ant insurance achieves large-scale “instant compensation” for medical insurance claims below 10,000 yuan
2024-09-02
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on september 2, the internet insurance agency platform ant insurance announced the launch of the "second compensation" service, and took the lead in piloting with selected insurance institutions for "anxin compensation". currently, sunshine property & casualty insurance has become the first pilot insurance company. reporters learned that sunshine property & casualty insurance has achieved second-level review of more than 81% of outpatient insurance and more than 50% of inpatient medical insurance claims on the ant insurance platform, achieving large-scale coverage.
this means that users of sunshine property & casualty insurance's good medical insurance series of products can submit online applications through the "an xin pei" claims service page after completing medical treatment at an offline hospital. for claims applications for outpatient insurance below 800 yuan and inpatient medical insurance below 10,000 yuan, as long as all materials are complete, the system will complete the claim review within 30 seconds and notify the user of the conclusion.
it is understood that ant insurance's "instant compensation" integrates rich medical and insurance knowledge through generative big model technology, can read medical documents, understand insurance terms, and reason about claims conclusions in multiple steps, shortening the review time to seconds, and achieving zero human involvement in medical insurance and automated review in seconds.
"in recent years, government agencies have continuously promoted the popularization of electronic medical receipts. it is this initiative that has provided the possibility for the large-scale development of instant compensation services." sun zhenxing, chief technology officer of ant group's insurance business group, introduced that in addition, in order to overcome difficulties such as the large amount of claims materials and high professional audit thresholds, the company has changed its infrastructure thinking and integrated insurance knowledge into the big model. using the big model thinking chain method, it simulates the thinking framework of claims experts, searches for key clues step by step, and then gives the audit conclusion after reasoning, which effectively improves the accuracy of the audit.
pilot data show that, at present, the average review time for eligible medical insurance claims of sunshine property & casualty insurance is 25 seconds, and the number of claims service people per month is tens of thousands. gai xueying, deputy general manager of the internet business department of sunshine property & casualty insurance, said that with the application of big model technology in claims services, the pressure on claims auditors has been greatly reduced, and manpower can be focused on the review of complex claims applications, thus improving the review time of complex claims applications.
it is understood that after the pilot of sunshine property & casualty insurance, the "instant compensation" service of anxinpei will be connected to more cooperating insurance companies in the future to achieve larger-scale coverage so that more claims users can experience it.
