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1 Feb 2021

5 things you need to know when integrating AI into your claims environment

By: Jimmy Spears, MAL, MSPM, AIC, AAM, AIS

In my 30 years of experience in the industry, I have seen several great advances in claims processing, but nothing as exciting as AI. 

The benefits of applying AI can be transformational for an insurance provider, not only when it comes to cost control and claims acceleration, but also in providing an exceptional customer experience. 

Several players are promoting AI technologies now — whether it’s for auto or property, underwriting or claims – which means it’s important for claims professionals to be able to see past the AI buzzwords, and evaluate the impact of solutions against solid criteria. 

According to MIT Technology Review, 40% of AI companies don’t actually have operational AI to apply. As a result, it can be challenging to see which provider actually has a functioning solution, versus one that aspires to do the work in time. 

Here’s my recommendations of what to look for when evaluating an AI platform for claims processing – is the AI making predictions that drive business value or are they just nice to haves?


When the AI processes photos it has never seen before, does it make accurate predictions? 

An effective AI system can provide a recommendation in real time on a photo it’s never seen before. A quick way to weed out potential providers is to ask for a real-life demo and submit your own pictures. Grab random pictures from Google or from your own historical claims to really test the water. Did the AI accept the image? How long did it take to process? What was the confidence of their recommendation? And most importantly, is the vendor comfortable with the approach or coming up with an excuse to dodge this particular exercise? These results will separate a seasoned AI platform from ones that are closer to beta. 

How accurate are the results against my existing data? Now that you have seen if the AI works – you have to grade it against your historical figures. Ask for a calibration period where you send past photos from your own operations and ask for the AI’s recommendations. Use this as a “report card” to grade the accuracy of their technology. 

Do you have an open platform in which to deploy your AI? An open platform is more advantageous now and in the future. This allows for flexibility and will make scaling easy by adding, upgrading or swapping in the best vendors and their software for your organization. An open ecosystem also helps in reducing cost by avoiding vendor lock-in and increasing competition to get the best technology out there. The ability to integrate this technology with your existing tech stack and processes will enable each system to “speak” to each other and give a greater picture of your claims operations. Examples of open claims platforms include Mitchell, Guidewire and Duck Creek. If your Claims Management System is home-grown, it is also an open platform. 

Will it be adopted by the end-user? While the concept of AI can sound complex and daunting to the person on the ground, a good platform will help their day-to-day so they can see the value that will enable them to focus on other duties and be much more efficient. A good AI provider should have ease of use, with a seamless implementation process across regions. 

How will my customers benefit? The process of submitting a claim is already a stressful ordeal for your policyholders – not including the possibility of being without a car for weeks, or even months. A core KPI when evaluating an AI solution is, ‘how soon can my customer submit a claim? Be sure to ask how their AI can benefit the customer experience. The concept of generating an instant claim shouldn’t be far-fetched – insurers are already doing it. 

Want to know how our AI can help you accelerate auto claims? Contact us for a demo.

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