More insurers embrace AI to bolster efficiency

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A growing number of insurers are adopting artificial intelligence (AI) technology to streamline workflow and overall efficiency, market watchers said Thursday.

Samsung Fire & Marine Insurance said it has introduced an AI-powered system to digitally assess insurance claims such as cancer diagnosis reviews and surgery benefit payouts.

The system analyzes large-scale medical data, aided by optical character recognition (OCR) as well as generative AI, to review diagnosis documents, test results and other medical records.

The tasks were previously handled manually by employees and extremely time-consuming, leading to frequent delays.

However, the AI-mediated services will simplify and accelerate document review while increasing accuracy. Also bolstered are consistency and reliability of the overall process.

Cancer diagnosis claim reviews are among the most complex, requiring detailed reviews of up to four dozen pages. Included are the doctor’s written opinion, clinical data such as biopsy results and other medical reports.

AIA Life has also introduced an AI-enabled large language model (LLM) OCR technology as an upgrade to its current claims and payout processing system.

The insurer said the upgraded version significantly reduces the time needed to process claims for hospitalizations and surgeries, therefore enhancing customer convenience.

The new solution self-learns from large datasets and understands medical context, helping with accurate identification of essential claim-related data, the firm said.

Customers can now file claims online or via mobile app. The photo of hospital documents uploaded by the customers will then be reviewed by the AI program.

The system can then automatically detect all relevant details including diagnosis code and claim amount, enabling a faster and more accurate process.

About 83 percent of the claims related to hospital stays, surgeries and fractures processed were paid out within one business day as of Aug. 1, up significantly from 64.9 percent last year.

“The claims process is the most direct experience customers have with their insurers, a gauge of customer experience,” the firm said. “We will continue to improve our services through our mobile platform, ensuring timely and positive experiences for our policyholders.”