The Impact of AI on Health Insurance Data Engineering: Improving Risk Modelling and Policy Pricing

Sunil Kumar Mudusu

Authors

Sunil Kumar Mudusu Church Mutual Insurance Company, S.I, Georgetown, TX, USA Author

Keywords:

Insurance, Risk, Policy, Data Engineering

Abstract

In this paper, the task of integrating AI driven models into the realm of health insurance is analysed and how the integration can affect the level of premium pricing and accuracy of risk prediction. There is comparison of several machine learning techniques and use of AI models such as Random Forest and XGBoost to demonstrate the superiority of the same in terms of precision and cost efficiency over traditional approaches in the case of insurers.

References

Bhargavi, R., & Arumugam, S. (2024). Predictive Analytics in Healthcare: A Hybrid Model for Efficient Medical Cost Estimation for Personalized Insurance Pricing. https://doi.org/10.21203/rs.3.rs-4697357/v1

Ridzuan, A. N. A. A., Azman, A. Z., Marzuki, F. A., Faudzi, W. S. D. M., Abd Aziz, S. H., & Bakar, N. A. (2024). Health Insurance Premium Pricing Using Machine Learning Methods. Journal of Advanced Research in Applied Sciences and Engineering Technology, 41(1), 134-141. http://semarakilmu.com.my/journals/index.php/applied_sciences_eng_tech/article/view/3284

Belispayeva, A., & Nassyrova, G. (2024). Navigating Health Insurance Economics: A Data-Driven Approach to Enhanced Pricing in the United States. ECONOMIC Series of the Bulletin of the LN Gumilyov ENU, (2), 280-293. https://doi.org/10.32523/2789-4320-2024-2-280-293

Ben Hamida, A., Kacem, M., de Peretti, C., & Belkacem, L. (2024). Machine learning based methods for ratemaking health care insurance. International Journal of Market Research, 66(6), 810-831. https://doi.org/10.1177/14707853241275446

Makaronidis, I. (2024). SOCIAL HEALTHCARE INSURANCE PRICE DISCRIMINATION IN THE BIG DATA ERA. https://www.researchgate.net/profile/Ioannis-Makaronidis/publication/385998863_Social_healthcare_insurance_price_discrimination_in_the_big_data_era/links/673ef6f2b94c451c116e691b/Social-healthcare-insurance-price-discrimination-in-the-big-data-era.pdf

Valli, L. N. (2024). Under the titles for Risk Assessment, Pricing, and Claims Management, write Modern Analytics. Global Journal of Universal Studies, 1(1), 132-151. https://media.neliti.com/media/publications/590133-under-the-titles-for-risk-assessment-pri-0998b5e2.pdf

Van Anh, N., & Duc, T. M. (2024). Big Data-Driven Predictive Modeling for Pricing, Claims Processing and Fraud Reduction in the Insurance Industry Globally. International Journal of Responsible Artificial Intelligence, 14(2), 12-23. http://neuralslate.com/index.php/Journal-of-Responsible-AI/article/view/82

Hommels, T. C. (2024). Exploring Data-Driven Clustering in Generalized Linear Models for Insurance Pricing (Master's thesis, University of Twente). http://essay.utwente.nl/98022/1/Hommels_MA_BMS.pdf

Bau, Y. T., & Hanif, S. A. M. (2024). Comparative Analysis of Machine Learning Algorithms for Health Insurance Pricing. JOIV: International Journal on Informatics Visualization, 8(1), 481-491. http://dx.doi.org/10.62527/joiv.8.1.2282

Hassani, H., Unger, S., & Beneki, C. (2020). Big data and actuarial science. Big Data and Cognitive Computing, 4(4), 40. https://doi.org/10.3390/bdcc4040040.