Page 26 - The Insurance Times January 2025

Tools and Platforms Used: This case study illustrates how ICICI Lombard General Insur-
1. Cloud Computing Platforms: ance has successfully implemented Generative AI and the
impact it has had on their customer services.
AWS (Amazon Web Services): Robust cloud infra-
structure, scalability, and data management capa-
bilities. Reference:
https://www.cio.inc/icici-lombards-ai-strategy-automates-
Microsoft Azure: Used for Enterprise Solutions and
integration capabilities with other Microsoft prod- customer-services-a-25256
ucts.
Anthem Inc: Enhancing Claims Manage-
2. NLP-Enabled Chatbot:
RIA (Responsive and Intelligent Assistant): ICICI ment through Generative Models
Lombard's NLP-enabled chatbot with generative AI Anthem Inc., a leading U.S. health insurer, faced rising
capabilities; assists customers in policy purchase, claims and costs, prompting a shift to Generative AI for
renewal, and claim intimation. claims management. Partnering with Google Cloud, Anthem
uses AI to analyse data, detect fraud, and personalize cus-
3. Data Lakes and AI/ML Tools:
tomer experiences, training bots to handle claims, client
Data Lakes: Built on AWS or Azure, these data lakes concerns, and medical histories for improved care.
store vast amounts of structured and unstructured
data, enabling advanced analytics and AI/ML ap-
plications. Implementation of Generative AI:
Anthem Inc. deployed advanced Generative AI models
AI/ML Tools: Tools such as Amazon SageMaker or
across its claims management operations to streamline
Azure Machine Learning could be used for building,
training, and deploying machine learning models. workflows, enhance efficiency, and improve accuracy in
claims processing. Here's how Anthem implemented Gen-
4. Mobile Application: erative AI to revolutionize claims management:
IL TakeCare App: Allows customers to file vehicle 1. Automation of Claims Processing: Anthem's AI-driven
insurance claims without third-party intervention. approach automates the initial triage and processing
of claims using natural language processing (NLP) algo-
Implementation of Generative AI: rithms.
Migration to Cloud: ICICI Lombard migrated 170 ap- 2. Claims Validation and Fraud Detection: Anthem's AI
plications, 1,000 servers, and four petabytes of produc- analyzes claims data in real-time, validating patterns
tion data to the cloud which facilitated the use of ad- and flagging fraud, accelerating adjudication.
vanced AI, ML tools available on cloud platforms.
3. Enhanced Efficiency and Cost Savings: Anthem's AI
Development of RIA: RIA an NLP Chatbot, uses NLP and automation reduces operational costs, accelerates
AI to provide accurate, relevant responses to customer claims processing, and enhances customer satisfaction
queries. and retention through faster settlements.
Integration with IL TakeCare App: Integrates AI to al- 4. Integration with Existing Systems: Anthem integrated
low customers to file vehicle insurance claims directly. Generative AI into claims management, ensuring legacy
Project Orion: Aims to modernize legacy core backend system compatibility and enhancing data analytics and
systems to complement the front-end cloud-native sys- predictive modeling capabilities.
tems integrating AI/ML solutions to enhance process 5. Scalability and Adaptability: Anthem's scalable AI
efficiency and build data-backed solutions. claims management efficiently handles growing claim
volumes, maintaining accuracy and service quality.
Impact:
1. Increased Efficiency Impact:
2. Improved Customer Service Anthem Inc.'s adoption of Generative AI in claims manage-
ment has yielded substantial benefits across multiple fronts.
3. Enhanced Data Management
By automating and optimizing processes through AI-driven
4. Modernized Systems through Project Orion technologies, Anthem has achieved:

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