

Health Insurance on EMI

Health Insurance for Mother

PED in Health Insurance

Cashless Health Insurance

How to Port Health Insurance?

Health Insurance Tips

Moratorium Underwriting vs Full Medical Underwriting

Government Insurance Schemes

Loading in Health Insurance

AYUSH Health Insurance Benefits

Health Insurance Tax Benefits

Super Top-up Health Insurance for Employees Retiring Soon

Personal Accident Insurance

Super Top-up Health Insurance for Senior Citizens in India - Check Prices

Sum Insured in Health Insurance

What is Long-term Health Insurance? Features & Benefits Explained

Individual Health Insurance

Term Insurance vs Health Insurance

Health Insurance for Diabetes Patients

Corona Kavach Policy: Buy COVID Kavach Health Insurance Online

File Health Claims Online on Digit App

Health Insurance After Retirement

Organ Transplant Cover in Health Insurance

List of Excluded Hospitals

Family Floater vs Individual Health Insurance

How to Choose the Right Sum Insured in Health Insurance?

Room Rent Capping in Health Insurance

How to Reduce your Health Insurance Premium?

Check Digit Health Insurance Claims Status on Digit App

Family Floater Health Insurance

Cumulative Bonus in Health Insurance

Download your Health e-Card

Wellness Benefits with Digit Health Insurance

City

Inpatient vs Outpatient Hospitalisation

Health Insurance with Free Medical Check Up

Deductible in Health Insurance

List of Excluded Hospitals

Maternity Health Insurance

Indemnity Based vs Fixed Benefits Health Insurance

Maternity Coverage with No Waiting Period

GHC

Health Insurance Bariatric Surgery Cover

Super Top up Health Insurance

Cataract Health Insurance

Best Health Insurance Policy

Corona Rakshak Policy Online: Health Insurance for COVID-19 in India

Arogya Sanjeevani Policy

Health Insurance OPD Cover

Coronavirus Health Insurance: COVID-19 Insurance Policy in India

Government Health Insurance Scheme

Health Insurance for NRI Parents

Exclusions in Health Insurance

Sub Limit in Health Insurance

Health Insurance for Disabled & HIV/AIDS Patients: Check Coverage and Benefits

Terminal Illness vs Critical Illness

Health Insurance Plan that Covers Infertility Treatments

Health Insurance Options for Retirees

Check Pending Challan only on Digit App

Install

Check Pending Challan only on Digit App

Latest News

Currently there are no news to show.

Renew & Download Policy Document, Check Challan, Credit Score, PUC & more

60K+ Reviews

4.8

Rated App

60K+ Reviews

12K+ Reviews

4.3

Rated App

12K+ Reviews

Download the App

CIN: L66010PN2016PLC167410, IRDAI Reg. No. 158.

Go Digit General Insurance Limited | Corporate Office Address: Atlantis, 95, 4th B Cross Road, Koramangala Industrial Layout, 5th Block, Bengaluru 560095 | Registered Office Address: 1 to 6 floors, Ananta One (AR One), Pride Hotel Lane, Narveer Tanaji Wadi, Shivaji Nagar, Pune-411005, Maharashtra | Trade logo of Go Digit General Insurance Ltd. displayed above belongs to Go Digit lnfoworks Services Private Limited and is provided and used by Go Digit General Insurance Ltd. under license.