Page 17 - Insurance Times October 2020

care cost, purchase of monitoring de- customers can get updates and can panies say the hikes are necessary as
vice, PPE kit cost and diagnostic cost keep a check on the status of their the IRDAI has asked them to cover a
among others. The policy covers claims. It also helps them with the dif- range of conditions excluded earlier.
hospitalisation expenses or home care ferent processes which are to be fol- From pandemics like Covid-19 to age-
treatment expenses after an insured is lowed. related ailments such as cataract sur-
found to be coronavirus positive. "In a way, the physical touch which gery, knee-cap replacements,
Insurers say that while the number of was earlier needed where someone Alzheimer's and Parkinson's, insurers
claims in August was in a few hun- actually had to send in the documents, could earlier exclude them. With regu-
dreds, they jumped 60-70 per cent in wait for the courier to be delivered latory changes in the last one year
September for home quarantine treat- and then the action to be taken, some making it mandatory for them to cover
ment. "We are expecting a jump in the of those processes have been fully Covid-19, HIV/ AIDs, artificial life main-
next month," said a senior official with onboarded," said Suresh Kolla, Head- tenance, treatment of mental illness,
another insurance firm. In fact, in case IT, Care Health Insurance said. mental disorders, age-related degen-
of in-patient treatment too insurers "There was a lot of to and fro earlier eration, internal congenital diseases,
are saying that while claims peaked in because the customer basis his or her insurers say price rise is inevitable.
mid-September, the daily claim figures understanding would share some docu- Covid coverage, insurers say, is the
have fallen by around 30 per cent in ments. Only when it comes to our heaviest burden in recent weeks. Last
the first half of October. team, deficiencies if any would be month, the General Insurance Council
raised. This used to take a lot of time appealed to the Supreme Court along
Care Health Insurance cuts which has gone down significantly," he with policyholders over exorbitant
claim settlement time by added. rates charged by private hospitals for
Covid treatment. While most health
Artificial Intelligence According to Kolla, there has been a insurance policies had got IRDAI ap-
The Artificial Intelligence is making in- 40-45% reduction in time to process proval before the pandemic, brokers
the claims. This has also decreased the
roads in insurance industry. With the number of calls which the company say that insurers are raising rates by
technological innovations catching up, used to get earlier. pricing policies at the highest end of
the use of AI has the potential to bring the rate band approved by the regula-
a severe disruption in seamless cus- Earlier, the customers would call to get tor, instead of pricing it mid-range.
tomer experience, efficient claims the updates on the status of their Insurers say that standardisation of the
management, reduced turnaround claims. With the claim gene, they can cooling period for exclusions is pushing
time and has also helped save costs. see the status on their phone itself. up costs.
Hence, the number of calls has gone
Care Health Insurance has introduced down by 30-40%. IRDAI had ruled that every health in-
an online claims solution - 'Claim-Ge- surance product should cover all pre-
nie' which is available both on its mo- By making use of artificial intelligence existing diseases disclosed after the
bile application and website. Through and machine learning techniques, the expiry of 48 months or lower time pe-
'Claim-genie' the customers can file company is also developing a robust riod. Another industry-wise trend that
and track claims from the comfort and mechanism of analysing claims in order industry observers are seeing - is the
safety of their homes. to recommend further actions to the change in slab-based pricing. "So ear-
servicing teams.
"It is a platform that we have given to lier, insurers used to have larger age-
our customers which is a one-click plat- Health insurance may wit- wise bands of 25-35, 35-45, 45-55. As
form enabled on different touchpoints policyholders crossed these age-bands
for a website, mobile application or ness premiums jump upto there would be a price increase. But
self-service portal, where customers 70% increasingly, the market has been
can come in, initiate a claim, upload The premium on health insurance poli- flooded with new products, which have
the details and documents required," cies have risen by 40-70% for policy- a shorter age-band of 5-years. So that
he said. holders after insurers hiked rates fol- means every 5 years, prices change for
All claim related updates and docu- lowing a regulatory note to widen cov- customers. There are even products,
ments are made available to our cus- erage and standardise conditions with where every year, the insurer can
tomers via whatsapp & chat-bot. The regard to exclusions. Insurance Com- change the price.
The Insurance Times, October 2020