AI-Powered Innovations Redefining Fraud Detection And CX In Insurance

Pankaj Pandey

AI integration in fraud detection and risk assessment has been a game-changer for SBI General Insurance. The AI implementation in fraud detection is multi-faceted, shared Pankaj Pandey, Chief Information Officer, SBI General Insurance, in an exclusive interaction with Srajan Agarwal of Elets News Network (ENN).

How is SBI General Insurance leveraging digital transformation to enhance customer experiences, and what notable improvements have you seen in areas like customer self-service options and digital policy issuance? What challenges have you faced in implementing these technologies?

Digital transformation is central to SBI General Insurance’s strategy, fundamentally enhancing customer experiences through several key initiatives. We’ve launched a unified distribution portal and mobile app that streamlines insurance transactions across all channels, simplifying the journey for distributors and customers alike.

Our use of advanced analytics enables insights into customer behaviour, helping us refine and improve their digital experience continuously. For example, our self-service capabilities now go beyond basic policy viewing. Customers can independently manage policies, initiate claims, and access services through our user-friendly digital platforms, designed for accessibility across diverse demographics.

A standout initiative is our Krishak app, which underscores our commitment to digital inclusion. Tailored for farmers, it provides policy management, essential farming information, weather updates, and more in multiple regional languages, making insurance accessible and relevant to our agricultural community.

These customer-facing advancements seamlessly integrate with back-office operations, linking customer requests directly to internal processes. This approach has notably reduced turnaround times, boosted satisfaction, and set a new standard for efficiency in customer service.

With an increasing reliance on digital infrastructure, how is SBI General
Insurance ensuring the security of customer data? Could you share specific steps being taken within the zero-trust security framework to address evolving cybersecurity threats and maintain regulatory compliance?

At SBI General Insurance, security is foundational to our operations, upheld through a multi-layered security framework that covers every aspect of our infrastructure. Our architecture spans from robust perimeter defenses to sophisticated endpoint protections, ensuring security for both traditional data centers and our cloud ecosystem.

Cloud security is especially critical, with standards as rigorous as those in physical data centers. We have implemented comprehensive protocols across network, application, and data layers, bolstered by advanced monitoring, frequent security audits, and ongoing updates to stay ahead of emerging threats. Being part of the SBI group means we follow some of the industry’s highest security standards.

We’ve also built redundancies into our architecture to ensure not only prevention of breach but also continuous business operations and customer trust. With tailored disaster recovery and business continuity plans, we maintain resilience across all critical assets.

How does SBI General Insurance use AI to detect and prevent fraudulent claims, and could you provide examples where these interventions have effectively minimized financial losses and improved claim accuracy?

The integration of AI in fraud detection and risk assessment has been a game-changer for us. Our AI implementation in fraud detection is multi-faceted. One of our most successful applications is in motor insurance claims. We’ve implemented an AI-powered system that automatically assesses vehicle damage through photographs and videos.

The system works by analyzing visual data against our extensive database of claim patterns, helping us identify anomalies that might indicate fraudulent activities. We’ve gone beyond just motor claims. Our AI systems are now integral to our claims processing workflow, from initial assessment to final settlement.

What’s particularly exciting is how we’re using AI for document processing and verification. The system can automatically read and verify documents, cross-reference information, and flag discrepancies that might indicate potential fraud. This has significantly enhanced our ability to detect and prevent fraudulent claims while ensuring legitimate claims are processed more quickly.

We’re also using AI in our underwriting processes. The technology helps us assess risks more accurately, leading to better pricing decisions and reduced exposure to potential fraud. This integration of AI across different touchpoints has created a more robust fraud detection framework.

Can you discuss how automation is being implemented across internal workflows at SBI General Insurance? What has been the impact on operational costs, productivity, and overall efficiency?

Automation has greatly enhanced our operations at SBI General Insurance, and we’re excited to share our approach to this transformative journey. We’ve established a dedicated Center of Excellence (CoE) for Robotic Process Automation (RPA), staffed by an in-house team of experts. This team enables us to continuously identify and implement automation across the organisation.

Our automation spans key areas: in claims processing, automatic assessments have cut processing times significantly; our document processing uses AI to streamline policy and invoice handling, reducing manual errors. We’ve also introduced auto-underwriting, which enhances risk assessment and policy issuance by ensuring efficiency and consistency.

What sets our automation apart is our end-to- end workflow optimisation, with a focus on reducing routine manual tasks. This frees up our team to concentrate on strategic decision-making. As a result, we’ve seen improvements in speed, accuracy, and efficiency, empowering us to better serve our customers and innovate in response to their needs.

What is your approach to collaborating with Insurtech startups, and how do you see these partnerships transforming the traditional insurance business model for SBI General Insurance?

Innovation is the cornerstone of growth in the financial services industry. It unlocks new
opportunities and business models for products and services. SBI General envisions Insurtech partnerships as catalysts for transforming the traditional insurance business model

At SBI General Insurance, we’ve established the Digi-Lab as a hub for exploring cutting-edge technologies and solutions. The Digi-Lab team actively collaborates with promising Insurtech startups to identify technological advancements that can fuel our growth and enhance customer satisfaction. This collaborative approach, guided by the ETPR model – Evaluate, Test, Prototype, and Rollout – ensures a systematic and efficient evaluation and implementation of promising solutions.

What emerging technologies do you believe will most significantly impact the insurance industry in the next five years, and how is SBI General Insurance preparing to integrate these advancements, especially with cloud adoption impacting efficiency and cost management?

We believe the future of insurance technology is on the brink of a transformation as impactful as the smartphone revolution coupled with the mobile internet. AI is driving this change, with applications like Generative AI, AI-powered OCR, RPA integrated with AI, and Natural Language Processing. Each of these technologies adds distinct value, and we’re actively incorporating them into our operations.

Also Read | How AI Is Shaping The Next Chapter Of Customer-Centric Insurance Solutions

Looking forward, I envision fundamental shifts in both customer experience and internal processing for the insurance industry. With advanced data analytics and AI, we’re moving toward more personalized services, offering enhanced customer segmentation and tailored service delivery. This sets the stage for a new kind of insurance marketplace—one that’s more personalized, responsive, and aligned with evolving customer needs.

At SBI General Insurance, we’re not just preparing for this future; we’re actively shaping it. From claims to policy servicing, these advancements will redefine how insurance is delivered and managed, offering customers a vastly improved experience. This is only the beginning — we’re at the forefront of an era filled with transformative potential.

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