How technological advancements are overcoming traditional GMC challenges

Biresh Giri, Executive Vice President and Appointed Actuary, ACKO highlights the role of technology in insurance sector

From the invention of the wheel to the creation of smartphone apps, technology has played a crucial role throughout human evolution. The same applies to the evolution of the insurance sector as well. Technology has transformed the passive nature of insurance-related products and services into an active one by making them accessible, customer friendly, and hassle-free. Here’s how digital-first insurers are changing the Group Medical Cover’s (GMC) landscape by overcoming traditional challenges with the help of technology.

Nature of policy

A prime challenge associated with a traditional GMC is its standardisation. It offers the same insurance cover for all employees, which is counterproductive because each employee is different, and so are their insurance requirements. If an employee is underinsured, they are bound to opt for a separate health insurance policy of their own, which in a way, defeats the GMC’s purpose.

Technology overcomes this challenge by enabling customisation. In a modern GMC, each employee can have the option to enhance their insurance coverage as per their needs. This can be done by incorporating add-on covers and top-ups that suit their requirements. Family members can also be included in the cover. Most importantly, all this can be done digitally!

Service quality

Offering quality services is equally or perhaps more important than simply covering employees under a group insurance policy. Post the pandemic’s peak, a GMC needs to go beyond insurance. One way to do so is by incorporating wellness under its ambit.

Tech-based GMCs enable quality services associated with both insurance and wellness. Apart from easy customisation, employees can also avail services such as teleconsultation, ordering discounted medicine online, etc., via the insurer’s app.

Claims settlement

Settling claims smoothly is the core function of any insurer, irrespective of the type of policy offered. Traditional GMCs rely on old-school claims management processes that involve physical documentation and demand extensive paperwork. This non-tech approach, by default, prolongs the time taken to settle claims and makes the process tedious.

In the case of a tech-based GMC, an employee can raise claims via the insurer’s app without unnecessary paperwork. Once everything checks out, the approved claim settlement amount is credited to the bank account mentioned by the employee. Thus, making claim settlement stress free!

Policy utilisation

Often, the employees might not be aware of what’s covered and what’s not covered in their employer-offered health policy. Such lack of awareness translates to a non-utilisation of benefits, as the employees don’t know how to benefit from their GMC. One of the reasons for this scenario is the GMC provider’s inherent lack of tech-based infrastructure to communicate effectively with the covered employees.

A new-age GMC provider has no such problems as they can educate the covered employees about the policy via webinars, emailers, push notifications, etc. Besides, as a modern GMC also enables preventive healthcare check-ups and fitness tracking, employees don’t have to particularly ‘raise a claim’ to benefit from the cover. As a result, policy utilisation is enhanced.

Admin costs

Without tech support, employers covering their employees under a GMC might have to rely on a dedicated team to manage policy-related tasks. Managing the cover regarding employee exit and onboarding along with associated paperwork can increase the overall admin costs.

Such admin costs can be reduced considerably thanks to a tech-based GMC’s features. For instance, a modern GMC can be integrated with the employer’s Human Resource Management Systems (HRMS) to streamline admin-related tasks and mitigate related expenses.

Paradigm shift

There’s no doubt that technology has disrupted the insurance sector in a positive way. New-age GMCs have contributed immensely to this paradigm shift due to digital processes, quick query resolution, and telemedicine. Thus, people-centric organisations must partner with a digital-first insurer that covers the organisation’s employees with a productive GMC to ensure employee welfare, reduce admin costs, and ensure value for money.