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From claims to clinical advice to health assessments, coverage gets tech-savvy

Nellie D. Ashmore by Nellie D. Ashmore
February 15, 2026
in Health
0
Home Health

MUMBAI: Paper paintings and insurance dealers have long been the inspiration stones in your coverage policies. However, insurers have used era and diverse steps of the coverage offerings cost chain: from the utility to the claim-processing stage. Artificial intelligence, wearable devices, cellular packages, virtual help, and video conferencing are changing paperwork. Let’s take a deeper look at the blessings of those services and the challenges you face.

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Artificial intelligence: Artificial intelligence (AI) first entered insurance via chatbots. Some insurers have now integrated the use of AI on WhatsApp. For example, Reliance General Insurance Co Ltd has used AI by introducing Reliance Interactive Virtual Assistant (RIVA), which generates coverage quotation, accepts declaration intimation, and presents policy reproduction on WhatsApp and Facebook Messenger. It replaces human intervention and reduces the time taken for claim processing. Using AI and technology, queuing theories, and smart analytics, HDFC Ergo General Insurance Co Ltd claims to have reduced the average time to fourteen minutes from three.8 hours.

Wearable gadgets: Insurers deliver reductions in coverage rules by using tracking of lifestyle sports. For instance, ManipalCigna Health Insurance’s Get Proactiv is incorporated with their Healthy Rewards Program, permitting you to earn incentives via monitoring your activities using pick wearable devices. You can also enter non-track-in position activities into the application at once. Healthy reward points are then earned based on the quantum of physical interest. The enterprise uses these reward factors to provide you with a few discounts on your top class, limited to a most of 10% of your annual top class.

Mobile programs: Some insurers permit you to add your declared files for a certain amount digitally. Bajaj Allianz General Insurance has a characteristic known as Health–Claims By Direct Click (CDC), which lets you post files through the mobile software ‘Insurance wallet’ for evaluation and settlement. You may receive claims of as much as ₹20,000 in two working days for admissible claims through this. Another fitness insurer’s cellular app, Max Bupa Health App by Max Bupa Health Insurance Company Ltd, offers offerings available to those who’ve bought Max Bupa’s Goactive policy. ‘Go active clients’ can get admission to offerings furnished with the aid of the plan at the app – cashless OPD, diagnostics, buying drug treatments, a customized recommendation from fitness specialists, fitness tests, behavioral assistance, and 2d medical opinion in case of serious illnesses, and more. Aditya Birla Health Insurance Company Ltd has a web-based cashless platform for OPD claims. “There is a centrally positioned team of professionals who reach out to customers to clear up their queries and help them for the duration of the direction of hospitalization,” stated Mayank Bathwal, CEO, ABHICL.

Video conferencing: One of the examples of this service is Motor On The Spot (Motor OTS) through Bajaj Allianz General Insurance Company Ltd. “Normally, the claimant has to post original hard copies followed by a physical inspection of the automobile,” said Sasikumar Adidamu, leader technical officer, Bajaj Allianz General Insurance. Through Motor OTS, you want to add the images of the broken car alongside the needful claim files to the mobile application.  After your consent, the business enterprise will approve the claims charge, which the insurer claims,s will get credited within 30 minutes into your bank account. The organization using the Facts analytics tool will immediately recommend liability to you and advise a restored workshop within a turnaround time of around 20 minutes. Some insurers actually have a live video streaming facility. “Through our stay video streaming characteristic for motor insurance claims, our workshops/customers can without problems perform self-inspections,” said Santosh Menon, executive vice president and national head of claims private strains, auto, Tata AIG General Insurance Co Ltd.

Experts agree that these projects come as an alleviation. “From a purchaser’s point of view, the manner of filing claims has become simpler,” stated Naval Goel, Founder,  Policyx.com. The usage of AI has fastened things in all three degrees of the coverage cost chain: Distribution and pricing, underwriting and coverage issuance, and claim servicing“. A.I.-powered chatbots assist within the software stage, and algorithms used in underwriting have reduced the time taken for coverage issuance,” stated Goel. However, such AI-powered services may additionally face a glitch.

“A trouble that you may face with AI-powered chatbots is that if it can no longer provide the exact answer you have been looking for, and particular questions may be less complicated to carry to a human. However, this is nevertheless an evolving function,” said Mahavir Chopra, director – fitness, life, and strategic initiatives, Coverfox.com.

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