The future of claims: Humans vs AI

James Sterling, head of claims, Kayzen Specialty.

As a cautious claims professional and former lawyer, deeply passionate about human-centric client service, my unconscious bias puts me naturally on the defensive when I receive questions about automated claims solutions.

Robots replacing humans? Computer says no? One size fits all? No thank you! What do our clients actually want? Good question!

Technology is clearly here to stay, and, throughout my career in the insurance market, it has been constantly bedded into my claims DNA that we need to evolve to stay at the top of our game. The challenge, then, is how to utilise technology while maintaining our core values and the vital human element, ensuring we don’t alienate our clients.

While researching “Claims AI,” I found a lot of enthusiasm for innovation but also some caution from industry experts. It was certainly a relief to read that efforts are being made to bring customers along on the technology journey. Bespoke solutions are being created for some very different first- and third-party product lines, and robots aren’t destined to take over the world!

While the last point remains uncertain, in my current company, we strive to excel daily and are committed to continuous improvement. What resonates with me is the ethos of doing the simple things well and embracing incremental change without wholesale revolution.

Let’s apply this to what is actually going on in the claims space:

• AI can expedite the claims process. For example, AI algorithms and image recognition swiftly analyse claim data, assess damages, and determine coverage using visual data from property inspections or accident scenes, including drone footage and automobile telematics.
• It can help detect fraud and predict trends.
• It provides a theoretically seamless continuum through from any automated underwriting stage.

Sounds great, but what about some real-life examples of how this actually benefits customers?

• Zurich’s “Zara” automated system analyses images, videos, and audio recordings, reducing processing time by over 30% and boosting customer satisfaction above 80%.
• Ernst & Young present a case study on real-time claim document processing, albeit with a current success rate of only 70%.
• Stat