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Over the past several years, AI technology has made great progress and continues to develop and improve. AI is increasingly proficient at performing tasks historically difficult for computers to execute, including recognizing images, identifying spoken words, and using unstructured data. AI is driven by significant technological advances with a major shift in customer expectations.

Today, AI is being used across a wide range of industries to automate tasks previously performed by humans, such as translating text from one language into another, identifying customers and prioritizing customer service inquiries, managing inventory, analyzing legal documents, and more. The impact of AI on the insurance industry is significant. In claims processing, underwriting, fraud detection, and customer service, it improves customer experience by using virtual assistant chatbots to provide these services 24 hours a day.

A chatbot carries out conversations with human beings and can be available 24/7 to answer basic questions and address common inquiries, as well as carry out simple transactions like reviewing billing information. The following are some of the ways Insurance companies are implementing AI:

  • Medical Claims Processing
  • Claims triage and management
  • Fraudulent claims detection
  • Operational Efficiency

Medical Claims Processing

With the rise of machine learning and artificial intelligence in general, there are many media reports on how the technology can help insurers. AI analyzes large amounts of data from images and clinical research trial data to medical claims and identifies patterns to generate insights. This will assist in the identification of fraud, abuse, waste management, and claims utilization, which could result in tremendous savings for insurers.

Claims triage and management

Claims triage is a method of sorting high volumes of insurance claims by urgency. In order to maximize the efficiency of your organization, you need to know which claims are time-sensitive and which ones can wait for a bit before being resolved. You also need to be able to understand the total loss early in the process so that you can minimize further expenses by acting quickly.

Artificial intelligence plans to speed things up by taking over some of the labor-intensive and often downright dangerous inspection tasks. For example, In the case of inspecting power lines, oil pipes of industries, crops, and fields, collapsed buildings, and water damages after a natural disaster, the insurer flies drones with computer vision to assess

  • Geospatial data (GIS) data from the satellites
  • HD video or imagery from the drone
  • IoT data sets, including object position, temperature, pressure, and more

Fraudulent claims detection and prevention

The goal of the anti-fraud system is to detect and prevent fraudulent claims, in order to protect honest policyholders. The insurance company will review all claims that are submitted by the insured. The insurance company will look for evidence that the insured is at fault. If the insurance company determines that the insured is at fault, they will deny the claim.

In the past, fraud detection systems were limited to sets of rules that could not be easily updated. Now, AI-powered systems have evolved to address this shortcoming. They can also help augment human judgments by supplying valuable information and data. Machine learning and deep learning systems are well capable of identifying recurring and out-of-the-ordinary patterns to identify fraudulent applications and eliminate the same.

Operational Efficiency

Using AI in Insurance companies helps by saving time and money, and also improves the customer experience. It can be used to process claims faster, detect fraud, or offer more personalized service.

AI is being used in insurance companies for many reasons. Some of them are listed below:

  • Accurate processing of insurance claims
  • Efficient communication with customers
  • Accurate predictions of risk

The insurance industry is struggling to recover from the pre and post-pandemic crisis. The ongoing shift in consumer behavior and technology has created a new set of challenges for insurers. However, AI use cases hold strong potential to help insurance companies understand their data, identify trends and patterns and make better business decisions.

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  • March 1, 2022
  • admin@admin.com
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Over the past several years, AI technology has made great progress and continues to develop and improve. AI is increasingly proficient at performing tasks historically difficult for computers to execute, including recognizing images, identifying spoken words, and using unstructured data. AI is driven by significant technological advances with a major shift in customer expectations.

Today, AI is being used across a wide range of industries to automate tasks previously performed by humans, such as translating text from one language into another, identifying customers and prioritizing customer service inquiries, managing inventory, analyzing legal documents, and more. The impact of AI on the insurance industry is significant. In claims processing, underwriting, fraud detection, and customer service, it improves customer experience by using virtual assistant chatbots to provide these services 24 hours a day.

A chatbot carries out conversations with human beings and can be available 24/7 to answer basic questions and address common inquiries, as well as carry out simple transactions like reviewing billing information. The following are some of the ways Insurance companies are implementing AI:

  • Medical Claims Processing
  • Claims triage and management
  • Fraudulent claims detection
  • Operational Efficiency

Medical Claims Processing

With the rise of machine learning and artificial intelligence in general, there are many media reports on how the technology can help insurers. AI analyzes large amounts of data from images and clinical research trial data to medical claims and identifies patterns to generate insights. This will assist in the identification of fraud, abuse, waste management, and claims utilization, which could result in tremendous savings for insurers.

Claims triage and management

Claims triage is a method of sorting high volumes of insurance claims by urgency. In order to maximize the efficiency of your organization, you need to know which claims are time-sensitive and which ones can wait for a bit before being resolved. You also need to be able to understand the total loss early in the process so that you can minimize further expenses by acting quickly.

Artificial intelligence plans to speed things up by taking over some of the labor-intensive and often downright dangerous inspection tasks. For example, In the case of inspecting power lines, oil pipes of industries, crops, and fields, collapsed buildings, and water damages after a natural disaster, the insurer flies drones with computer vision to assess

  • Geospatial data (GIS) data from the satellites
  • HD video or imagery from the drone
  • IoT data sets, including object position, temperature, pressure, and more

Fraudulent claims detection and prevention

The goal of the anti-fraud system is to detect and prevent fraudulent claims, in order to protect honest policyholders. The insurance company will review all claims that are submitted by the insured. The insurance company will look for evidence that the insured is at fault. If the insurance company determines that the insured is at fault, they will deny the claim.

In the past, fraud detection systems were limited to sets of rules that could not be easily updated. Now, AI-powered systems have evolved to address this shortcoming. They can also help augment human judgments by supplying valuable information and data. Machine learning and deep learning systems are well capable of identifying recurring and out-of-the-ordinary patterns to identify fraudulent applications and eliminate the same.

Operational Efficiency

Using AI in Insurance companies helps by saving time and money, and also improves the customer experience. It can be used to process claims faster, detect fraud, or offer more personalized service.

AI is being used in insurance companies for many reasons. Some of them are listed below:

  • Accurate processing of insurance claims
  • Efficient communication with customers
  • Accurate predictions of risk

The insurance industry is struggling to recover from the pre and post-pandemic crisis. The ongoing shift in consumer behavior and technology has created a new set of challenges for insurers. However, AI use cases hold strong potential to help insurance companies understand their data, identify trends and patterns and make better business decisions.