This post is a quick overview of an Abto Software blog article.

Pet insurance has undergone many transformations, with more pet owners now understanding the importance of protecting their four-legged family members in emergencies, injuries, illnesses, and other health problems. Given these positive tendencies, rising costs for professional veterinary assistance, and overall adoption rates pet insurance service providers are moving towards integrating computational technology, in particular artificial intelligence and its many techniques.

But what are the main challenges and opportunities business leaders should consider before digitalization?

Pet insurance: how does it work?

Pet enrollment

Before purchasing preferred coverage, you must fill out the application to submit to the insurance company. This means providing details about age and breed, pre-existing conditions, and more.

Waiting period

During so-called waiting periods, insurance companies typically handle:

• Underwriting processes
• Policy setup and review
• Additional interaction to provide supporting documentation
• Customer service

These might range between just days to even 6 months in dependence on the selected vendor and coverage.

Premium payment

As soon as the pet insurance is purchased, you’ll have to pay your premiums, either monthly or annually.

Veterinary treatment

During visits to the veterinary office, you’ll have to keep the copies of invoices, medical records, and other related documentation to provide those later to the insurance company and receive your reimbursement.

Claim submission

After receiving veterinary assistance, you have to proceed with the claim submission to the insurance provider.

Claim review and processing

The said insurance provider will review and process the information your provided to ensure it meets the terms of the purchased coverage, which involves the verification of treatment and assessment of deductibles.

Expense reimbursement

Right after claim approval, you will get reimbursed for a certain portion of your veterinary expenses.

Continued coverage

As long as the specified premiums are paid, you will remain covered, so always make sure to review your policy and make necessary updates to ensure the coverage still meets your needs.

Pet insurance waiting periods: one of the main customer pains

Pet insurance waiting periods are causing significant concerns and frustration to customers obtaining coverage. This delay might cause severe anxiety, in particular for those pet owners facing immediate veterinary expenses in case of emergencies.

Pet insurance waiting periods might also hinder customers from accessing timely assistance from professionals. This might either result in more severe conditions to-be-addressed later or in pet owners paying out-of-pocket, which isn’t always possible for those with complicated financial situations.

Talking about business performance, waiting periods might cause rising dissatisfaction among customers feeling that their needs are not being addressed.

Decoding delays: the causes behind lengthy waiting periods

Rather prolonged waiting periods are typically associated with:

Complex underwriting procedures

Underwriting procedures involve assessing various factors – age, breed, activity levels, hereditary conditions. Data collection, processing, storing, and management are traditionally performed manually and, accordingly, quite resource-intense.

Manual claims processing

Claims processing involves careful account review, coverage cross-checking, legitimacy verification, and more. As these day-to-day processes are typically handled manually, they appear quite inefficient, not mentioning human error, and other related complications.

Pre-existing condition evaluations

Distinguishing between pre-existing conditions and recently emerged problems is a process necessitating thorough examination, oftentimes requiring back-and-forth communication with involved veterinary offices. Without automation, this process becomes tangled, thus prolonging waiting periods even more.

Medical record review

Medical records are hard-to-review, often compounded if there are discrepancies and missing health details. Without automation, the process can take several weeks, thereby causing customer dissatisfaction.

Introducing innovation – artificial intelligence to address waiting periods

Artificial Intelligence can expedite various processes, in particular:

Risk assessment

AI software can automate risk assessment by analyzing pet age and breed, health-related records, and other. Advanced algorithms can identify risk factors, allowing organizations to make faster decisions.

Claims processing

AI software can handle claims processing by extracting and analyzing submitted information from documents. Trained algorithms can validate claims submitted, helping companies to facilitate reimbursement approval.

Decision-making support

Artificial intelligence can analyze health records to help human workers in identifying pre-existing conditions. Such solutions detect indications of chronic health conditions, thus accelerating policy decisions.

Data interpretation

By adopting modern techniques – natural language processing (NLP), optical character recognition (OCR) – human employees can digitize and interpret medical records much faster than utilizing traditional methods. This helps to highlight relevant information, thereby streamlining business efficiency.

Summing up

Artificial intelligence has many useful applications in modern pet insurance, so why delay modernization?

Abto Software sees future-proof business opportunities in implementing artificial intelligence to revolutionize pet insurance, from accurate claim processing and 24/7 customer service, to hassle-free regulatory compliance. Our engineers can cover every stage from design to deployment and support to empower business leaders moving towards digital transformation.

Our expertise:

• Artificial intelligence
• Computer vision
• Natural language processing (NLP)
• Optical character recognition (OCR)