.jpg "Usage of Conversational AI in the Health Insurance Sector")
At the Conversational AI and Customer Experience summit last week, PB Fintech President, Rajiv Gupta stated how AI systems are being put into use to drive progress in the health insurance sector of the country. Industry reports reveal that more than 60 percent of the individual healthcare costs in India are still being spent from the pockets of the consumers. In this regard, he mentions why AI systems are required to enhance and improve the rate of consumer literacy in India and how will conversational AI systems be helpful in driving growth in the health insurance domain.
“Currently, in the health insurance sector of the country, there is a huge trust deficit. Through our AI platform, we are trying to form an interconnection between the hospitals, the TPAs and the insurers in order to provide faster delivery of insurance claims to consumers. Through AI, we are trying to ensure that consumer interaction becomes much easier and efficient”, mentioned Rajiv Gupta, President, PolicyBazaar Fintech at the summit.
Conversational AI has been able to transform consumer interactions in various industries and health insurance can be no exception where consumer understanding and behavior plays a vital role. There are several aspects that can be elaborated in this regard.
It is a known fact that currently in India; it is only through the health insurance agents that consumer education is predominantly done. With the advent of conversational AI, this scenario is changing fast. Integration of these systems is helping in providing education two ways. First, it is providing consumers with basic to advanced information regarding health insurance and its benefits. Consumer interaction has become more efficient as companies are able to manage a complete network of agents with the incorporation of conversational AI. Consumers are able to search for themselves about the basics of health insurance and also the kind of policies they should opt for that aligns with their requirements.
On the other hand, it is also helping agents and representatives at remote locations of the country and tier 2 and tier 3 cities to better understand the policies themselves and educate the consumers. Access to health insurance information and understanding why does one need a health insurance is still a matter of concern in India.
“There are health insurance agents in the country who might not be highly educated but are good salesmen. These AI systems are helping them gain knowledge about the policies so that they can pass that knowledge on to the consumers”, states Rajiv Gupta.
A digitized framework also brings quite an amount of risks that need timely assessment and mitigation. The growing number of false and fraud claims is enough to prove that a supervising infrastructure must also be present that will be able to distinguish between true and false claims. Fintech companies like PolicyBazaar and PaisaBazaar have incorporated AI systems that are able to eliminate any human error and process a true report of the claim.
These systems also have the capability to go through consumer data and create a portfolio for insurers. These systems are creating a platform where consumers can get clear information on the insurance through conversational AI and on the other hand, the insurers are also able to assess AI generated portfolio of the consumer and suggest them about what policy will suit them best.
“Conversational AI takes the consumer in an engaging journey and is able to help clients with a portfolio and also a credit score to make them know where they stand in taking a loan or doing a policy”, mentioned Rajiv.
Despite massive digitization, majority of the health insurance providers are unable to make their presence felt in the tier 2 and tier 3 cities. It is because the requirement is different for a consumer in a tier 1 city and following that plan is not helping the insurer to strike on the exact consumer requirements. In this regard, conversational AI has played a transformative role. Systems have been put into place which can interact with the consumer individually irrespective of their location. They are able to inform the insurers about the requirements of consumers so that policies can be customized according to that.
“The requirement of consumer in a tier 1 city will hugely differ from that in a tier 2 or tier 3 city in India. Conversational AI systems take the conversation to an intellectual plane where a sense of trust is created. Individual assessment of portfolio is helping us understand consumer requirements and suggest them on the right products”, said Rajiv Gupta.
Usage of conversational AI in the health insurance sector has made it easier for consumers and insurers to have access to information that was not accessible before. It has created a lot of transparency within systems and has the potential to create a much larger impact in the years to come.
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