{"title":"Customization of health insurance premiums using machine learning and explainable AI","authors":"Manohar Kapse , Vinod Sharma , Rutuj Vidhale , Varun Vellanki","doi":"10.1016/j.jjimei.2025.100328","DOIUrl":null,"url":null,"abstract":"<div><div>This study presents an analysis of health insurance premiums across various customer segments. Specifically, it aims to identify the factors influencing the pricing of health insurance premiums, vis a vis their impact on different customer segments. Using a dataset from consumer surveys, coupled with multiple Machine Learning models, the study analyzed and predicted features of importance for premiums paid across various age groups, gender, health conditions, policy duration, and the number of members included in the policy. Finally, the explainable AI was used to predict the weightage of each variable in determining the price of the insurance policy for the individuals. The findings provide crucial insights into the factors such as demographic factors and lifestyle that effectively influence the pricing of health insurance premiums vis a vis their impact on various customer segments. The results of this study will assist prospective buyers and decision-makers in choosing the best health insurance plans.</div></div>","PeriodicalId":100699,"journal":{"name":"International Journal of Information Management Data Insights","volume":"5 1","pages":"Article 100328"},"PeriodicalIF":0.0000,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Information Management Data Insights","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2667096825000102","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
Abstract
This study presents an analysis of health insurance premiums across various customer segments. Specifically, it aims to identify the factors influencing the pricing of health insurance premiums, vis a vis their impact on different customer segments. Using a dataset from consumer surveys, coupled with multiple Machine Learning models, the study analyzed and predicted features of importance for premiums paid across various age groups, gender, health conditions, policy duration, and the number of members included in the policy. Finally, the explainable AI was used to predict the weightage of each variable in determining the price of the insurance policy for the individuals. The findings provide crucial insights into the factors such as demographic factors and lifestyle that effectively influence the pricing of health insurance premiums vis a vis their impact on various customer segments. The results of this study will assist prospective buyers and decision-makers in choosing the best health insurance plans.