You probably do not think much about your health insurance until something goes wrong. And when it does, the last thing you want is confusion, paperwork, or a long wait to get help.
The good news is that the future of health insurance in India is getting smarter, faster, and more human-friendly. Insurers like ACKO are already using artificial intelligence and automation to simplify everything from buying a policy to getting claims approved without a dozen follow-up calls. Let’s take a look at what this shift means for you.
What Is Changing?
Health insurance used to be something you bought, filed away, and hoped you never had to use. But when the need arose, many found themselves stuck navigating call centres or long processes, often while already dealing with a health crisis.
With AI and automation stepping in, the experience is shifting to simplify how you:
- Choose a plan that fits your family, age or medical history
- File claims with less paperwork and faster results
- Get reminders for check-ups, policy renewals, or tests
- Speak to support teams who actually understand your problem
Where Are AI and Automation Making a Difference?
Here is a closer look at how these technologies are being used in the real world.
1. Claim Approvals in Minutes, Not Weeks
Earlier, you might have waited days or even weeks for a health insurance claim to be processed. With AI tools reading documents and checking claim rules in seconds, this timeline has shortened. For simple, cashless claims, approval can happen almost instantly.
2. Chatbots That Actually Help
AI-driven virtual assistants are no longer just pasting standard responses. Some, like those used by ACKO Health Insurance, can now guide you step by step through buying a policy, raising a claim or understanding coverage, all without repeating your details multiple times.
3. Preventive Health Gets a Boost
Some insurers now use AI to track lifestyle inputs like sleep, exercise, and diet through apps or wearables. In return, you may get rewards, discounts or personalised check-up reminders.
4. Tailored Plans for Unique Needs
AI helps analyse medical history and family data to suggest policies that actually fit individual needs, not just the most expensive ones. This is especially helpful for first-time buyers or older adults with pre-existing conditions.
How This Works
Let us break down what is changing behind the scenes when insurers use AI and automation.
The Role of ABHA ID in Smarter Health Systems
One of the biggest enablers of this shift is India’s ABHA ID (Ayushman Bharat Health Account). This digital health ID allows your medical records to be securely stored and shared across hospitals, labs, and insurers.
When combined with AI tools, ABHA can help insurers:
- Access verified medical history instantly
- Make faster, data-driven decisions for claim approvals
- Suggest policies or wellness tips based on your unique health profile
Numbers That Matter
Let us look at how this shift is already showing results across India:
- 76% of Indian IT leaders say their AI investments have already delivered positive ROI, according to a recent study
- AI tools can resolve up to 70% of simple claims in real time, reducing operational costs by 30-50%
- AI adoption in India’s healthcare sector has surpassed 40 %, leading other industries such as FMCG and manufacturing
These numbers show the change is not just theoretical. It is helping real people every day.
Who Benefits Most from These Changes?
Navigating insurance is often difficult when:
- You are buying it for ageing parents with pre-existing conditions
- You are a young couple with a toddler and need family cover
- You are managing health issues while working full time
- You are switching from a corporate policy to a personal one
In each of these cases, smarter systems reduce confusion and speed up support. However, it is also important to understand that not every customer is comfortable with mobile apps or chatbot conversations. That is why many insurers now offer a mix of digital tools along with real-time human help.
Why This Matters
Health insurance in India is no longer a once-a-year paperwork exercise. With AI and automation, it is evolving into an active support system that’s more responsive, more accessible, and more transparent. As the AI adoption in India’s healthcare sector grows, this shift is set to become the new standard.
Note: This article is a part of ETCIO’s Brand Connect Initiative.
- Published On Aug 20, 2025 at 12:07 PM IST
Join the community of 2M+ industry professionals.
Subscribe to Newsletter to get latest insights & analysis in your inbox.
All about ETCIO industry right on your smartphone!
