Comment by CatDivers

a. Claims calls are often used to better detect fraud (tone/pauses etc) and ask probing questions to deny claims. The friction of having to make a call also helps to reduce claim volumes.*(not all insurers)

b. Not sure, the insurer should negotiate competitive rates and know what they are. This could be on a sliding scale or otherwise vary dynamically based on claims and performance criteria.

c. Insurance is state-regulated in US. There may be specific requirements relating to this.

I spent a decade working in insurance and reinsurance in the UK. The US healthcare system is a different beast but there are some similarities.

Insurers are using tech in lots of interesting (and... unethical?) ways. Some reasonable ways would be linking to wearable or IoT devices for real-time data and offer incentives to care better for your health and home.

Others, like pricing and claims optimization strategies are a bit more questionable. This is where they'll vary prices and claims to maximize profitability. With claims optimization, the insurer will use data about the person's financial situation to determine how low a pay-out they can make e.g. £1000 today or new car next week.

With AI, they can analyze more datasets e.g. social media activity to analyze behaviours and likelihood of claims in order to adapt pricing... they've done this forever. 20 years ago they'd vary pricing based on your email provider.

There are new models like UBI (usage based insurance) and on-demand insurance, and some new entrants are using tech to streamline operations including cutting the contact centres - so it's being done by some.

I think there are more fundamental opportunities to disrupt and build more accessible and profitable insurance models with a longer-term view though.