NTUC Income partners IBM to automate medical claims process

INSURER NTUC Income said on Monday it has moved to automate and improve its pre-hospitalisation and post-hospitalisation claims process by embedding cognitive technologies operationally.

Income receives an average of 14,000 hard copies of IncomeShield pre-hospitalisation and post-hospitalisation claims a month, which are currently reviewed, assessed and approved manually, where a significant number of man hours are spent on data entry before claims data can be processed to enable payouts.

To better manage claims, the insurer is adopting IBM's Datacap that combines advanced imaging, business rules, natural language processing and machine-learning technologies to automatically classify and extract information in real-time from most types of documents. This in turn eliminates labour-intensive manual data entry from paper claims.

To process data, Income said it is using IBM Watson Explorer, a cognitive search and content analysis platform, at different stages of the insurance life cycle. It can read and analyse structured and unstructured data, such as medical certificates and bills. The length of hospital stays, medical histories, surgical procedures, and other contributing factors are then taken into consideration by the system before it makes claims recommendations and calculates the payouts to policyholders.

Andrew Yeo, Income's general manager for life and health insurance, noted that the move is significant especially as the insurer expects claims volume to rise amid Singapore's growing silver population.

"By automating the most tedious aspect of the claims process, Income is better placed to scale our responsiveness to higher volume of claims and to provide our policyholders with a favourable claims experience as we continue to enhance our efficiency and accuracy in claims assessment, review and approval."