What claims professionals should focus on amid the AI hype

Artificial intelligence is one of the most discussed subjects in insurance, yet much of this talk remains vague. 

The question is no longer whether AI will change claims handling, but rather where its impact will be greatest, and which problems it actually solves.

As customer expectations keep rising, quicker, more transparent claims journeys will matter more, not less.

John Bissell, Chartered Institute of Loss Adjusters

AI is too often treated as a single technology. In claims, its influence is better understood through four distinct lenses: the claims professional, the claims process, the policyholder, and predictive capability.

The claims professional

Much of the debate concerns whether AI will replace claims handlers and loss adjusters. It will not, but it will no doubt be a useful tool to augment and improve aspects of the role. 

Administrative and repetitive tasks such drafting reports, extracting information from documents, or organising large volumes of data, are obvious candidates for automation. 

Many firms already use data-extraction and analytical tools to process information that once required hours of manual work. This speeds up the process and frees claims professionals to spend more time on technical judgment, communication and decision-making.

Claims process 

Insurance claims remain a fragmented business. 

Information passes between policyholders, insurers, adjusters, contractors and other specialists, with decisions made at multiple points – each one a potential source of delay and cost. 

AI offers a chance to simplify this. Better use of data could cut duplication, improve information flow and help parties reach decisions faster. As customer expectations keep rising, quicker, more transparent claims journeys will matter more, not less.

Policyholder

Claimants now have near-instant access to vast amounts of information. Someone affected by flood, fire or theft can get guidance from an AI tool within seconds. 

That creates opportunities and challenges. As in other professions, insurers and claims professionals are already encountering AI-generated information that is inaccurate, incomplete or taken out of context. 

Claims professionals may increasingly find themselves correcting or challenging information their clients have gathered from third-party AI systems. The need for expertise is not disappearing. In some cases, it is becoming more important.

Predictive capability

Insurance has always relied on data to price risk. What is changing is the volume of data available and the speed at which it can be analysed. Loss adjusters sit on a vast reservoir of information about cause, effect and emerging risk. 

Sharper analytical tools could help the profession spot patterns earlier, improve surge planning, and give insurers and underwriters better insight. The more effectively that information is captured and analysed, the better the outcomes for insurers, brokers and policyholders alike.

None of this diminishes the human element. If anything, the opposite is true. As routine work becomes automated, professional judgement becomes more valuable. 

Large and complex losses still demand communication, empathy, negotiation and technical skill - and increasingly, the coordination of several disciplines at once, from engineers and forensic accountants to cyber specialists and lawyers.

Technology may change how claims are handled. It will not remove the need for people who can be trusted to handle them. This is where bodies such as Chartered Institute of Loss Adjusters have a role to play. 

Building the technology is one thing, but using it in a way that supports trust in the profession, and the insurance process more broadly, is another.

The industry would do well to spend less time debating artificial intelligence in the abstract and more time identifying the specific problems it can solve. The real opportunity lies in how AI improves outcomes for the people who rely on insurance when it matters most.