When Priya, a diligent employee at a fast-growing company, found herself unexpectedly hospitalised, the experience turned out to be more than just a health scare. Despite having group health insurance (GHI) through her employer, navigating the claims process quickly became an overwhelming ordeal. Instead of focusing on her recovery, she found herself entangled in a web of paperwork, endless phone calls, and confusing instructions. This is a familiar scenario for many employees.

GHI should act as a safety net, providing security in unpredictable moments. Yet, traditional approaches often feel weighed down by administrative hassles and inefficient processes, particularly for small and medium enterprises (SMEs) where lean HR teams and limited resources complicate matters further. Here, technology offers a way forward, transforming how GHI is accessed, managed, and optimised — even for companies with as few as seven employees.

By embedding technology into every aspect of GHI, companies can enhance operational efficiency and cost-effectiveness while delivering a more human-centered experience that genuinely supports employee well-being.

Simpler onboarding

Traditionally, procuring GHI was a time-consuming process involving piles of paperwork, endless agent meetings, and long waiting periods. However, tech-driven platforms are changing this narrative. Digital onboarding allows SMEs to compare policies, customise coverage options, and complete applications online with minimal documentation.

Advanced AI algorithms can also help generate personalised policy recommendations for firms based on workforce demographics and health needs. This eliminates guesswork and speeds up decision-making.

Once a policy is established, technology enables HR managers and business owners to maintain real-time control over its management. Digital platforms offer instant access to data on policy usage, claims history, and benefit utilisation. This transparency helps optimise costs, allowing proactive adjustments and ensuring employees fully utilise their coverage.

Through interactive dashboards, SMEs can monitor their claims ratio and track essential metrics related to their GHI plans.

Automating claims

Claims processing is often the most critical component of any health insurance plan, yet it’s traditionally bogged down by manual procedures prone to delays and errors. Automated claims management systems can help expedite processing, reduce costs, and enhance accuracy.

Telemedicine and virtual health services have gained prominence, offering SMEs an affordable way to provide accessible healthcare to their employees. Virtual consultations, remote diagnostics, and online wellness programs allow employees to seek medical attention without the logistical and financial challenges of in-person visits.

To sum up, for SMEs, harnessing these technological advancements means can lower costs and enhance employee satisfaction and health outcomes.

(The writer is Head, Policybazaar For Business)

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