The future of claims: how insurers can use AI to drive better claim outcomes
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The Inside TrackInsurtech

The future of claims: how insurers can use AI to drive better claim outcomes

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Insider Engage caught up with two companies at the 2023 edition of Insurtech Insights Europe to discuss how artificial intelligence implementations can enable insurance companies improve efficiency and help them better serve their customers.

Insurance companies are now more than ever using artificial intelligence (AI) to achieve better claims outcomes; and to create a customer experience that will attract as well as retain customers.

AI insurtech startup Omni:us provides intelligent insurance claims automation solutions and aims to help insurance companies to automate claims processing and reduce costs. “We handle claims from the beginning of the process right until the end where we initiate the final pay out,” says Micko. “We want to make sure that we are able to fully support our clients with our technology, however, if necessary we will also have human input,” says Martin Micko, chief operating officer at Omni:us.

With AI you can identify the characteristics of the claim and align that with indicators that would suggest there may be something fraudulent or something that should be reviewed.
Bill Brower, vice president, industry relations, Solera
Bill Brower -Claims .jpg

According to Micko the insurance industry’s culture has impeded progress in adopting new technology. “Claims management start with culture,” he says. “The industry’s culture influences the strategy they adopt. Twenty years ago insurers believed they could develop everything by themselves versus buying off the shelf.”

“First and foremost insurance companies need to take a decision to move towards new technologies,” explains Micko, however he points outs it’s still hard to shift the mindset of decision makers in the industry.

“Nowadays there is a paradigm change as technology can offer a human customer-centric approach during the claims journey, whereas in the past this was not the case,” explains Micko. “Technology is a game changer but at the same time insurers need to embrace it.”

While consumers are interested in and having more digital-based interactions, consumers still place a lot of trust in interactions with humans.

Accenture’s Global Insurance Consumer Study in 2021 found almost half of consumers (49%) place a lot of trust in a human advisor in an office when making an insurance claim, while 12% say the same of automated service over phone,web and email, and 7% say the same of a chatbot.

“From the surveys we have done we know that more than 50% of customers are interested in using digital but if you layer in the ability to opt out of using digital to provide a safety net that percentage of customers interested in digital rises,” says Brower.

“Insurance companies needs to take a customer friendly approach and technology allows that as the as in the past the customer needed to do a lot of the work or face difficulties if they were filing a claim. For instance, if a customer took out insurance using an app but only needed to make a claim five years down the line, in that time they could have forgotten their password and be locked out of their account. A QR code on an insurance card solves this problem as once you scan it without the need of a password and you immediately gain access.”

According Bill Brower, vice president of industry relations at Solera, a specialist in vehicle lifecycle management also plays a significant role in identifying fraudulent claims, as it does not require insurers to ask their policyholders a list of endless questions.

“With AI you can identify the characteristics of the claim and align that with indicators that would suggest there may be something fraudulent or something that should be reviewed," says Brower. "It's helpful in that space, otherwise you're just asking every customer many questions and with AI that can be done electronically.”

Insurance companies need to embrace technology and look for ways to transform their value proposition and elevate their brand."
Martin Micko, chief operating officer, Omni:us

While technology can improve customer-centricity in the process it can also allow insurance companies to eliminate repetitive tasks and spend their time in other areas, which is more important now than ever as they navigate difficult market conditions.

In Brower's view the insurance industry is facing “the perfect storm.”

“There are three factors that have driven this; the rapid increase of inflation, staffing issues and problems with the supply chain issue as parts are taking longer to get delivered,” he says.

Though technologies such as AI can help process high volumes claims, Micko notes when it comes to complex claims this is better dealt by humans. “AI is able to cognitively understand more complex decision-making. Our company focuses predominantly on low to medium complex claims because that's where the volume is,” he says.

Micko highlights this technology is best used in high volume claims rather than complex claims, as for these type of claims humans can make “better, faster and more customer-centric decisions”.

Despite the insurance industry being slow to adopt new technologies, digital tools such as AI are transforming the global insurance landscape.

“The insurance industry has been slow to change but when adopting new technologies I recommend a test and learn approach where an insurance company can test the new solutions, for instance, across a small part of the business and oversample them for customer feedback before they roll out them out to the entire company. However, many in the insurance industry are accustomed to bringing new things in and putting it in across the whole company."

According to Micko, some of the biggest trends in insurtech are around automated underwriting, the automation and digitization of the sales process and claims automation. “Insurance companies need to embrace technology and look for ways to transform their value proposition and elevate their brand,” he says.

For Brower the most impactful use of AI today is in estimatics and in the future he expects to see more around loss prevention. “In the past we were simply sending pictures but using AI means that a process which would usually take one week can be reduced to only a couple of hours,” he says.

“The more you use it, the more you think about how you could use it in the future. I can imagine there would be an application in loss prevention that monitors where you travel to and from layering in AI around where accidents are happening and where problems could be avoided so you can be directed a different way,” says Brower.