AI predictive capabilities find applications in insurance claims

Integrating artificial intelligence directly into insurance claims processing is improving the industry’s predictive analytics capabilities and ability to apply predictive models to processing claims, helping reduce the costs of claims and making it easier to apply staff resources, carriers’ claims technology executives say.

“AI and its analysis of the data and its ability to identify patterns, can begin to judge sentiment across all the parties to a claim,” said Shawn Crawley, chief operation officer, American claims at Sompo International. This means detecting a claim’s severity, possibility for litigation, or possibility of fraud, Crawley explained. 

Don Jones, senior vice president, claims design and delivery at Allstate.

AI can analyze claims trends and data, supporting informed, data-driven decisions, according to Don Jones, senior vice president, claims design and delivery at Allstate. He cited handling of first notice of loss (FNOL) as an example.

“AI can really show up in that process and make it very easy for the customer and the transmission of that information to the FNOL taker,” he said. “That way we can set up that claim the right way, the first time, consistently with accurate information.”

AI-powered predictive models using photos of damage details from claims can predict losses more accurately and consistently, according to Jones. For auto claims, this allows carriers to “get our customers back on the road faster, in terms of faster cycle times, more efficient processes, and making sure that we’re accurately managing their claim,” he said. 

In turn, the carrier pays exactly what it really owes based on the accurate assessment of the claim, Jones added. 

Customers and adjusters alike get something out from AI increasing accuracy and lowering costs for claims.

With AI, the customer claimant is “able to tell their story in a very intuitive and contemporary digital experience,” Jones said.

Charlie Wendland, head of claims at Branch Insurance.

Noah Stephens

AI automation frees up adjusters time, according to Charlie Wendland, vice president and head of claims at Branch. “We leverage this technology and our claims experiences to see what rote tests our adjusters are completing on a daily basis that, quite frankly, are bogging them down from spending more time on complex claims or delivering better customer care,” he said. “That first call that claims adjusters will start to make before long will be less about ‘tell us what happened’ to ‘it seems like this happened, do I have that right?’ “