AI in Insurance Claims

AI is playing an increasingly important role in insurance, and claims is no exception to the trend. As part of an Innosuisse-funded innovation cheque, we review the current status and potential future development of AI in claims. Focus of the analysis is the point of view of Swiss InsurTech companies. Because InsurTechs combine technology and insurance expertise with their future-oriented underlying motivation, we believe they can provide interesting insights for the industry. The project was conducted in close collaboration with the Swiss InsurTech Hub.

Maturity vs. future impact

The methodology reviews academic papers and trade publications for the last two years to extract a view of the current state of maturity of AI tools. This analysis is broken down by element in the claims value chain. The maturity estimate was provided by subjective opinion of project experts. In the spirit of the topic, AI tools were also engaged to provide a first iteration of the maturity assessment. Against this baseline, we conducted a survey of 40 Swiss InsurTech companies active in artificial intelligence and claims to understand their aggregate view of the future impact of AI. This analysis is again structured by element of the value chain. The picture combines the two dimension for comparison and analysis.

First Notice of Loss and Adjusting are high priority

Three areas appear to be particularly interesting for future analysis and transformation of the industry in the near future. While already in the scaling phase of maturity, both First Notice of Loss and Adjusting appear poised for a significant impact from AI. Not shown in the graphic, but particularly interesting for AI applications, are the assignment and coverage verification for new claims. The evaluation of damage and claims valuation are particularly interesting for claims adjusting.

Provider Management with high potential

In addition, provider management seem to be an area of high potential impact and low maturity of current solutions. Given the important role of provider networks in provide in-depth technical expertise, geographic coverage, and professional customer interaction, this area seems to be critical for future AI implementation projects. In this area, especially real-time performance monitoring seems of critical importance.