Elena has a Health insurance policy with the RGI insurance company. RGI has obtained some information on her state of health and, against a discount on her premium, has offered her a smartwatch with an app that can record and send her vital parameters to the insurer.
Elena has given her consent to the use of her personal and health data to activate a personalised assistance service and to send it to approved healthcare facilities.
Elena puts her smartwatch on and goes running.
While running she feels unwell and has to stop. Her smartwatch detects an anomaly in her vital parameters and automatically sends a report to the insurer’s system.
The insurer’s system receives the alert message, checks Elena’s profile and her benefit card, and activates the personalised service chosen by Elena, sending her an SMS to see if she needs help. Elena receives the SMS on her smartphone, but does not answer.
After a few minutes, the insurer’s system notes that there has been no reply to the SMS and notifies the Call Centre that there has been no reply to the control SMS, sending to the operator’s job queue all the data needed to call Elena.
Elena replies and confirms that she needs medical aid. The operator therefore activates the request for and the insurer’s system automatically detects Elena’s position via geolocation and identifies the nearest approved healthcare facility.
The insurer’s system opens the claim and sends the policyholder’s healthcare documents, including the recording of her vital parameters from the smartwatch, to the healthcare facility.
The healthcare worker activates the emergency aid procedure and in the meantime checks the documents sent by the insurer.
The healthcare facility then sends the insurer information on the termination of the service, Elena’s new healthcare documents and the request for payment for the service.
The system checks that it matches Elena’s policy cover and settles the claim.
After a few days, Elena is recovering at home and the system sends her an SMS to notify her that the summary of the service and a Customer Satisfaction questionnaire to check the level of satisfaction of the service offered by the insurer have been sent to her reserved area.
Elena accesses her Home Insurance page from her tablet, checks that the system has automatically updated her insurance situation and fills in the customer satisfaction questionnaire.