Digital health solutions are transforming the insurance landscape

Digital health solutions are transforming the insurance landscape

Embracing health tech

Travel insurance companies are embracing the adoption of digital health technologies to improve speed, functionality and the ease of use for their customers with wearable devices.

“In terms of customer service, we’re using digital tools to speed up the process for the customer to make a travel insurance purchase, and we also offer an online ‘First notice of loss’ (FNOL) tool that allows customers to go in and enter their claims information,” said James Page, Chief Administration Officer and Head of Assistance and Claims at AIG Travel. “Collection of information from the customer, as well as the simplification of providing electronic documentation, makes completing a claim for reimbursement of medical expenses easier and simpler for the customer. From a processing point of view, for simple claims that are submitted through our technology, we have automation tools to verify coverage and authorize payments, to speed up the response to the customer.”

Best customer solutions

There are now many health technologies available. Key areas include telehealth and virtual health services, AI, health informatics, payments and e-referrals.

“Telehealth is certainly an area of ​​opportunity for us,” Page said. “We have not yet seen widespread adoption among leisure travelers (mostly because they tend not to be in touch unless they are significantly ill or injured, at which point anything short of in person medical care is insufficient), but we do see more usage on our business-travel accident side. In all cases, we are actively looking for the best solutions for our customers.”

Customers can digitally authorize the release of data such as medical history and details on insurance policy coverage to insurers and healthcare providers respectively.

“If we look at the percentage of our claims that we receive electronically – versus the old-fashioned method of getting a claim form, filling it out and sending it in – our ratio is about 80:20. No more than five years ago, we received approximately 20 per cent electronic and 80 per cent manual claims, but that is now completely reversed,” he explained.

Page believes that the customer has embraced the technology because it’s a simpler way of completing things. From a distribution partners point of view, working with insurers who have a strong suite of digital health solutions gives a strong vote of confidence that these companies are staying ahead of the curve.

Claims processing is also faster as claims can be submitted digitally to insurers on behalf of patients. Bill of information and details about a patient’s status, such as their length of stay in the hospital, can be sent to insurers, who can then provide quicker updates on the estimated claimable amount. In this way, claims processing can become a seamless and data-driven process.

A changing landscape

The most prominent area of ​​innovation is the ability to provide claims servicing and response to customers (electronic signature, electronic submission) 100 per cent electronically, says Page. “As an insurer, as one might imagine, we used to have filing cabinets, full of claims files, but not any more. All the documentation that we send to the customers, and everything they come back to us with, is transmitted electronically. So, the transformation from the old days of having filing cabinets full of documents is complete – we are now almost completely paperless, which brings numerous benefits.”

The 2022 report on the Australian digital health sector shows that there has been a 20-fold increase in the global investment in the digital health sector over the past ten years.

There seems to be a shift towards prevention, not just the healthcare for the sick, but also for the healthy

Government bodies and private companies within the healthcare industry are increasing the uptake of digital health technologies to meet the needs of the 21st century. There is an emphasis on prevention, in-home care, assistance for the aging population’s specific requirements, hospital waiting times and funding shortfalls.

In Australia, the Covid-19 pandemic has led to a focus on moving patients out of hospitals and medical facilities and treating them in their homes. The 2019–2020 bushfires have also led to a focus on a fast-response, which digital health technologies can facilitate.

ANDHealth, a health technology initiative which addresses an identified gap in the Australian Innovation landscape and provides programs and supports digital health, reports that there has been a 20-fold increase in worldwide investment in the digital health industry in the last ten years. However, it also reports that 2022 saw a worldwide slowdown in digital health funding, which may be partly a result of economic turmoil, and a knock-on effect from the Covid-19 pandemic.

Changes in the APAC region

There are significant developments in technology solutions for insurance customers in the APAC region. There is a transition for some insurers to move from offline to online, and there are insurers in Singapore who started out their operations by being solely online. Singlife is one of only a few fully digital insurers licensed in Singapore and an example of the new breed of digital native companies.

“There’s also been an increase in home-based healthcare services,” said Melisa Teoh, Chief Operating Officer of MyDoc, which has a telehealth platform. “All these changes are forcing our partners to rethink the customer journey and the role of the payer in that journey, and at which point that actually comes into play,” he said at a recent ITIC conference.

“We’ve been working very closely with all the insurance providers to figure out how best to leverage telemedicine in order to create stronger engagement between the insurer, the healthcare provider and the patient in a way that helps control the costs without the adversely impacting the healthcare journey for the patient,” she added.

The MyDoc platform facilitates multiple services from a variety of providers through a digital healthcare ecosystem. There are home-based health screening options and chronic disease management programmes, which have virtual follow-ups. There is also medical nutrition therapy with virtual touchpoints.

