Page 35 - The Insurance Times May 2025

pended on manual risk evaluation and historical data 3. Claims Processing & Customer Service Automation:
analysis. With the introduction of AI, it is possible to Faster claim processing in commercial insurance can be
analyze vast datasets within a few seconds (or less). The quite critical, as any delays can lead to businesses fac-
datasets can include market trends, customer behav- ing huge financial losses or even closure. AI and ML-
ior, and historical claims. Machine learning (ML) mod- powered claim processing and customer service make
els can identify hidden risk patterns and predict future it possible to process claims in minutes and with the
claim probabilities more accurately. This could be a criti-
utmost reliability. AI-enhanced document verification
cal step in offering dynamic and tailored prices to com- enables insurers to process and approve claims within
mercial policyholders.
hours instead of weeks.
2. Fraud Detection and Prevention: As suggested before,
fraudulent claims can cost insurance companies a for- Summing Up
tune. Due to manual data assessment, conventional The role of AI and ML is to identify and quickly resolve the
processes make it difficult to analyze anomalies. How- issues and challenges the insurance sector has been facing
ever, with the introduction of AI, suspicious claims can for years. In commercial insurance, AI and ML can help
be identified through in-depth analysis of behavioral improve operational areas, from automated underwriting
patterns and transaction histories. Predictive analytics to fraud prevention and seamless claims processing. Using
help flag potential fraud before payouts occur, reduc- the latest technologies is cost-effective and provides a win-
ing financial losses. win for insurance companies and businesses.

Insured and invested: Women take charge of their health finance

H ealth insurance is no longer an afterthought for Age-wise cover
women, who are increasingly recognising its impor-
tance amid rising cost of healthcare. Instead of deferring Metro cities lead in health insurance adoption, but purchases
are not concentrated in urban areas. Delhi, Mumbai,
the decision or relying on male family members, women are Bengaluru and Hyderabad account for a bulk of the demand
increasingly playing an active role in securing adequate cov-
for health insurance. About 46 per cent of health insurance
erage. This growing awareness is reflected in the rising
purchases comes from tier-1 cities, while tier-2 cities ac-
number of women choosing high-sum insured plans, to en- count for 34 per cent and tier-3 stands at 20 per cent The
sure they are well-prepared for health contingencies.
change is gradual but evident - women buyers in
underserved regions want to be equipped against the finan-
There is a surge in interest among women for higher cover-
cial strain caused by a medical emergency.
age, according to Policybazaar's recent insights. The share
of women as policy proposers has grown from 15 per cent Women's health insurance needs are also evolving with age.
(FY23) to 22 per cent (FY25). This reflects greater aware- In their 20s and 30s, more women consumers lean towards
ness and more proactive decision-making among women. A maternity benefits and wellness programmes that focus on
growing preference for comprehensive coverage is also evi- reproductive health and preventive care. In the 40s and 50s,
dent, with 70-75 per cent of women opting for policies with higher hospitalisation costs drive them toward Rs. 25-plus
a sum insured of Rs. 10 lakh or above. The rising cost of lakh coverage. Over 50 years, there has been a shift towards
medical care weighs heavily on household finances, and comprehensive plans with critical illness riders and shorter
women are increasingly taking this into account while choos- waiting periods for pre-existing conditions.
ing their health insurance.
As more women continue to break barriers, the industry is
The affinity towards high-value policy was also observed also evolving to meet their growing demands. Maternity
among women aged 40 and above, with several opting for plans with lowest waiting periods, women-specific critical
Rs. 1 crore coverage. The use of a super top-up option is illness plans, and inclusion of preventive health check-ups are
gaining traction, making coverage accessible and affordable. a few examples of product innovation. With women taking
This approach ensures improved financial protection against charge of their health, the industry has an opportunity to
critical illnesses and major medical expenses without an set new benchmarks in innovation and inclusivity. (Source:
overwhelming financial burden. BusinessLine)

The Insurance Times May 2025 33