Case Study of Claim Data and Participant Data in Indonesian Insurance Companies.

Solontio, Chris; Hidayanto, Achmad Nizar

Data has become an asset for insurance companies, especially health insurance, which has many benefits so management needs to realize the importance of good data quality to avoid the impact of poor data quality. In this study, data quality measurement will be carried out by observation to see the total amount of invalid data from the data dimensions, namely, accuracy, completeness, and consistency on the connection between claim data and participant data as well as findings from all data from the case study site of this research. In addition to the data analysis, interviews were conducted with the IT, Customer Retention, Operations, and Actuarial teams which are directly related to data flow and data processing to make analyses that assist management in making decisions. From the results of the analysis and interviews that have been conducted, there are still inappropriate data and obstacles faced by users in dealing with poor data quality. From the results of the analysis, management needs to form a data govenance team that has responsibility for the entire data flow and maintains data quality. Later, the data set that has been managed will have a positive impact on other teams in terms of analyzing trends or fraud in a faster time, helping in the creation of data warehouses, the application of artificial intelligence (AI) and digital transformation as a form of company improvement to insurance policyholders.

INDONESIA; DIGITAL technology; TECHNOLOGICAL innovations; ARTIFICIAL intelligence; INSURANCE companies

Jurnal Indonesia Sosial Teknologi, 2024, Vol 5, Issue 12, p6060

2723-6609

Academic Journal

10.59141/jist.v5i12.7043