Data and Behavioral Science: The key to reducing claims and costs in health insurance?

May 24, 2023

This paper is part of our new Industry Perspective Series, read the full report here.


Health insurers are facing pressure from two directions. The costs of providing health services are rising thanks to higher inflation and the emergence of new but costly treatments. At the same time, consumers expect an ever-greater level of personal service.  Could combining data science and Artificial intelligence (AI) with the insights of behavioral science be the key to reducing claims and costs, while also meeting those rising customer expectations?

In this first edition of our Industry Perspectives series, we spoke to Alex Holdsworth, Executive Strategy Director at Monstarlab, a global digital consultancy focused on helping companies effectively leverage technology, and William Trump, who leads the Office of the Customer at iptiQ, the digital insurer owned by Swiss Re. They outlined three critical building blocks for insurers to harness the power of data and behavioral science effectively:

  1. Focus on small high-value steps and learn to walk before you jog. Insurers shouldn’t aim straightaway for an all-embracing solution. Aim for small changes in customer behavior such as attending doctors’ appointments, taking medication on time, or activating their online account.
  2. Timing is everything – deliver the right intervention at the right time with personalization. Insurers should identify the optimal moments to nudge consumers and do so in a personalized way. Knowing when a consumer has visited their doctor or had a scan will allow for follow-up actions to be encouraged at just the right moment.
  3. Setting a realistic path to quickly realize value. Those initial small steps will quickly deliver value but will also form the foundation on which to build a wider solution. As more data points are collected, everything from engagement with consumers to risk analysis will become easier and more effective.

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