MyDoc’s services assist travel and international health insurers’ service offering through its virtual consult service by providing policyholders with convenient options that allow for care continuity throughout a business trip.

Agile solutions

Telemedicine has enabled remote and increasingly accurate diagnosis. Databases and images can be curated by which algorithms can crawl in order to determine the best course of action. Image recognition technology can also assist medical teams with diagnosis.

The Covid-19 pandemic has focused the minds of insurers as well as customers on the importance of providing adequate health cover and more agile medical assistance when abroad. This shift has required ongoing investment into the developing and rollout of new health-related technologies.

Teoh reported a sharp spike in monthly active users between 2019 and 2021, with each subsequent wave of Covid-19 resulting in further increases in traffic. “What is interesting is that it’s not just information about Covid-19 vaccinations or recovery that people are seeking,” said Teoh. It also points to a demand for services that go beyond GP care, such as nutrition and mental health support. “There seems to be a shift towards prevention, not just healthcare for the sick, but also for the healthy,” she added.

Technology companies around the world have collaborated in strategic partnerships to fast track the claims process for health insurance.

DocDoc, a digital health insurance platform, has a group health insurance product with partner QBE Singapore for employers in Singapore. The product was offered to employers via partnerships with brokers and will be offered in other Asian countries in the future.

Cole Sirucek, Chief Executive Officer and Co-Founder of DocDoc, said: “The health insurance market in Asia has witnessed an increasing number of exits that underpin issues centered around profitability and scale. We believe that this is driven by legacy inertia within the industry preventing innovation and the transition to a digital, member-centric approach.

“DocDoc harnesses cutting edge clinical informatics and artificial intelligence to increase the efficiency of health service management. We aim to make obsolete legacy approaches through automation and personalization, thereby reducing inefficiencies and improving member experiences.”

There are significant developments in technology solutions for insurance customers in the APAC region

Two healthcare technology providers in Singapore – DocDoc and SpesNet – have also collaborated to develop a comprehensive digital health ecosystem which will provide cashless and integrated claims processing to insurers. This newly developed platform will allow for the matching of policyholders to relevant healthcare providers which enhances their claims processing. Providers are able to quickly ascertain if a policyholder is eligible and if the benefit covers the pending claim, effectively preventing any claim related disputes.

Under the agreement, DocDoc will integrate SpesNet’s digital TPA technology with DocDoc’s telemedicine platform and AI-powered doctor discovery platform, HOPE (Heuristic for Outcome, Price and Experience), which matches policyholders to relevant healthcare providers.

CEGA has developed Antidote – an online medical screening tool that supports insurers, brokers and aggregators. The mechanism assesses medical conditions in a single transaction and provides an insurer with a risk outcome enabling accurate underwriting. The automated medical screening tool simplifies pre-travel medical screening for travelers. The assessment allows customers to self-declare pre-existing medical conditions to their travel insurers. It features pre-prescribed questions and provides insurers with algorithmic outputs.

Added extras

Travel insurers are adding extra benefits to their digital offerings. AXA has developed an insurance app which includes a medical translator and a jet lag calculator which calculates how long it will take to adjust to a new time zone when traveling – and to adjust back again on the return journey. The app can also direct customers to the location of the nearest hospital, if they need treatment.

Customers are increasingly sophisticated, and expect a stress-free, faster and more efficient response, which can be offered by travel insurers enhancing and improving distribution platforms. Players who have adopted technologies such as geo-location, AI, data analytics and GPS can increase their market penetration and strengthen their position in the industry.

It’s important from a digital and technology point of view to better prepare customers for travel, in a way that helps them identify risks, identify safer and more intelligent ways to travel, in order to avoid costs, in addition to providing solutions when costs are incurred .

“This evidence tells us that the customer has embraced the technology, because it’s a simpler way of completing things. Plus, it’s worth noting that when we talk to our distribution partners, they often require us to provide electronic solutions,” said Page of AIG Travel. “So, the embrace by the customer, as well as the requirement to provide the solutions by the partners who work with us, offers a clear indication this is the direction that people want.

“Our websites and travel apps provide educational materials on safe travel, as well as information around the medical risks and things travelers could be exposed to, depending on their medical conditions; how to travel effectively with certain medical conditions to avoid flare-ups. We can share information on water and safety while abroad, traveling with medications, all manner of things. And using electronic tools to do that is helpful to both the traveler and the insurance provider.”

For travelers, insurance companies are investing in programs to educate them on what to be aware of, before, during and after their journeys. Providing information regarding the places and ways that people can be impacted by fraud and other potential mishaps is also a growth area. Using digital tools to educate people on how to travel safely and more intelligently, to avoid medical situations, is just as important as being able to digitally collect their claims information when they have a loss.

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