Guest Speak Part 3: AI in Claims – Speed to Market with Artificial Intelligence Workflows

Predictability, repetitive task management, and streamlining of events that follow one after the other lend a sense of comfort to the performance of any process. Done over several years and decades, it has become continuous, automated, and predictable, an integral part of everyday life. In the unpredictability of life, this sense of predictability can be reassuring, calming, and comforting.

            Legacy insurers in the insurance domain have for several decades now understood, conceptualized, and defined strategic, planned workflows or series of actions that are created in the organization’s best interests and to make work predictable and defined for everyone concerned. Whether analysts or customers, stakeholders know what to expect and how things will unfold because of the strategic processes put into place over performing the same tasks several times over the years. Any chinks or hiccups have been ironed out, gaps addressed, and eventualities prepared for. This workflow creation also ensures that insurers are safeguarded against vulnerable and unpredictable situations in the face of the changing dynamics of economies, volatile extraneous factors, and innovations sweeping into everyday life. Whether the wildfire disasters are rampaging across our country or the rash of new technologies in the automotive sector, the basic workflow of managing and overseeing the claims process, for example, has remained unchanged across the board through the decades. This workflow process isn’t just for one type of insurance line but covers many different areas, from straightforward claims to complex professional indemnity claims. The steps might be similar, although treatment and work in every workflow varies.

The advent of AI into this predictable workflow in the insurance domain transforms the long, drawn-out claims process, reshaping the claims management landscape. As the factors impacting the insurance domain become more complex, AI is bringing in the crucial streamlining of processes, enhancing every stage for everyone concerned. With AI’s intervention beginning at the initial FNOL (First Notice of Loss) when a claim is reported to raise alerts and assess risks during progress, workflows are simplified. Predictive analytics that examines current claims against historical claims data utilizing Large Language Models (LLMs) to detect patterns are signaling potential frauds and cases of litigation; AI is subtly but undoubtedly impacting the claims workflow management at every step by analyzing datasets, identifying irregularities while ensuring integrity and ethical monitoring of the insurance ecosystem.