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Insurance Article

AI Based Claim Approval

May 05 2019
aiclaim

ICICI Lombard, the leading private sector general insurance company in India has always been synonymous with tech advancements in the Insurance sector. However, they are not only a tech first insurance company but they also rely heavily on their customers for inspiration. Take for example, the Artificial Intelligence (AI) based cashless claims settlement process.

Traditionally cashless claim settlement is a process that not many of us looked forward to. It is complex and time-consuming. In fact it needs a lot of technical know-how and human dependence. With all of this in place the total time taken for such a process is at least an hour. During medical emergencies when we seek immediate treatment for our loved ones, waiting for so long is not an option. At times like these we wish that there was a human touch to all these processes. We hope that someone would consider what we’re going through and hold our hand through this ordeal.

With ICICI Lombard’s AI based cashless claims settlement, the complete claim authorization process has been automated. The company has harnessed Algorithms using Cognitive Computing along with Intelligent Character Recognition (ICR) & Optical Character Recognition (OCR) in this tech enabled innovation. The decision on the claim authorisation have also been updated. Once the data is uploaded in the system, the AI based technology evaluates the admissibility of the claim. A deep learning module is deployed, which automatically provides the amount to be approved using defined algorithms. As a result the time required for reading and then subsequently approving the form has become a matter of seconds. The entire process is now complete in just a minute. The varied medical procedures where AI is being deployed includes Cataract, Maternity, Appendicitis, Hemodialysis and Hysterectomy. The insurer is looking to expand this list over due course of time.

“The solution is designed keeping in mind medical emergencies. For health insurance policy holders, this would mean instant cashless processing of their request; thereby ensuring that they avail immediate treatment that is so important in case of medical exigencies. This solution will make claims processing faster, consistent and convenient for our customers, significantly enhancing their claim experience.” says ICICI Lombard’s Executive Director Sanjeev Mantri.

This is not the first time that ICICI Lombard has come up with an innovative solution for its customers. In the past it has introduced several ‘industry first’ solutions such as 'InstaSpect ' – India’s first real time claims approval for motor insurance claims using live video inspection and an AI powered interface for customer query management through chat bots (MyRA). As always ICICI Lombard has strived to deliver technology with a human touch.

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