Secure your healthcare insurance with eKYC and prevent fraud

eKYC – Healthcare Insurance

The Healthcare sector is one of the most vulnerable sectors in India. No one wants to experience the financial and emotional shock when they find out that someone has stolen/misused their identity to gain healthcare benefits or to purchase drugs. 

Fraudsters may also go the extra mile and misuse credit cards belonging to someone else to pay their medical bills. Solutions in eKYC for healthcare can help prevent such unfortunate incidents. 

It is not just the customers who land in a soup when they are a victim of frauds. Insurers too suffer significant losses. According to a report by the Insurance Institute of India, the healthcare insurance industry is experiencing a loss of Rs 600-800 crores annually, due to fraudulent activities.


What is health insurance fraud?

Health insurance fraud is an act of deliberately submitting false claims to health insurance plans; deceiving or misrepresenting despite knowing that it could result in unauthorized benefits to the individual or to another party. 

Going digital is crucial in safeguarding an individual’s identity and keeping fraudsters at bay. It has also simplified customer onboarding and verifying their identity. The rise in medical and healthcare insurance frauds has brought people’s attention to the importance of digitizing their health insurance. 

When it comes to sensitive information, especially in the finance and healthcare sector, eKYC or digital KYC cuts the risk of identity theft and misuse of an individual’s information. 

Going digital simplifies not only the insurance process but also prevents fraud in the healthcare system. In order to understand how online eKYC safeguards against insurance fraud, it’s imperative to be aware of the various types of health insurance fraud.

Types of health insurance frauds in India

  • Claim fraudWhen a customer claims health coverage they are not entitled to, as per the terms and conditions of an insurance policy, it is a claim fraud.
  • External and internal fraud External fraud refers to fraud committed by a customer, beneficiary, or service provider against the insurance company. In contrast, internal fraud refers to the fraud committed by the company or an agent against the customer.
  • Eligibility fraudEntering wrong information such as employment term to gain eligibility status and additional benefits falls under eligibility fraud. Any information provided by the customer that violates the terms and conditions for eligibility can lead to dire consequences. 
  • Medical identity theft This is one of the most prevalent frauds existing in India. In this case, anyone can misuse a policyholder’s name without them knowing to avail free healthcare benefits or treatment. They may also claim insurance that does not belong to them, which leads to incorrect information entered in the policyholder’s medical records.
  • Application fraudIn this case, a customer enters inaccurate information related to their bio, pre-existing health issues, illness, etc., despite knowing the right information. They do this to gain additional benefits and more coverage.zzz

In some cases, agents may encourage the customers to enter false information and not to disclose previous illnesses to pay fewer premiums.

This brings us to the question – how to prevent healthcare insurance fraud? What can secure the customer’s information and prevent instances of insurance theft & healthcare fraud? 

Going digital is one way to go. Today, advancements in technology have made securing information a lot easier. eKYC for healthcare insurance ensures that the customer’s identity & details don’t fall into the wrong hands, and saves insurers millions in fraud losses. 

Let us understand how eKYC helps prevent fraud in the healthcare sector.

eKYC for healthcare insurance fraud prevention

KYC is full for Know Your Client. The KYC process involves identifying and verifying a client’s identity periodically when they open an account. eKYC is the online process of the same, which is more secure and saves time for both insurers & customers. 

eKYC or Digital KYC strengthens the requirements to prevent fraud in the healthcare system. It employs Artificial Intelligence (AI) and Human Intelligence (HI) to detect money laundering and attempts at fraud. 

eKYC uses biometric recognition in some cases, which can involve authentication of a customer’s fingerprints, iris or even facial features. Recent advancements in AI technologies now allow for more accurate facial recognition. 

A camera used for live facial recognition creates a small encrypted file, encoding vectors unique to a face, called a template. This template is then used to compare a file captured live from a customer’s ID. 

Online eKYC verifies a customer through their document details and live facial recognition techniques to determine if they are using fake or stolen identity credentials for illegal purposes. In some cases, video KYC, which is more reliable during a pandemic, is also used for the same purpose. 

You can approach eKYC solution providers to get started on securing your identity and credentials to gain and secure your health and medical insurances. 

eKYC provides many benefits and gets straight to the point, unlike conventional insurance processes.

How going digital with eKYC can help you

Let’s face it. The conventional method of customer onboarding in the insurance process is unreliable and lengthy. 

A majority of customers get impatient and frustrated by the lengthy process, leading to a bad customer experience. There is also a lack of solid ID and document verification processes, which becomes more susceptible to fraud. 

Especially in times of the coronavirus pandemic, it is convenient and faster to get things done digitally. Contactless documentation and application for health insurance are a lot safer than approaching an insurance company. 

Switching to eKYC makes the process a lot easier and more time-saving. Here’s what you can gain from going digital –

Customer safety and security

This is the most important benefit you can gain from going digital with health and medical insurance. Buying insurance with conventional methods is not so safe. With eKYC online, there’s almost no chance of someone stealing your medical or financial details for misuse. 

All your data is stored in the company repository, leaving no chance for data leakage. This way, your information is safe from the hands of hackers and fraudsters. 

