Health insurance
Udayan Joshi, President - Claims & Personal Lines Underwriting, Liberty General Insurance and Dr Sudha Reddy, Head - Health and Travel, Digit Insurance, speaks about issues relating to data for the health insurance sector:
Ravi Lalwani: What are the new types of data that health insurers are seeking?
Udayan Joshi:
A revolution has been sweeping the insurance industry for a few years now, to improve the management and utilization of data. Data is critical for designing new products, offering better service, improving customer experience and eliminating frauds. An established new trend is wearable technology that enables customers to track their routine, calorie intake and manage their lifestyle choices. This data can help i nsurers design better products that can reward customers maintaining healthy habits. Technologies like machine learning and artificial intelligence are now widely used - assessing fewer complex claims and deploying chatbots to manage customer relations better are some of the examples. Similarly, predictive models built based on richer data collated from various sources are helping in several business areas such as renewals management, cross-selling, fraud filtration, etc.
Dr Sudha Reddy: Health insurers look for both customer level data as well as overall trends in the health and well-being space across the world. For policy issuance, insurers are more and more looking at personal details, family history, lifestyle patterns etc, to gauge the overall health score of a person. Insurers also keep looking at overall health trends to understand what would be needed from a product level.
What are the sources of data for health insurance companies? What is the quality of the data?
Udayan Joshi: With this movement from the traditional structure to the unstructured data of today, there has been an evolution in the sources of data such as mobile applications, providers of wearable technologies and even web search providers. Many fintech companies specialize in providing data related to specific use cases and demographic/psychographic analytics. The quality of this data has improved significantly over the last few years. Also, the use of technologies like OCR is helping insurers improve the quality of input data coming f r o m v a r i o us documents.
Dr Sudha Reddy: Health insurance companies either look at trends from customer data or use open-source data from IIB, GIC or other authentic research intermediaries. For instance, when we were curating India’s first covid insurance product, with no earlier references and evolving treatments, pricing was a real challenge. We improvised and used data from public domains globally - like the John Hopkins Report, Worldometer, research studies published by medical societies, hospital accounts, third-party databases and hospital expenses reports. This helped us understand the main levers of higher/ lower risks and develop our product accordingly. The quality of such data is generally high as they are curated by research bodies, health ministries or healthcare bodies.
What new functionality and analytics health insurance companies are developing for leveraging the data?
Udayan Joshi: The goal of any insurance company is to build a sustainable book. This can be done through precise risk selection, which in turn is enabled by data models determining accurate customer profiles and pricing – and right pricing helps in maximizing customer delight. While analytics can help in mitigating the risk of fraud and cancellation thus benefiting the company, it can also aid in designing better customer and partner journeys. Predictive tools can churn data to create personalized experiences and machine learning and artificial intelligence is used to improve turnaround time during
claims and endorsement. These together result in increased customer and partner retention.
Dr Sudha Reddy:
Health insurance companies are developing predictive analysis for claims, especially to gauge claim predictions that can help in scaling up claims processes, in looking at underwriting ratios and in being ready for any sudden increase in claims. These are relevant especially in such times with more and more covid claims coming in.
What kinds of queries are coming from customers? How are health insurers handling vernacular language data?
Udayan Joshi: While customers continue to interact with i nsurance companies with queries about their policy and to highlight challenges faced during their policy servicing, now, in addition to the traditional call center option, the mode of this interaction has expanded to include social and digital media. There has been a recent growth in technologies that can not only read, translate and organize data in any language from the written text but also analyze and respond through automated text and voice communication – and all this in the customer’s language.
Dr Sudha Reddy: Queries are usually on covid related claims. Customers usually want to know about expenses that are covered, whether consumables and preventive devices like thermometers and oximeters are covered and the kind of hospitals that are treating covid. Customers are also seen to be enquiring about digital claims processes and seeking guidance on the same.
More and more insurers are examining use of vernacular l anguages to help customers from across the country. We also have our documents in vernacular languages and our website is translated in multiple vernacular languages.