What Is an Insurance Chatbot? +Use Cases, Examples

chatbot for health insurance

A chatbot can help customers get a quote for an insurance policy or purchase a policy directly. This makes the process of buying insurance much easier and more convenient for clients. Claims processing is one of insurance’s most complex and frustrating aspects. To put it more simply – our machine-learning technology has listened to thousands of interactions and come to understand the intent behind the queries that members have typed into our virtual assistants.

  • Chatbots experience the Black

    Box problem, which is similar to many computing systems programmed using ML that are trained on massive data sets to produce multiple layers of connections.

  • They can answer questions related to health insurance policies, including cost of insurance, financial assistance, and coverage.
  • The health insurance chatbot helps in making the complete insurance process easier and quicker.
  • Using this data, it can give tips and reminders that are actually useful.

The latter aspect could explain why cancer is slowly becoming a chronic disease that is manageable over time [19]. Added life expectancy poses new challenges for both patients and the health care team. For example, many patients now require extended at-home support and monitoring, whereas health care workers deal with an increased workload. Although clinicians’ knowledge base in the use of scientific evidence to guide decision-making has expanded, there are still many other facets to the quality of care that has yet to catch up. Key areas of focus are safety, effectiveness, timeliness, efficiency, equitability, and patient-centered care [20].

Why should I use a chatbot for automated medical claims processing?

Insurance chatbots are revolutionizing the way insurance brands acquire, engage, and serve their customers. There’s no end in sight to the possible benefits of using chatbots and voice assistants as customer engagement tools. They enable insurers to provide convenient services that can be accessed anytime and from anywhere. Payers can also use the technologies as a cost-efficient way to quickly scale customer service operations. Regulatory standards have been developed to accommodate for rapid modifications and ensure the safety and effectiveness of AI technology, including chatbots.

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Such focus is due to the use of intelligent personal assistants to streamline processes and AI-enabled bots to uncover new offers for customers. They’ll make customer contacts more meaningful by shortening them and tailoring each one to the client’s present and future demands. Therefore, a healthcare chatbot can offer patients an easy way to obtain pertinent information, whether they wish to verify their current coverage, file for claims, or track the status of a claim. As more and more businesses recognize the benefits of chatbots to automate their systems, the adoption rate will keep increasing. The healthcare chatbot market is predicted to reach $944.65 million by 2032 from $230.28 million in 2023.


Healthcare Chatbot tells patients about the type of insurance plan the facility accepts and how much they can reimburse for particular services or procedures. For every minor and major illness, people google their symptoms instead of scheduling an appointment with a doctor. The reason can be the growing healthcare cost or reluctance to visit the doctors who prescribe excess medication. Chances are high that people end up diagnosing themselves falsely and try healing themselves.

chatbot for health insurance

For patients with depression, PTSD, and anxiety, chatbots are trained to give cognitive behavioral therapy (CBT), and they may even teach autistic patients how to become more social and how to succeed in job interviews. Chatbots allow users to communicate with them via text, microphones, and cameras. Large-scale healthcare data, including disease symptoms, diagnoses, indicators, and potential therapies, are used to train chatbot algorithms.

Successful insurers heavily rely on automation in customer interactions, marketing, claims processing, and fraud detection. Traditional call centers got hours, but your insurance chatbot doesn’t need a break. Whether it’s a query or a claim, your virtual assistant is ready to jump in 24/7. Furthermore, chatbots are essential in helping customers compare plans and find the best coverage. Even though this process can be complex, chatbots make it simpler by asking the right questions and giving personalized suggestions, making decisions easier.

chatbot for health insurance

Cem’s work in Hypatos was covered by leading technology publications like TechCrunch and Business Insider. He graduated from Bogazici University as a computer engineer and holds an MBA from Columbia Business School. Insurance companies can also use intelligent automation tools, which combines RPA with AI technologies such as OCR and chatbots for end-to-end process automation. Brokers are institutions that sell insurance policies on behalf of one or multiple insurance companies.

What our customers say

It hasn’t been easy for insurers to provide anytime/anywhere services that also offer a personalized human touch. However, with policyholder expectations evolving so quickly these days, it is more important than ever for insurers to tackle customer demand for experiences that are convenient, personal, and accessible. One of the most tasking operations of the healthcare industry is scheduling appointments. Despite scheduling systems, several patients face challenges in navigating the scheduling system. Due to the long waiting times and slow service, nearly 30% of patients leave an appointment, while 20% permanently change providers.


They reply to users using natural language, delivering extremely accurate insurance advice. A chatbot for insurance can help consumers file claims, collect information, and guide them through the process. Nearly half (44%) of customers find chatbots to be a good way to process claims. You can use them to answer customer questions, process claims, and generate quotes.

Train your chatbot to be conversational and collect feedback in a casual and stress-free way. While a popular belief about chatbots is that they will make human agents completely redundant, that is not entirely true. Chatbots can actually work for insurance agents, complementing their efforts and helping them carry out their jobs more effectively.

  • This data enables insurance companies to provide individualized services and improved quote suggestions that take into account the requirements of each client.
  • This streamlines the policyholder journey and makes it easier for customers to get the help they need.
  • This helps streamline claim processing and makes it more efficient for both clients and insurers.
  • Apart from giving tons of information on social insurance, the bot also helps users navigate through the products and offers.
  • Insurify, an insurance comparison website, was among the first champions of using chatbots in the insurance industry.

If you have an insurance app (you do, right?), you can use a bot to remind policyholders of upcoming payments. A bot can also handle payment collection by providing customers with a simple form, auto-filling customer data, and processing the payment through an integration with a third-party payment system. Feedback is something that every business wants but not every customer wants to give.

Give a name to your healthcare bot

It interacts with the customers and collect user data like their preferences, what kind of insurance they are looking for, and so on. Automating medication refills is one of the best applications for chatbots in the healthcare industry. Due to the overwhelming amount of paperwork in most doctors’ offices, many patients have to wait for weeks before filling their prescriptions, squandering valuable time. Instead, the chatbot can check with each pharmacy to see if the prescription has been filled and then send a notification when it is ready for pickup or delivery. Now that you understand the advantages of chatbots for healthcare, it’s time to look at the various healthcare chatbot use cases. It is only possible for healthcare professionals to provide one-to-one care.

chatbot for health insurance

Acquire is a customer service platform that streamlines AI chatbots, live chat, and video calling. Sensely is a conversational AI platform that assists patients with insurance plans and healthcare resources. Chatbots helped businesses to cut $8 billion in costs in 2022 by saving time agents would have spent interacting with customers.

chatbot for health insurance

This will then help the agent to work faster and resolve the problem in a shorter time — without the customer having to repeat anything. Chatbots for banking are becoming more efficient in providing businesses with high customer engagement. Despite these challenges, chatbots can be valuable to an insurance company’s client service arsenal. It has helped FWD Insurance scale its client service by allowing users to get answers to their questions 24/7. In addition, chatbots can proactively reach out to insurance customers to offer assistance.

chatbot for health insurance

Challenges like hiring more medical professionals and holding training sessions will be the outcome. You may address the issues and provide the scalability to handle real-time discussions by integrating a healthcare chatbot into your customer support. Several healthcare service companies are converting FAQs by adding an interactive healthcare chatbot to answer consumers’ general questions. As a result of this training, differently intelligent conversational AI chatbots in healthcare may comprehend user questions and respond depending on predefined labels in the training data. By automating all of a medical representative’s routine and lower-level responsibilities, chatbots in the healthcare industry are extremely time-saving for professionals.

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