22 October, 2020

How digital health is shaping the medical insurance scene

By: Cesilia Faustina

The health sector is of great importance. It continues to be a huge market with 1.4 billion dollars of gross-written-premium in 2017, according to McKinsey. With rising numbers of natural disasters and diseases, more and more people are looking for greater solutions to maintain good healthcare.

Technology is becoming a powerful trait in healthcare these days. The industry is now taking advantage of various different tech, from AI and blockchain to wearables. This ecosystem has created a world of digitalization that has seeped into the way healthcare is measured and analyzed. Examples of this may be seen through many companies now gathering health data through machines, even health insurance companies now are getting in on the action.

This brings us to the case of medical insurance. Rising populations, greater risks, and high mortality rates are ensuring insurance as a crucial industry to maintain, especially when it comes to health insurance.

Healthcare and the insurance sector is no doubt inseparable, and now with the rise of digitalization, we are seeing the same concept being adopted by many insurance companies. Many big-time companies today like Amazon, Google and AXA are partnering with different health insurance companies for digital insurance processes.

This usually works in the form of some digital transformation. Many of these insurance companies are buying out software or working with tech organizations to create digitized platforms for health insurance purposes. So with the trend of digitalization, what can we expect to see in the health insurance sector?

Insurers are moving towards digital

As discussed earlier, we can see that many insurers are now working together with tech companies in order to create digital processes; that said, many health insurers are now transforming into a fully digital process thanks to the simplicity and accessibility of digital health.

Both the healthcare and the health insurance sector are adopting management systems in order to get the job done, such systems allow for direct results and full integration, making it so much easier when looking at policy administration and claims management. These two elements function as main activities in medical insurance, having a digital process for policies and claims creates a faster and more productive operation on all aspects.Such digitalization will also create greater integrations between sectors and functionalities, like with financial systems and CRM. This will surely support a more powerful operation in this sector. It will complete the whole medical insurance lifecycle, in correlation with calculations from related healthcare providers.

This creates greater benefits and customer satisfaction for the insured. Imagine having to pay for a giant medical bill after getting into an accident, something like that, ideally, would like to be handled smoothly and directly, well apparently the use of software systems do exactly that.

More and more software companies are supporting this movement with the creation of various systems to help with the management of medical insurance. The use of systems means insurers are able to organize and track all claims along with the medical records of insurers all through one digital platform.

Medical networks are becoming more manageable

By adopting a software system, handling medical providers can also become so much easier. Many insurance companies are adopting management software in order to simplify, accelerate and increase customer satisfaction; in relation, such systems can help insurers to be more flexible in determining their medical networks.

As one health insurer differs from one another, the ability to pick and choose their medical networks and providers is truly important, whether doctors and hospitals to pharmacies and laboratories. Going digital means the ability to connect and integrate with a customizable medical circle. Now with the digitalization of healthcare providers, insurers can directly link and unlink to them; meaning greater productivity, on top of cost and time efficiency.

Efficient underwriting is key

Underwriting is the core of all insurance processes. By adopting a digital underwriting process, as we are seeing with many companies today, this may accelerate the workflow of processing claims, as well as providing efficient services from healthcare providers.

The fact that the healthcare sectors are going digital has made the underwriting process for many insurers more productive and able to adopt the same style of automated processing. Having all data stored through one platform means one can easily access that data without the complications of mix-ups, from a client’s medical records to their histories of check-ups and medical providers. Such data can be transferred between a medical provider and an insurance company.

In addition, thanks to the power of digital software, many tools to support underwriting is popping out, making the process even easier. Tools seen in many of these systems include pricing, quotations, policies, endorsements, renewals and more. Such tools can help to process any underwriting tasks in minimal time with greater results.

The utilization of big data in insurance means the need for integration and convenience amongst providers and insurance companies. Insurers are now utilizing the convenience of an automated system, along with a digital healthcare process to conduct fast and reliable underwriting operations.

Powerful integration between healthcare providers and insurers

We have been mentioning a lot about integration between healthcare providers and insurers, so surely, this would be the main point to look at regarding the power of digitalization. Seamless integration means direct communication and a unified process between healthcare providers and insurers. Data that needs to be accessed and updated between insurers and providers can be easily done and automatically processed.

Thanks to digital health, we are seeing more insurers following a digitized trend. Greater healthcare demands mean insurers now need to keep up with healthcare needs, this means without proper digital integration amongst one another, insurers are risking falling behind.

This is why we are seeing many three-way partnerships between software companies, healthcare providers and insurance companies. These three institutions are important for full customer satisfaction and will need to work in relation to smooth integration.

The creation of a sales network

Thanks to the process of digitalization and the utilization of online portals, we are seeing greater advancements when it comes to sales network management. As an important part of an insurer’s success, it is important to mention this point. Digitalization has created new means of sales for the insurance sector. With the use of online portals, we are seeing more insurers utilize this for sales purposes.

By going digital, many insurers are documenting all sales activities through one automated platform where they can track their targets, configure commissions and bonuses, and incorporate agents, brokers and bancassurance reps.

All sales agents can easily complete tasks and get the job done through the use of online portals. This is especially true for an industry like health insurance; with no signs of slowing down, we are witnessing a new standard for insurers and insurance operations.

Many insurers are utilizing mobile apps

The digitalization of everything has led many insurance companies to start integrating with mobile apps and online portals. The shift in healthcare has led to the rise of various apps to accelerate both the insurance and medical services operations.

Instead of worrying about making claims through a long and gruelling process, customers can now simply insert whatever claims they are making through the simplicity of their phones. These apps are usually connected to the system itself where it will process the premiums, as well as informing medical providers.

The use of mobile apps and online portals are making it easier for customers to connect to both their insurers and providers, creating a healthy ecosystem when filing for health insurance.

Learn more about ESKADENIA's Medical Insurance software.

About ESKADENIA Software

ESKADENIA® Software is a three-time MENA Award Winner & CMMI® level 3 certified company that is active in the design, development and deployment of a range of software products in the Telecom, Insurance, Enterprise, Education, Healthcare, and Internet application areas. The company is based in Jordan and has sales activities in Europe, the Middle East and Africa; more than 85% of its sales are exported to the global market. For more information, visit, or contact us at