Tongyang Life Expands AI Applications from Pre-Assessment to Claims Payment

Tongyang Life, an affiliate of Woori Financial Group, is expanding the application of digital and artificial intelligence (AI) technologies across all aspects of insurance operations, from policy enrollment to insurance claim submission and assessment. By automating repetitive tasks and reducing review times, the company aims to enhance both customer convenience and operational efficiency.

According to the insurance industry on September 28th, Tongyang Life operates a pre-assessment system that allows applicants to check their eligibility for enrollment before submitting a policy application. Previously, customers could only verify their eligibility after completing the plan design and application and undergoing the underwriting review. With the pre-assessment system, customers who give prior consent can receive the underwriting results during the plan design stage. This enables them to identify coverage limitations or conditional approvals before submitting an application, allowing adjustments to be made in advance.

AI is also being utilized for post-enrollment processes. Tongyang Life has introduced an AI-based Optical Character Recognition (OCR) technology to automatically classify documents submitted for insurance claims. By automating the repetitive document verification and classification processes, this technology reduces the time required to handle insurance claim requests.

During the insurance claim review stage, the company operates a Claim Risk Detection System (CRDS), which analyzes claim data and accident history to detect high-risk cases with possible insurance fraud.

Notably, the introduction of CRDS has improved insurance fraud detection efficiency by 63%, and the rate of automated claim review has increased from 22% to 45%. The company uses this system to identify high-risk claims while also improving the overall efficiency of routine claim reviews.

This digital and AI strategy is expected to continue after the integration with ABL Life. During a group CEO town hall where the integration with ABL Life was announced, Tongyang Life CEO Sung Dae-kyu cited the enhancement of customer service and sales competitiveness through AI as key priorities for the integrated company going forward.

An industry source said, "There is growing interest in whether a digital strategy innovating the entire insurance experience—from enrollment to claims—through AI will develop into a unique competitive advantage for the integrated insurance company in the future."

This content was produced with the assistance of AI translation services.