In a first-of-its-kind, ICICI Lombard General Insurance has come up with India’s first artificial intelligence-powered system to automate health insurance claims. While earlier the claims settlement process was a cumbersome one involving multiple persons, taking time, the AI-powered system aided by OCR can carry out the entire process in just a minute.
The AI-based system also aims to bring down the turnaround time for investigation of health insurance claims down to a day or even less. Girish Nayak, Chief, (service, operations and technology) at ICICI Lombard said that the moment a claim is raised, it gets into the queue and an investigator is notified about it on their app. Earlier, the investigation process, depending on its extensiveness, would take multiple days to complete.
Commenting on the new initiative, Sanjeev Mantri, Executive Director at ICICI Lombard said that since understanding medical diagnosis is a complex activity, the company has deployed AI technology. He further added that the system would help in better detection of frauds. He also pointed out a case where the consent for a cashless request for a patient admitted to a hospital in Vishakhapatnam was granted within a minute.
However, it’s essential to note that the system fails to work in case a proposal acceptance is refused. In such cases, an alert is raised, and the papers are scrutinized manually. Nevertheless, the AI-powered system from ICICI Lombard is another example of insurers deploying AI and technology to expedite claims settlement and enhance customer experience. Notably, it is already using AI for claim settlement related to cataract, hysterectomy, appendicitis and haemodialysis.