Star Health
Star Health aims for 50% of routine cashless claims to be settled through AI in two years
Health insurer Star Health and Allied Insurance Company Limited expects Artificial Intelligence (AI) to play a significantly larger role in processing routine cashless hospitalisation claims, with the company targeting 50% of such claims to be settled through AI intervention over the next two years.
Speaking to IBNS, Atin Roy, Business Head – West Bengal, Star Health Insurance, said AI-driven claim settlements currently account for around 20% of the company's settlements.
“Settlements due to AI interventions have increased and stand at 20% at present. We want to increase it to 50% within the next two years,” Roy said.
“It is an ambition which we will surely fulfil,” he added.
AI helping detect fraudulent claims
Roy also highlighted the role of technology and AI in identifying fraudulent insurance claims.
“Today, as the world is becoming more digitised, we can detect these cases. And we can deny these claims and take necessary legal action against them,” he said.
Explaining how AI is being used to identify fraud, Roy said: “We are also taking advantage of AI to find out and understand where all these frauds are happening because there are a lot of patterns which the human mind cannot make out, which AI can make out easily. And we are getting the advantage of it.”
Star Health settles over 6 lakh claims in West Bengal
Star Health said it has settled more than 6 lakh claims worth over Rs 3,200 crore in West Bengal since inception, highlighting the scale of financial protection provided to customers across the state.
The insurer currently operates more than 60 branches and over 650 network hospitals across West Bengal.
During FY26, the company settled more than 1.18 lakh claims worth over Rs 600 crore in the state. In Q1 FY27, it settled more than 33,000 claims amounting to over Rs 140 crore.
Roy said the company's extensive hospital network and distribution presence are helping it expand its reach across the state.
“Our network of 650+ hospitals gives us a strong foundation to serve customers across the state, while our expanding distribution presence helps us stay closer to families across both Kolkata and emerging markets,” he said.
Preventive healthcare and telemedicine see strong growth
Star Health also reported significant growth in its preventive and home-based healthcare services.
In FY26, preventive health check-ups increased 42% to 5.48 lakh, while telemedicine consultations grew 88% to 1.17 lakh.
The company's Home Healthcare service recorded utilisation of 92,153, with eligible customers across more than 300 cities able to access clinically appropriate care at home through a cashless model.
The insurer said these initiatives are aimed at making healthcare more accessible while expanding the role of technology in customer service and claims management.
(Reporting by Supriyo Hazra)
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