Artificial intelligence (AI) and insurance is one of the industry’s most talked about topics. One key area where AI is being deployed is in the claims process. However, a challenge for insurers and brokers is how to manage and resolve customers’ claims using this technology but without compromising the human connection.
A panel of speakers at the recent Claims Leaders Summit in Sydney addressed this issue and lifted the lid on how their insurance firms are using AI.
Abhi Bhola (main picture, left side) said his AI is fundamentally about being able “to elevate people to deliver the experience.”
Bhola is vice president of growth across APAC for insurance technology company EXL. He said across the industry, skilled claims assessors spend a lot of time on mundane tasks “which are not value adding.”
“The way AI is coming in, and this is one of the principal areas that we are seeing, is taking that administration away, so that the person can focus on interaction with the customer,” he said.
The firm now operates on one system, he said, instead of the three it used a few years ago. Gow said this system is both front end and back end and brokers see exactly the same information as his firm’s claims processors.
He explained one way AI is deployed on this new set-up. “We now use AI to give our claim staff and brokers access to immediate information,” said Gow. For example, he said brokers can now get a summary of their customer’s claim up until the last action.
Another AI improvement, said Gow, can send claims updates to customers, detailing any claim progress since they were last contacted by the insurer. He described this as “a godsend” after the recent ex-Tropical Cyclone Alfred because, during that busy time, it freed up staff to do more value adding tasks.
Mary Magallanes said her firm refers to AI as augmented intelligence as a way of making their AI adoption more appealing to staff. Magallanes is general manager of claims management at MLC Life Insurance.
“We're very deliberate about that because it's part of taking your people on the journey,” she said. “You can have the best processes, technology and procedures in the world, but if you don't have an engaged workforce that truly believes in what you do it's not going to deliver the outcomes that you're after.”
For her, one important focus is “to remove any assumptions that AI is here to replace their jobs, because that couldn't be further from the truth.”
Much like Gow and Bhola, she said her firm uses AI to augment the ability of staff to offer consistent service.
“We use it very much to speed up the claims process to get to point of a decision - but all our decisions are human-led,” said Magallanes.
One reason why AI won’t replace humans, she suggested, is that a claims process will always need the human element. She gave the theoretical example of a claim being rejected – that’s a situation where human empathy is needed, she said, and AI won’t be enough.
She said one AI system they’ve deployed is robotic process automation which takes care of simple, repetitive tasks. One of those tasks is claims payments.
“We've implemented a number of bots where we can schedule payments ahead of time,” said Magallanes “They're raised, paid on that particular date and authorised - so we don't actually need a human to do any of that.”
However, she stressed that there is considerable human oversight and embedded checks and balances.
Her firm has also deployed a speech analytics AI system. “This is an artificial intelligence platform that sits and listens to the call, the language used, the responses provided and determines, based on a customised approach that's fit for purpose, how satisfied that customer was at the end of a call,” said Magallanes. “You'd be amazed with the insights that you gain.”
One surprising insight, she said, was the realisation that her firm had received 1,400 phone calls requesting updates by email. “There was clearly a disconnect somewhere in the process because I know I'd much rather have my staff on the phone having meaningful conversations with customers, trying to understand their unique circumstances and how we can support them in their recovery, as opposed to being held up trying to update email addresses,” said Magallanes.
One important difference about AI driven technology compared to previous tech, she said, is its ongoing appetite for more data. This requires, said Magallanes, a mindset and cultural shift at a firm.
She gave the example of an AI system that predicts the duration of a claims process.
“But that's a model that we're constantly feeding information into,” she said. “It's constantly learning and constantly evolving.”
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