What can the claims function gain from artificial intelligence (AI)? Plenty. From machine learning to natural language processing, AI can help claims leaders strengthen the customer relationship.

Responsible for the moment of truth in the customer-insurer relationship, the claims function has much to gain from AI. For example:

  • AI can help insurers triage claims more quickly and effectively. It can also help identify complex or severe claims early—again, so that claims can be triaged to the most qualified adjuster.
  • Rules-based processes are good candidates for automation through AI. This may pertain to a single process within the overall claims purview, or entire processes. Many property and casualty insurers already auto-process small-ticket property claims without human intervention.
  • AI can identify next-best actions to assist adjusters, especially junior adjusters. Especially as the claims workforce ages and retires, AI can be a valuable tool to transfer knowledge to newer workers.

By layering these capabilities on top of each other, insurers can enable better outcomes, faster service and a better customer experience. Crucially, by using AI, claims leaders can empower and equip adjusters to add the valuable human touch to the claims process. However, that also means retraining and educating workers so they are equipped for new roles in which customer service is paramount.

 AI, chatbots and the customer experience

As outlined in the Accenture Technology Vision for Insurance 2017 report, AI isn’t just relegated to back-office functions. In Japan, Fukoku Mutual Life Insurance uses AI to calculate claims payouts, and to classify diseases, injuries and procedures. When policyholders file claims by telephone, the system analyzes the customer’s voice and detects keywords.

And peer-to-peer insurer Lemonade made headlines with its AI capabilities that settled a claim in 3 seconds—over a customer’s mobile phone, no less. (Lemonade reportedly ran 18 anti-fraud algorithms on that claim, though it hasn’t provided specifics.) While some analysts have expressed concern with the long-term ramifications of such touchless processing, it’s hard to argue with the customer experience that Lemonade provided—responsive, on-demand and delightful.

AI is the new UI: Action items

Certainly, implementing AI is an IT project—but it also requires changes to business processes and infrastructure, and strong leadership. Claims leaders must also ensure that adjusters are empowered by the introduction of AI. Reskilling and training may be required to shift adjusters in tactical positions to adopt more customer-facing, problem-solving roles.

To learn more about Accenture Technology Vision for Insurance 2017 and the era of the intelligent insurer and our 100- and 365-day plans to help insurers capture the opportunities of AI. If you’d like to discuss how Accenture can help insurers use AI to streamline the claims function, please email me.

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