Experts highlight how using AI in the right way offers the industry clear opportunities to improve decision-making and customer outcomes.
Technology is changing insurance and how claims are handled at a rapid pace. The COVID-19 pandemic forced the agenda for technology change, and innovations such as generative AI are now creating the potential for the sector to evolve at an even faster pace.
Wayne Brand, head of TPA, UK & Ireland at Crawford, who led a panel discussion on the topic at the Crawford Technical Claims Forum in London, commented:
“We're on this journey and in many ways just getting started. We expect faster decision making and innovation using AI, which we anticipate will expedite the claims process and lead to faster settlements. It's an exciting time for the sector but we've got to get it right.”
The pace of change driven by the pandemic forced industries to adopt more digital-oriented practices to overcome the limitations imposed by multiple lockdowns.
Chris Tunnecliff, chief technology officer, International at Crawford, noted how the enforced working from home led to an acceleration in transferring files from paper to digital formats and helped fast-track the industry toward “digital journeys”.
The changes catalysed by the pandemic have also caused a shift in market expectations for the claims process.
“The main takeaway from that particular element was just how we've got the market to really focus on what providers should be able to do from a tech perspective,” noted Stephen Hearn, business development director, TPA, Crawford.
The industry is now leaning-in to using these newer technologies such as AI and more recently generative AI to enhance processes and customer satisfaction.
Greg Smith, president, Canada added: “It's really just the tip of the iceberg. I don’t think it will be long, for example, before we have AI responding to simple queries for policyholders giving them intuitive updates on the file without the adjuster manually having to send those out.”
Crawford has been using AI applications for years, but is working to accelerate what it can already do.
Smith highlighted Crawford’s AI platform Digital Desk in use in North America, a self-learning system which supports greater speed, accuracy, and efficiency regarding the intake, triage and distribution of insurance claims.
“It explores different ways to investigate the loss and potential outcomes,” he explained, “recommending to our specialists the best path for the claim – which could be an immediate assignment to a field adjuster, or going directly to a preferred contractor network. It’s about getting the most help to the people that need it most as urgently as possible.”
Tunnecliff added: “The excitement is where we go next which is the generative AI.”
He suggested that AI tools may even be used to help the claims journey become more ESG-friendly and help adjusters to understand more quickly what ecologically friendly repair materials might be available. AI will also be able to keep up with and recall scientific developments much faster than a human, and adjusters can utilise that in claims processing.
However, while AI opens up huge potential, the industry must also be alive to the challenges it poses as a potential disruptor. It cannot, for example, allow rules-based decision making to engender a ‘computer says no culture’ without empathy or input from a person who cares about the claimant. Consumer trust is a key consideration.
Talking about how the AI-enabled claims journey might go, Smith said: “Getting from point A to point Z is going to look very, very different. But there will always be critical points along that journey that require the skill, expertise, and empathy of an experienced insurance adjuster.”
“We're not the first industry that feels like they're staring disruption straight in the face but we believe the benefits are greater than the risks,” he added. “This is the tool we need and the resources we need to level the playing field enabling us to make really good decisions really quickly.”
Ultimately, the panel was positive about how AI will develop how loss adjusters use technology in tandem with human empathy and decision-making.
“AI is here to stay,” said Hearn. “It's a crucial part of the entire process, not just claims, but down through the underwriting actuarial functions as well. From a client engagement perspective, the more we collaborate, and more familiar we become with their operations and objectives, the better able we will be to offer a bespoke experience using AI to best service their business.”
