The main function of insurance is to ensure a smooth cashless claim settlement or reimbursement along with key product features, but is the sector doing enough to help the insurers?
India’s healthcare sector stood at US$160 billion in 2017, and it is estimated to reach up to US$372 billion in 2022, according to Statista. India’s healthcare market, without a doubt, is now one of the largest sectors in terms of revenue and employment as the industry continues to grow at a rapid speed.
From Long Turnaround Time (LAT) to submitting truckloads of paperwork, from long lines at TPAs (third-party administrators) to pestering doctors to issue another letter for a claim, a health insurance claim often leaves one frustrated. It is not surprising then that ‘claims’ has become a differentiating factor for most providers in the market.
Insurance providers need to get smarter and move beyond risk remediation to create partnerships with their customers and mitigate risks. With the scope of the market expanding and maturing, lesser capital, new entrants and increasing competition, and tech-enabled customers, insurance companies need to reinvent the whole cycle of how they service their customers.
A ‘claim’ is crucial to the retention of the customer and the company’s growth, given that it might be the only touchpoint between a consumer and the insurance provider.
Also Read: Why India needs to improve access to instant healthcare solutions
Here are the challenges that need to be addressed:
Multi-channel seamless experience
With COVID-19 pushing for digital adaptability, the Indian consumer is increasingly becoming platform-agonistic, beyond metros as well. Technologies such as artificial intelligence, big data analytics, and blockchain can help transform IT systems for the insurance provider.
Insurance providers need to adopt AI-powered platforms to help agents market the right policy, set up virtual branches, and then provide a seamless experience when settling claims.
According to IBM, two years before the pandemic in 2018, only 12 per cent of insurance executives reported prioritising true digital transformation, moving toward entirely digitised data and processes, with intelligent workflows spanning systems across the insurer and ecosystem partners.
This number is expected to jump to 64 per cent by 2022. The data that the insurance company receives from the prospective client can help it create a seamless and personalised offering for the person.
Risk concierge
Risk concierge helps boost business value at multiple levels. By moving from being just a seller, insurance companies need to become companions by acting as a concierge for their health needs.
Essentially, a risk concierge finds out what a customer wants and provides what they need at every step of their health insurance, from buying one to hand-holding the insurer through their insurance cycle.
It should be able to assess risks, provide recommendations, and schedule health check-up appointments in case of impending risk to a person’s well-being. For a risk concierge to work well, the company would need to invest heavily in cloud, AI and connected technologies such as the Internet of Things (IoT).
A concierge helps address the health risk of an insured individual holistically, leading to better loyalty from the consumer and creating a true competitive advantage in the over-crowded insurance market, which is inundated with new products and players every day.
It is imperative to move from traditional health insurance providers to an emerging concierge, especially in the Indian market.
Going cashless
Digital claims can increase customer satisfaction scores by 20 per cent, reduce claims expenses by 25-30 per cent, and improve claim handling accuracy, by reducing both overpayments and underpayments, according to McKinsey.
However, a cashless process can only work if the insurer is fully digitally-covered, ensuring end-to-end digitisation of the claims journey.
Multi-channel FNOL (first notice of loss), automated claims segmentation, and digital claims status tracking are some of the digital processes that an insurance company can adopt.
Servicing the non-digital natives
However, since many people still don’t have credit cards or cannot use digital payment modes, overreliance on IT might undermine customer experience in the most important moments of a customer’s journey. Hence, insurers need to balance the integration of automation with differentiating personal services.
Also Read: Shaping the future of healthcare with smart hospitals
While most Indian consumers are increasingly moving online, the category called baby boomers (born between 1946 and 1964) is still struggling with many aspects of technology. This category is the one that needs the claim assistance the most, and thanks to their age, they need to visit the hospital quite regularly.
For a consumer, who is not a digital native, it is imperative for insurance providers to preserve the human touch in insurance claims transformations. The answer would be to balance both aspects, IT and human approach, to provide a holistic experience.
Communication
Do your communication channels for next-gen customers, and baby boomers line up with customer preferences? With young customers preferring full-service apps or non-selling direct outreach through affinity and community groups, many people need that hand-holding through each step.
As a health-insurance provider, is your communication segmented based on these preferences?
Moreover, insurers should look at providing services that add value for and delight customers. Based on customer feedback, it should continually improve service offerings, usability, and performance.
This value proposition is usually an underestimated element of a digital transformation. Still, it adds much more value than just introducing newer products in the healthcare insurance market in the longer run.
–
Editor’s note: e27 aims to foster thought leadership by publishing views from the community. Share your opinion by submitting an article, video, podcast, or infographic.
Join our e27 Telegram group, FB community, or like the e27 Facebook page
Image credit: Canva Pro
The post 5 reasons easy claims are important for India and the healthcare sector appeared first on e27.