A Theoretical Perspective on AI's Transformative Role in the Health Insurance Sector: Unveiling the Future

Abstract

The application of artificial intelligence (AI) in the health insurance industry can significantly improve access, efficiency, and equity. This chapter explores the foundation and potential impact of AI in reshaping the landscape of the health insurance industry. By investigating how AI is used in processing claims, detecting fraud, and improving customer service, this chapter highlighted the potential for AI to transform the industry. By making claim processing more efficient, reducing errors, and improving fraud detection abilities, AI offers the promise of enhancing effectiveness, precision, and risk mitigation. Moreover, AI's involvement in delivering customer service through chatbots indicates a move towards responsive interactions. The study ponders paths envisioning AI's progression towards ethical, transparent, and fair health insurance systems. Ultimately, this theoretical viewpoint offers guidance to stakeholders navigating the interplay between AI advancement and the evolution of health insurance paradigms.