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Taiwan Life Insurance AI Platform for Claims

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21 March 2024
Karen Monks

Winner of the 2024 Celent Model Insurer of the Year

Abstract

Taiwan Life Insurance’s AI Platform for Claims provides multiple convenient claims delivery channels that address the many issues Taiwanese policyholders experienced when submitting insurance claims. The platform can settle claims for all Taiwan Life’s commercial medical insurance offerings, which includes life insurance, disability/long-term care insurance, accident insurance, medical insurance, cancer insurance, and major injury and illness insurance. The platform uses AI to read and interpret claims files and diagnosis reports. AI is also heavily used in the case acceptance operation process. Unique to the industry, Taiwan Life Insurance is actively providing a post-claim counseling service to expand the value of the insurance for the policyholder.

Built inhouse over a few years, the AI Platform for Claims creates a paperless, contactless, and secure information claims application process, which follows the international trends in Green Finance 2.0 and environmental, social, and governance (ESG). In addition, policyholders do not need to download any software to use AI Platform for Claims. A policyholder can use any mobile device to apply for claims. The positive benefits and social impacts of AI Platform for Claims are as follows:

1. Paperless and low-contact claims settlement across many channels.

2. Embedded blockchain medical insurance platform enables multicompany authorization and processing; same shared platform supports medical receipt transmission by hospitals.

3. Unique convenience store claim application services (i.e., submit claims at 7-Eleven stores).

4. AI Platform with OCR/NLP is used to extract information from diagnosis reports, thereby reducing processing time for claims.

5. Post claim counseling services has a 100% satisfaction rate.

Taiwan Life’s AI Claims Platform exemplifies a customer-centric claims experience from understanding the customer journey to providing a better claims experience through the use of AI and blockchain. The insurer tested the boundaries of how claims could be applied for and processed and, as a result, set the bar for other insurers in Taiwan by creating an ecosystem of connected participants that underpins the straight-through, digitally enabled customer service experience.

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