Why customer experience is crucial for health insurers

Health insurance is a crucial aspect of people’s lives as it provides financial protection and access to quality healthcare. However, navigating the complexities of health insurance can be overwhelming and confusing for customers. The use of digital tools and platforms can play a significant role in creating a better customer experience for health insurance.

Access customer data anytime

Digital transformation has significantly impacted the way health insurance companies operate, and it has given them access to more customer data than ever before. As more healthcare data moves online, insurers have access to more detailed and accurate data on their customers’ medical histories, treatment plans, and health outcomes.

Digital tools such as electronic health records (EHRs), wearables, and telehealth services provide valuable data that insurers can use to improve their services, better understand their customers’ needs, and personalize their offerings. EHRs contain comprehensive medical histories, including diagnoses, medications, and test results, which can help insurers identify health risks, improve care coordination, and manage chronic conditions.

Wearables such as fitness trackers and smartwatches can collect data on customers’ physical activity, sleep patterns, heart rate, and more. This information can help insurers assess customers’ overall health and identify risk factors. Telehealth services, which allow patients to connect with healthcare providers remotely, provide insurers with data on the frequency and type of medical services their customers use.

Provide personalized experiences

Health insurers can provide personalized experiences to customers with digital tools by leveraging technology to better understand their customers’ needs and preferences, and by using this information to create tailored solutions and services.

Here are a few ways health insurers can use digital tools to provide personalized experiences to customers:

  1. Data analytics: Health insurers can use data analytics to gain insights into their customers’ health and wellness needs. By analyzing data from wearable devices, fitness apps, and other sources, insurers can get a better understanding of their customer’s health status, behavior, and lifestyle. They can then use this information to personalize their offerings and services.

  2. Mobile apps: Health insurers can develop mobile apps that offer personalized health coaching, disease management, and other services. For example, an insurer could create an app that tracks a customer’s health goals and progress, sends reminders to take medication, and provides personalized recommendations for healthy lifestyle choices.

  3. Telemedicine: Health insurers can provide telemedicine services that allow customers to consult with a doctor or nurse practitioner via video chat or phone. This can be especially helpful for customers who live in remote or rural areas and have limited access to healthcare providers.

  4. Online portals: Health insurers can create online portals that give customers access to their health information, medical records, and claims data. They can also use these portals to provide personalized health and wellness resources, such as articles, videos, and interactive tools.

  5. Chatbots: Health insurers can use chatbots to provide personalized customer support and assistance. Chatbots can help customers find information about their insurance benefits, check the status of their claims, and get answers to their health-related questions.

  6. Messaging apps: A lot of people these days are learning and adopting new ways of doing business and engaging with providers through their favorite messaging apps like Facebook, Whatsapp, WeChat, and more. By delivering insurance experiences and services through a customer’s favorite messenger, it goes a long way to improving relationships, and overall reducing the hurdle of requiring an app download otherwise. 

By using these and other digital tools, health insurers can provide personalized experiences to customers that improve their health outcomes and satisfaction with their insurance provider.

Streamline claims processing

Digital tools and platforms can also streamline the claims process, which is often a frustrating experience for customers. With the use of mobile apps or web portals, customers can easily submit claims, track their status, and receive updates. This not only saves time but also reduces the likelihood of errors and delays.

Digital transformation refers to the integration of digital technologies into various aspects of a business to improve its operations and create new opportunities. In the case of health insurers, digital transformation can significantly streamline claims processing, resulting in faster, more efficient, and cost-effective operations.

Digital transformation enables the automation of the entire claims process, from claim submission to reimbursement. This can significantly reduce manual errors, speed up the claims process, and free up staff time for other tasks.

With digital transformation, insurers can use advanced technologies like machine learning and artificial intelligence to analyze data and identify patterns that help to identify fraudulent claims, thus improving the accuracy of claims processing.

Digital transformation can streamline the claims process by automating routine tasks, reducing the number of manual interventions required, and ultimately speeding up the overall process. This can result in significant cost savings for health insurers.

Self-service benefits

Digital technology allows customers to manage their health insurance plan online, such as enrolling in a plan, changing coverage options, and making premium payments. This can provide customers with more control over their plans and simplify the process for them.

Health insurance self-service refers to the ability of policyholders to manage their health insurance policies through a variety of online tools and resources, without the need for direct interaction with an insurance company representative.

This type of self-service typically includes the ability to:

  • View and manage policy information, such as coverage details, premiums, and deductibles.

  • Request changes to policy information, such as adding or removing dependents, changing coverage levels, or updating contact information.

  • Access information and resources related to health and wellness, such as preventive care guidelines, symptom checkers, and telehealth services.

  • Submit and track claims for medical expenses, prescription drugs, and other covered services.

  • Make online payments and view payment history.

Many health insurance companies offer self-service portals, mobile apps, and other digital tools to make it easy for policyholders to access and manage their policies at any time, from anywhere. Self-service options can save time and reduce the need for phone calls and paperwork, while also providing greater transparency and control over policy information and healthcare expenses.


To create a better customer experience for health insurance using digital tools and platforms, health insurance companies must invest in technology and ensure that their platforms are user-friendly and accessible. They must also provide adequate support and resources to help customers navigate the platforms and address any issues they may encounter.

Digital tools and platforms can significantly improve the customer experience for health insurance. By leveraging technology, health insurance companies can provide customers with access to information, personalized recommendations, streamlined claims processes, and virtual healthcare services. Ultimately, this can lead to greater customer satisfaction, loyalty, and retention.

At CoverGo, we help health insurers catch up with their customers with a true end-to-end core health platform that takes care of all the transformation without any of the headaches. No retrofitting requires, we’ll integrate with your systems as well was over 500 APIs. Contact us today to learn more.


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