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Exploring the Potential of AI in Health Insurance in India

Technology has solved many of the issues that have plagued various industries. Medical procedures have improved because of technological advancements. Computers have evolved rapidly over the past several decades because of continuous improvements. Cars, washing machines, TVs, mobile phones and refrigerators all have made leaps and bounds in what they offer because of technology.

There's hardly any industry not benefiting from technology.

Surely, even insurance has made forays into offering better products with technology. More so with the latest tech like Artificial intelligence. AI in health insurance especially is making waves albeit slowly.

This article will explore what the future of health insurance looks like now! AI in health insurance is already here.

Overview of Artificial Intelligence in Insurance

According to a report by Allied Market Research[1], the AI insurance market was valued at $2.74 billion in 2021 and is expected to hit $45.74 billion in 2031.

The report goes on to say that the Covid-19 pandemic expedited the use of AI in insurance which led to better customer experience, higher profits and lower costs. It also helped with reducing time spent on repetitive tasks, underwriting, claims and fraud detection.​

Presently, you can see AI implemented in sections of the insurance buying and claims process. For example, chatbots and voicebots are changing the way customers get what they need. These tools use Natural Language Processing (NLP) which is a try of AI that interprets and uses human language.

However, challenges remain. According to a Forbes article[2], without proper data points, AI cannot predict what a customer wants. Nevertheless, artificial intelligence in insurance still plays a vital role in its core processes. Let's take a look at those. 

How AI in Health Insurance Helps

As we mentioned before, AI in insurance aids insurers in the underwriting process, claim management and even occurrences of fraud. Here's how AI in health insurance helps in the very same areas: 

1. Risk assessment and management

With the help of AI in health insurance, insurers can gather and analyse large amounts of data. This helps in better assessing risks and in decision-making. According to a research journal published in MDPI[3], AI is used in the underwriting process to reduce the time taken to create a product. The journal gives an example of how data from fitness trackers are analysed to create relevant products for customers. 

2. Personalised insurance policies with AI

Insurance plans can be personalised to a greater degree for the customer since there's tons of data available that helps. AI can study and track customer behaviour and recommend products accordingly. In today's world, personalisation of such sort is available to the customer through other avenues like e-commerce. Achieving similar levels of personalisation is possible with AI in health insurance. 

3. Fraud detection and prevention

Since artificial intelligence in insurance can consume and analyse large datasets, the detection of fraudulent claims and the like has a higher success rate. This in turn helps resolve claims quicker and frees up time to dedicate to legitimate claims. 

4. Claims processing

According to a report by Ernst & Young[4], 87% of customers say that the claim experience decides whether they will stay with the same insurer or not. Therefore, the adoption of AI in health insurance claim processing is paramount. As fraud detection using AI allows insurers to focus on real claims, artificial intelligence in insurance makes the claim process faster by moving away from manually accepting a claim to fully automating it. This is a benefit for both the insurer and the customer[5], saving time and money for both parties. 

Examples of Artificial Intelligence in Insurance in India

In India, the best example of AI in health insurance is the use of chatbots and voicebots. These tools are automating some of the basic processes like giving service-related information and managing customer queries. Now chatbots and voicebots can also handle buying and renewing insurance policies with no dependency on human moderators. 

With the help of Natural Language Processing (NLP), customer inputs are interpreted and returned with relevant information. NLP also plays a big role in translating web content into various languages other than the standard internet language, English. This opens up huge markets in a country like India with so many diverse languages. 


AI in health insurance and the insurance industry as a whole is still in its budding stage. In India where insurance penetration is low, much more work is left. However, what we've seen so far with artificial intelligence in insurance is promising and has the potential to make the insurance process far easier and more accessible.​