Technology Enables a Better Ecosystem for Health Cover Business

Digital technologies have brought ease, speed and power into information processing.  With the advent of cloud-based data management and high-speed communication networks, accessing information has become convenient, particularly so on handheld devices. These technologies are now enabling an improved ecosystem within health insurance.

Digital technologies are easing customer interactions in various milestones of the health insurance experience journey, such as:

• Plan Selection: Digital comparison engines allow customers to analyse hundreds of plans online and select the one that fits their needs best.  Automated recommendation engines ease the process further by providing a ranked list of plans that perfectly match the customer’s profile.
• Proposal Submission: Paperless proposal forms can be filled up, signed and submitted electronically on mobiles or computers.
• Online Payment: Digital payment gateways support direct electronic payments from customers to insurers using debit or credit cards, e-wallets and even EMI options.
• Underwriting: Digital rule engines allow straight through processing of proposals with real time approval. Tele-underwriting speeds up the medical underwriting process too, wherever required.
• Information Access: Digital technologies enable policies and e-cards to be issued and sent electronically to customers through emails and apps.
• Cashless Claims: Cashless claim forms and approvals are transmitted electronically between the hospitals and insurers or third-party administrators.
• Reimbursement Claims: Reimbursement claims still involves quite a bit of paperwork.  Digital technologies within the National Digital Health Mission’s framework have the potential to eliminate this paperwork.
• Claims Pay-out: Digital payment modes enable reimbursement claims to be paid directly into the customer’s bank account.  Cashless claims are electronically paid to hospitals by the insurers.
• Renewals: Customers are able to pay renewal premium through electronic payment gateways.
• Endorsements: Customers can submit endorsement (information update) requests electronically through insurer apps or portals.

Digital technologies are helping other members of the health insurance ecosystem as well:

• Distribution costs are going down as insurers can sell and service health insurance digitally and no longer need armies of insurance agents. 
• Rule engines allow automation of first level of underwriting and claim processing, thereby increasing speed and reducing costs. Pattern recognition engines are beginning to help detect systemic frauds in claims.
• Digital health technologies such as Electronic Medical Record (EMR) systems are beginning to change the way hospitals capture and share information with insurers and insured. The National Digital Health Mission’s framework for electronic health record sharing, should drastically reduce claims related paperwork.

 The author Co-Founder, SANA Insurance Brokers Pvt. Ltd

DISCLAIMER: Views expressed are the author’s own, and Outlook Money does not necessarily subscribe to them. Outlook Money shall not be responsible for any damage caused to any person/organisation directly or indirectly.