By going digital, you can also avoid using wet signatures on paper-based insurance documents. Instead, you can receive life and health insurance & policies in electronic form & then provide your consent to said policies via an OTP sent to your registered number. Read more about that here

Improved customer experience 

With digitized management, insurers can cater to customers with a push of a button and not make them wait to give the information they require urgently.

But in the case of conventional methods, customers have to visit an insurance provider to verify insurance details, claim their insurance money, or to clarify their queries. 

Most of the time, they are told to come back on a given date. This is not always convenient and is terrible for the customer experience. Digitization of handling the customers can move at a fast pace and lead to better customer service.

With online eKYC for insurance, customers can be verified & onboarded remotely, receive insurance policies in electronic form, consent to proposals via OTP, & finally eSign proposals. Read more about how insurance policy dispensation can be end-to-end digitized here

One-time KYC for new policies

When you apply for other kinds of insurance, you don’t have to provide your KYC details again, as the database stores your KYC credentials. The insurance company has to just overwrite the digital application form with the data cached in their repository.

Insurers too can benefit from going digital

Portable documentsManaging the monumental paperwork is a headache for the insurers and the policyholders. There’s a risk of losing premium receipts, policy cards, and other essential documents. Digitization can provide a convenient solution for all such problems and reduce the hassle. 

e-Copies of the documents are stored in cloud-based data servers available on any digital device capable of analyzing and displaying the data. The data and the documents are preserved and acquired easily. 

IRDAI (Indian Regulatory and Development Authority) approved insurance repositories manage the database – 

  • Karvy Insurance Repository Limited
  • CAMS Insurance Repository Limited
  • National Insurance-policy Repository by NSDL database management
  • CDSL Insurance Repository Limited

Reduces TATInsurers can instantly verify customers and complete the onboarding documents within minutes. This reduces TAT on customer KYC verification by nearly 99%.

Reduces manual errorsDigitized documentation leaves little room for manual errors, ensuring that the customers’ details are entered correctly & verified quickly.  

Reduces KYC drop-offsDigital KYC and documentation ensure the verification process is completed, reducing KYC drop-offs by nearly 20%. 

Boosts efficiency and productivity –  eKYC and video KYC speed up customer onboarding so that insurers take less time to onboard more customers.  

Avoid multiple visits to the customersWith the eKYC method, insurers and policyholders can avoid visiting their customers several times. Using the customer’s eKYC credentials and OTP, insurers can authenticate and verify customer identity and transfer their insurance policies in electronic form. 

Cuts down onboarding costs With digital and video KYC, insurers can significantly cut down customer onboarding costs and ensure that the process is completed. The instant verification process with video KYC contributes to this benefit. 

Digitizing the process of selling insurances, especially with eKYC & video KYC, is smooth sailing and faster than the usual manual & paper-based verification methods. It also authenticates the information provided by the customers on a real-time basis, boosting security & efficiency. 

Now that you know how you can benefit from eKYC for healthcare insurance, let’s understand how the process works.

eKYC procedure 

eKYC procedure provides options for both online and offline methods of customer KYC verification

Online methods

Online methods consist of OTP verification and biometric authentication. A customer can choose either one of these methods. 

For OTP authentication, the customer has to register their mobile number and then consent to the procedure during Aadhaar eKYC. When they agree, an OTP is generated, which upon entering, their Aadhaar is authenticated. Their identity information in the UIDAI database will be provided to the service provider for verification. 

In the biometric method, a scanner captures the fingerprint image or the retina image. The images are sent to UIDAI to match the biometric data stored under the customer’s unique Aadhaar number. 

Upon verifying the match, UIDAI forwards the identifying information to the verification service provider for authentication. 

Offline methods

One of the offline eKYC procedures is through QR codes. If you have noticed, your Aadhar card has a QR code that contains your demographic information. Every QR code is unique, and only machines can read them to extract the information to authenticate Aadhar. 

The other offline method is through an XML file. The customer has to fill up the offline eKYC form on the UIDAI website to download their XML file. Like QR code, the XML file is unique, too, containing the customer’s demographic information. A service provider reads the Aadhaar XML file and extracts the information to complete the eKYC process.

Make customer onboarding easy with SignDesk’s eKYC and video KYC

Catering to 250+ clients for over five years, SignDesk is award-winning digital documentation and KYC verification solution provider. Our clients have successfully cut customer onboarding costs by 90% and experienced a 20% improvement in efficiency with our products. 

SignDesk‘s KYC solution is equipped with advanced Machine Learning technology to perform better facial recognition and AI for automated data extraction & real-time document verification, all compliant with IRDAI rules and regulations

Our Aadhaar eKYC solutions allow businesses to verify customer KYC online or offline, within minutes & at a fraction of the cost. We also offer eSign workflow solutions with templates to create legally valid insurance contracts & Aadhaar eSign to execute these documents remotely. 

Our healthcare eKYC solutions are cost-effective, compliant & utilize industry-grade security protocols.

Cut costs and save time in verifying & onboarding customers with SignDesk’s award-winning KYC solutions. Book a demo to learn more.

eKYC provides many benefits and gets straight to the point, unlike conventional insurance processes.

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