Description: Healthcare cost is increasing at 9.3% in Asia in 2017 and health insurance cost will eventually catch up, making healthcare unaffordable to aging populations. Inefficiency in healthcare system is a contributing factor. In this session, use cases on how AI is impacting the health insurance operations on 3 core challenges. Document processing: A lot of documents are generated in the healthcare ecosystem, medical reports, diagnosis, invoices etc. Currently most of the documents are still reviewed manually and rely heavily on users’ judgement. Customer engagement: Customers are generally under distress and feel rejected during the claim process. It is due to the time and process needed to get the information they look for, the gap between the sales and claims process, and the reimbursement amount. Claim settlements: Claim adjudication is a technical process that review the disease, treatment and policy coverage. The process is specific to disease and difficult to be generalized. Thus, the process is far from consistent and invites fraud, abuse and wastage in this area.

Description: James Glickman delivers his general session speech at the SOA 2019 SOA Annual Meeting & Exhibit in Toronto.