Revolutionizing healthcare insurance in India through technology

Brij Sharma, an engineering graduate from the College of Engineering, and an MBA holder from Yale in the US, made a remarkable shift from the corporate world to entrepreneurship. He is a serial entrepreneur and founded companies such as MDIndia TPA and Tela Sourcing, and is the Founding Partner of Naples Technology Ventures, a tech-focused venture capital firm, with a focus on SaaS startups in FinTech, HealthTech,InsureTech and Regtech area.

In conversation with Prisila,Correspondent, Asia Business Outlook Magazine. Brij Sharma discusses the use of AI to increase efficiency in insuance, deploy blockchain for transparency and security in Indian health insurance, highlighting challenges and opportunities in integrating telemedicine and insurance in a diverse country like India.

The Impact of AI and Data Analytics on Efficiency and Effectiveness.

Artificial Intelligence (AI) holds immense potential for businesses, particularly in data-driven sectors such as health insurance. The insurance industry heavily relies on data analysis to forecast future events and make informed decisions. From patient records to treatment history and insurance claims, the wealth of unstructured data can be structured and analyzed effectively using AI.

AI's predictive capabilities offer numerous benefits and can provide valuable insights. It can enhance patient diagnosis and treatment by assessing the likelihood of diseases, ultimately improving patient care. On the administrative front, AI can streamline claims processing, making it more efficient and accurate. Moreover, AI plays a crucial role in fraud prevention, a significant concern for insurers worldwide.

AI empowers health insurance companies to improve efficiency, reduce costs, combat fraud, and enhance customer service. This technology has the potential to transform the industry, benefitting both insurers and policyholders.

Blockchain Revolutionizing Transparency and Security in Indian Health Insurance Operations.

Blockchain technology holds significant potential in various sectors, including health insurance. Electronic health records (EHRs) are at the core of healthcare, as they aid in keeping track and if properly analyzed, in predicting an individual's health. Through blockchain which are essentially smart contracts, we can create a secure and trustworthy system for exchanging medical information and EHRs, addressing the current concerns regarding data privacy and trust. This technology can also be applied to streamline processes such as policy document management and provider networks, reducing operational costs. While the adoption of blockchain in India's insurance sector is still in its early stages, the country's insurance industry is growing rapidly with a conducive regulatory environment. The potential for blockchain in India's insurance market remains promising.

Challenges and Opportunities in Telemedicine-Health Insurance Integration in Diverse India

Telemedicine is a valuable tool, particularly within the realm of healthcare and insurance. The COVID-19 pandemic illustrated its efficacy, especially in primary care. However, in countries like India, where primary care often operates on an out-of-pocket basis along with insfrastructural issues and lack of regulatory clarity, telemedicine faces adoption challenges. People tend to prefer physical visits over online consultations, largely due to ingrained habits. Nevertheless, telemedicine holds immense potential for cost reduction and enhanced patient care. It also shines in home healthcare. Still, obstacles such as customer acquisition costs, data privacy concerns, inadequate infrastructure in rural areas, and the need for doctor training hinder its widespread use. Despite these challenges, telemedicine, once embraced by both healthcare providers and patients, has the capacity to significantly enhance patient care and aid in reducing healthcare costs.

Innovative Collaboration Between Insurance Companies, Healthcare Providers, and Startups Revolutionizes Digital Health Insurance in India.

In the context of health insurance in India, there's a pressing need for digitization and data standardization. Currently, the lack of data standardization poses a significant challenge. Many healthcare facilities still generate paper-based claims, making the processing of these claims a complex and time-consuming task. In countries with more advanced systems, such as the United States, the majority of claims are automatically adjudicated through digital processes, with rates as high as 80%. In contrast, in India, almost all claims require manual review and approval. To enhance the efficiency and effectiveness of health insurance in India, focusing on digitization and data standardization is essential. By addressing these issues, the Indian insurance industry can streamline operations and offer more advanced digital insurance products, particularly in the health sector.  The Insurance Regulatory and Development Authority (IRDA) have been very supportive of new technologies whether in distribution or administration.  

"The widespread adoption of wearable devices is still in its early stages, but these tools hold great potential for monitoring and improving health outcomes"

Anticipated Effects of Emerging Technologies like wearable devices on Health Insurance in India

The widespread adoption of wearable devices is still in its early stages, but these tools hold great potential for monitoring and improving health. Insurance companies stand to benefit significantly from the ability to remotely monitor and provide care, ultimately improving patient care and reducing costs. Wearables generate a wealth of health data, which, when properly analyzed, can offer valuable insights into an individual's well-being. This information can be advantageous for both individuals and insurers.

Smartwatches and smartphones in particular have the capability to track various health parameters, including blood pressure, sugar levels, and sleep patterns. The wearable sector offers a tremendous opportunity for collecting data that can aid insurance companies in assessing and enhancing an individual's health, ultimately leading to reduced healthcare expenses. However, it's worth noting that the widespread adoption of wearable technologies, especially in countries like India, may take time to fully materialize.

Conclusion: India's health insurance sector presents a significant opportunity. Currently, it's in an early stage with only 0.4% penetration, in contrast to around 5% in advanced nations like the US and Europe. India benefits from a robust regulatory framework, and the IRDA actively encourages international insurance companies to establish a presence here. This makes India one of the most promising, untapped insurance markets globally, offering immense potential for any company looking to enter this sector.