Augmenting and Improving Claims Management with AI

Global insurance leaders are challenged with increasing margin pressure and declining operational efficiency as a result of:

1. Premiums starting to stabilize. However, costs continue to increase (affecting combined ratios and incurring significant underwriting losses)
2. All major economies are now either in or entering a recession - driving up inflation and interest rates, affecting consumer and business price sensitivity
3. Ongoing talent challenges - fewer people demanding higher salaries.

According to our research, claims leakage as a direct result of inefficiency, errors and rework can account for up to 6% of total claim payments, leaving a significant opportunity for improvement.

Artificial Intelligence (AI) is rapidly becoming a key technology to improve quality, consistency and speed of claims processing AND that provides a critical solution for automating processes that deal with unstructured data.. 

While we have witnessed an explosion of excitement around AI following OpenAi’s launch of ChatGPT, these tools also have the power to introduce significant reputational, commercial, and operational risk if used carelessly.

In our most recent webinar, Augmenting Claims Management with AI, we discussed the reasons why the insurance industry is ripe for AI and Automation, what the ideal claims management operation should be, showcase how our Digital Coworkers are using Large Language Models (LLM) and offer considerations for adopting and deploying AI in the enterprise.

Key panelists in this webinar were:

• Andrea Buhl, President - Managed Care, Sedgwick
• Kenneth Saldanha, Senior Managing Director, Accenture
• Chaz Perera, CEO & Co-founder, Roots Automation

Click below to watch the webinar.

‍

Setting the Scene

Many culminating forces are now driving margin pressure for all players across the Insurance space. 

‍

First, many insurers have increased their rates to account for increased operating costs. Across the top 10 insurers, we are seeing roughly 8 - 10% rate hikes (depending on the product line). And while premiums are increasing (or beginning to stabilize), operating costs continue to rise – reducing overall operating income (which went down from $59bn in 2019 to $43bn in 2022). 

Our analysis found that further margin erosion occurs from inefficient claims management processes (Claims Leakage) - which can be as high as 6% of total claim payments. This represents around $67B margin erosion for US insurers annually.

Additionally, Verisk and the American P&C Insurance Association have just published a new report that found that

the P&C industry experienced a $26.9 billion net underwriting loss in 2022, more than six times the $3.8 billion underwriting loss in 2021. The underwriting loss was the largest the industry has seen since 2011.

‍

The Second driving force is that all major economies are now either in or entering a recession.

The ‘Great Recession’ as it’s being dubbed is compounded by the overhang of Covid PLUS the ongoing Russia / Ukraine conflict.  These forces are hitting consumer and business bank accounts, increasing sensitivity around the speed at which claims are paid out (i.e. claims efficiency) and then the overall cost of an insurance policy

While customers aggressively shop around for better deals and for products that offer innovative commercial options, more personalized to their needs, businesses are forced to look toward alternative solutions to improve working capital and operating margins.

‍

Finally, the talent crisis that has been looming over the insurance industry for the past 10 years has finally reached its peak. During a previous webinar around the current Talent Crisis in Insurance, PwC advised that

the average age of an insurance employee is 43 to 45 years old, among agents, underwriters, and claims adjusters.

In addition, 55% of Financial Services executives cite acquiring new talent and retaining the existing talent as the biggest risk for companies achieving their 2022 profit goals. Due to this, there is an opportunity for insurers to improve their claims management.

‍

These significant pressures are forcing business leaders to reimagine key aspects of their core operations, with claims management being an area ripe for augmentation with tools such as automation and AI.

And so, the webinar focussed on the role of these technologies in augmenting and improving claims management.

‍

Check out the webinar to learn more