Goutam Datta is the VP-Technology at ICICI Lombard General Insurance. Datta has more than 20 years of experience in strategizing and spearheading large-scale technology operations. His previous stints include companies such as Essel Group, Tata Infotech and Adsoft.
ICICI Lombard implemented a cognitive platform using various computing layers to leverage solution where systems (machine learning algorithm and artificial intelligence) does admissibility and adjudication of the medical cashless claims. Earlier, cashless approvals were traditional in nature, where doctors goes through the documentation submitted by hospital and checks the policy terms and conditions. This process was manual in nature, extremely cumbersome and time consuming.
Now, the AI engine produces its recommendation on admissibility almost instantaneously and suggests an initial approval amount for the patient to get admitted to the hospital and get the treatment started. This reduces the wait time for the patient and their family, enables to start the medical procedure almost immediately. All this becomes possible because a cognitive AI engine is trained to reproduce doctors’ decision digitally.