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Role of AI in Insurance Claims Transformation

By: Eicore Technologies | Thursday, 16 September 2021

The new-age insurance sector is highly focused on bringing seamless technological transformation to facilitate ease of management. Moreover, since the whole world is inclining towards active digitalisation, it has become crucial for insurance companies to step forward while aligning with the emerging transforming trends.

Now, compared to all areas of the insurance industry, claim management is of utmost importance for all insurers. Since claims cost about 80% of the premium income, insurance companies need to roll up their sleeves to delve into proper claim management to reduce loss adjustment expenses and enhance user experience. This is where newer digital technologies like artificial intelligence can cause a huge transformation in claim management. Are you wondering how? Well, here is what you need to know about it.

AnchorAdds better flow to the claim management outcome

Digitalisation is getting fuelled by the integration of artificial intelligence in insurance claim management. AI has an impeccable potential of allowing insurers to use historical data and algorithms to obtain accurate future predictions of the claim benefit.

AI integrates deep learning and machine learning algorithms to make insurance companies easily analyse the patterns and anomalies in claim processing, which, in turn, aids their decision-making process. Moreover, due to the implementation of AI in the insurance sector, insurers can visualise customer interaction patterns related to claims and improve their service accordingly to enhance user experience.

AnchorDelivers better interaction capabilities

Nowadays, customers are very particular about the ease of their interaction with insurance companies. Hence, they look for more personalised assistance than a standardised one, especially during claim processing. Nevertheless, it is pretty challenging for humans to deal with personalised services for every individual customer. So, this is where AI comes into the roleplay.

With AI integrated chatbots, insurers get the benefit of seamless interaction with customers for automatic acceptance of claims. Also, through these systems, insurance companies can effortlessly ask a few queries about the existing claims of the customers in a FAQ style. Thus, in this way, AI systems can reduce the claim management workload of insurers, improving their accuracy and efficiency in dealing with customers for quick claim processing.

AnchorHelps to detect dubious claims

With the utilisation of AI, insurance firms can seamlessly work on detecting dubious claims. While insurers need to sort out claims in the least possible time, it is also crucial to remove dubious claims. In most cases, a cumbersome manual verification of claim documents and other related information is necessary for claim sanction. But the process hikes the operational cost of insurance firms and increase the overall claim processing time.

So, with AI, the end-to-end claim process gets a better pace and high accuracy. Starting from data extraction, settlement initiation to claim approval, and payment and recovery tracking, AI-based systems do them all. As a result, it leverages claim processing speed and serves high accuracy for the entire operation.

AnchorOffers the advantage of data analytics

Most insurance companies deal with a large volume of data, which needs to be continuously tracked and analysed to deliver better outcomes. Thus, insurers must have robust and efficient IT and analytics capabilities to extract the necessary data quickly and facilitate improved claim processing experience to customers. But human involvement may delay the process and also cause errors in the results.

So, with the inclusion of AI and automation, human intervention can be significantly reduced. In addition, it facilitates cutting-edge data analytics, helping in better decision-making and delivering top-notch results. At the same time, data analytics-based AI systems can empower insurers to automatically detect claim frauds in real-time, leveraging the growth of the insurance sector.


Similar to many other industries, the insurance sector is also working strategically to integrate AI into its management system. This adoption of AI systems highly benefits claim management processes and help in improving the accuracy of insurance companies in performing related tasks and delivering enhanced user experience.

Written by Eicore Technologies

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