How Technology Is Enhancing Group Medical Cover Services

1. Challenges Faced by Traditional Group Medical Cover

Just like landline was replaced by mobile phones an up-gradation was required in the insurance sector also. In India, people in the 90s and early 2000s were not used to the concept of the internet. If we talk about the insurance companies, the people who had to purchase an insurance policy used to contact the insurance company either on phone or visit their office physically then the company put an insurance agent on duty who used to explain the policy details such as coverage, claim settlement, etc.

Lack of Information

Just to avoid the hassle of going through the insurance policy details by yourself, you end up depending upon the insurance agent. Sometimes for the insurance company’s advantage, these agents used to hide certain aspects of the insurance plan and you end up making a bad deal for yourself. This was one of the major concerns when these companies totally depended upon the agents to fill the gap between the customer and the company.

Standard Policy for Each Employee in the Company

Talking about the group health insurance policy, the employers used to go for a standard policy to cover each employee. Since each employee has a different health profile, the standard policy would not be enough for them. Hence it turns out as a bad deal for the employer as it does not fully serve the purpose of providing a group medical cover.

• Traditional group medical cover does not offer the feature of customisation of the health cover.
• The standard plan leads to inadequate coverage and keeps the employee underinsured.

Not Enough Services

Just offering a group medical cover without providing quality and timely services is of no use. Traditional GMC does not recognize this fault.

• Group medical cover needs to add wellness programs.
• Wellness programs such as fitness tracking, teleconsultation, etc. can help employees overall health.

Not Utilising Policy

It is quite often that the employees do not utilize the traditional group medical cover. This happens due to:

• Lack of awareness about the benefits of the insurance policy.
• Not able to understand as how to get the policy benefits.
• Traditional group medical covers find it difficult to make the employees aware of the benefits of the insurance plan due to the lack of technology.

Difficult Claim Settlement

Back in the day, most group medical cover-providing companies used to rely on manual claim management because the companies did not have any website or online claim settlement system in place.

• In order to raise a claim, the insured had to submit the required documents physically by visiting the insurance company or to the third-party administrator.
• Due to the tedious process of raising the claim offline, the claim settlement used to take way too much time.

2. How Technology Helped in Overcoming This Challenge?

When people started using the internet, insurance companies started making their websites to take things up a notch by starting services online. Usage of the internet and launching their website was a game-changer as it made the process of selling, purchasing and learning about the insurance plans easier and hassle-free.

Introduction of Personalised Policy

With the enhanced technology, the GMC providers started offering employers as well as employees a personalized policy experience.

• Organizations began providing basic coverage to the employee that would cover essentials along with the option of adding add-ons and an option of top-up to fulfill their requirements.
• Employees got an option of covering their family members as well.

Better Service

Providing group health insurance coverage to the customers is not enough, the insurance companies have to offer good service. In the 90s and early 2000s when the technology was not that advanced and insurance companies did not provide services online, the customers have to go through a lot of hassles such as visit the insurer’s office to get anything done.

When insurance companies launched their websites, it helped them make their services even better. They could provide services 24*7, online claim settlement, a list of network hospitals and not just this, after 2010, when every other company was launching their mobile applications to take things to their customer’s hands so that they can do anything related to their policy on their mobile phone, the services became more efficient and smooth.

Utilization Increased

When group health insurance companies started offering customized policies, they enhanced the coverage by providing OPD cover and regular health check-up cover as well. The utilization of the group medical cover increased.

• Organizations began providing full body check-ups within the ambit of the group medical cover.
• Also, technology plays a huge role in this. Companies can educate their employees about the benefits of the policy.

3. Disruption of GMC for Good

When the innovation and technology came to their fullest potential and everything started happening online. Group medical cover providing insurance companies began offering tech-based solutions to almost everything.

Teleconsultation

After the outbreak of Covid-19, it was not safe for the doctors to see patients physically, hence to resolve this situation, they started seeing patients online on video calls. Hence the insurance companies also started providing coverage for teleconsultation.

Here are some of the advantage of teleconsultation via GMC:

• On-time medical intervention
• Free online consultation
• Getting access to the best doctors available around the country

Solution Through Chatbots

The insurance companies started providing solutions through chatbots. Bots are computerized and their response time is quicker than any human being because they are AI-based.

• Chatbots answer your question by providing you with a set of options from which you can choose your query.
• Chatbots can be accessed 24/7

Digital Process

After going digital, any process related to the insurance policy became paperless as well as contactless. The employees do not have to physically visit the insurance company’s office to get anything done and they also do not have to provide any hard copies to raise claims or renew the insurance policy.

• Employers can easily purchase group health insurance online.
• Not just purchase but they can renew the policy online, make online payments as well as raise the claim online.
• Employees can also enjoy various services provided by the insurer online.

PAN India

Digitalization made it easier for insurers to spread their network PAN India. The larger the network the more beneficial it is for the insurers.

• The employers can get GMC services for different offices located in different situations.
• It is more beneficial in case an employee is getting transferred to a different location.
• Cashless claim settlement at the network hospitals

Online Order Medicine Coverage

Since everything is done online now a days, the medical sector has also made it easier for customers to purchase medicines online. Hence the insurance companies also started providing coverage for the online medicine orders which eventually became one of the key advantages of the tech-based GMC providers.

• The insured does not have to visit the medical stores to purchase medicine and then later worry about getting coverage for it.
• The customers get exclusive discounts while purchasing the medicines online.
• Customers get authentic medicines.

Conclusion

Digitalization has drastically changed the way employers and employees used to see group health insurance coverage and the services provided by the insurance companies. Online services have not only made it easier for employers to provide value through GMC but made it easier for employees to learn about the benefits of group medical cover.