The Insurance Claims You Filed Are Now Reviewed by AI

Insurance Industry Accelerates Insurtech... Active AI Adoption

[Asia Economy Reporter Oh Hyung-gil] The American insurance company Lemonade, known for "signing up for insurance in 90 seconds and paying insurance claims within 3 minutes," utilizes artificial intelligence (AI) to provide simple insurance enrollment and fast claim payment processes. By leveraging AI data analysis and chatbots, it shortens the customer claim processing procedure, handling 180,000 out of 310,000 customer interactions through AI.

Cases of integrating AI technology into the insurance industry to innovate operations are continuing. Domestic insurers are also leading digital innovation by applying AI technology in various areas, from insurance enrollment to payment, underwriting, and consumer response.

According to the insurance industry on the 16th, Kyobo Life Insurance independently developed an accident insurance claim AI automatic review system that applies AI technology to insurance claim payments. As a result, it has established an AI-based system lineup for insurance enrollment, claim payment review, and insurance fraud prediction.

The accident insurance claim AI automatic review system applies machine learning techniques and automation algorithms based on big data. It evaluates risk according to the type of insurance claim and determines whether it is suitable for automatic review. It divides models into six benefit categories such as indemnity, hospitalization, and outpatient care, calculates risk scores, and decides on automatic review payment eligibility.

Kyobo Life Insurance aims to increase the proportion of AI automatic reviews to up to 40% by 2025. The expected cost-saving effect is approximately 8 billion KRW. Many insurance claim reviews, including indemnity, will be resolved through AI automatic review, allowing reviewers to focus on high-risk reviews and verifications, thereby strengthening customer protection.

Hanwha Life Insurance and Hanwha General Insurance developed a claim AI in January last year that replaces the judgment of reviewers regarding payment or non-payment of insurance claims.

By utilizing this system, efficiency in processing low-risk review cases such as small insurance claims like indemnity can be improved, leading to customer satisfaction from prompt insurance payments and an expected cost-saving effect of over 10 billion KRW over the next five years. Additionally, the AI insurance claim payment system operates as a hybrid real-time cloud model integrating the cloud with the company's data center, offering the advantage of quickly responding to changes.

Hanwha plans to establish an IT infrastructure capable of agile response to the innovative changes of the 4th Industrial Revolution, including the first cloud-based core business implementation in the financial sector, through the "Insurance Core S" project.

Samsung Fire & Marine Insurance also introduced an AI contract review system in 2019. AI learns types approved without additional reviewer confirmation and is expanding cases that can be enrolled through computer-based review alone. Last year, it established a Digital Headquarters through organizational restructuring to serve as a control tower for digital operations.

DB Insurance actively responds to changes in the financial environment by introducing the industry's first AI-powered insurance consultation service "Promi Chatbot Service," mobile insurance policy patent acquisition, and biometric authentication for insurance enrollment. It also introduced a service (DB V-System) that allows consultations via high-definition video calls with customers and repair shops without face-to-face meetings.

Shinhan Life Insurance is expanding the use of AI in customer consultations. The chatbot system "Shinbi," developed in partnership with AI chatbot specialist WiseNut in September last year, has handled about 20,000 consultations monthly since its launch, maintaining an AI-based response rate of over 90%. The number of users is increasing by about 100% monthly.

The insurance inquiry tasks are optimized for chatbot UI/UX (user interface and experience) and provided in a card format for readability. Customers will be able to conveniently check contract details, payment history, insurance claim progress, loan information, and more. Major insurance processing tasks such as premium payment, claim filing, and loan applications have also been improved to be completed easily through conversational formats.

An industry insider said, "Efforts to combine insurance with AI and big data to develop new products and innovative services are bearing fruit," and predicted, "As the non-face-to-face era prolongs, advanced digital technology will emerge as a differentiating competitive advantage for insurers."