Artificial intelligence is increasingly becoming part of the claims journey, helping insurers and loss adjusters triage losses, review documents, identify potential fraud and process information far more quickly than traditional methods. As firms continue investing in automation, however, the focus is shifting from replacing people to using technology where it delivers the greatest value.
Paul Lofkin (pictured), president of UK & Ireland at Crawford & Company, said AI is delivering the biggest benefits in areas involving large volumes of information, repetitive processes and the need for speed.
"We are seeing strong potential in claims intake, triage, document processing, fraud detection, cover support and decision support, where AI can rapidly analyse data, identify patterns and help claims professionals focus their attention where it will have the greatest impact."
Rather than simply automating routine tasks, AI is increasingly being used to surface information earlier in the claims process, allowing handlers to make faster and better-informed decisions.
"The biggest benefit is not simply that AI can automate tasks. It is that AI can give claims professionals earlier insight and better information, which supports faster claims handling, improved consistency and more proactive intervention."
Those efficiencies also free claims professionals to spend less time on administration and more time on complex problem-solving, customer communication and strategic claims management.
While AI is becoming increasingly capable, the industry continues to draw a distinction between routine claims processes and the decisions that require experience, judgement and empathy.
"Claims are ultimately about people, trust and relationships, and there will always be parts of the process that require human judgement, technical expertise and empathy."
Complex coverage issues, liability determinations, catastrophic claims, disputed matters, negotiations and emotionally difficult customer situations all require context, experience and the ability to interpret nuance. Those are areas where Lofkin believes technology should support professionals rather than replace them.
"As AI becomes more capable, the role of the claims professional will evolve rather than disappear. We see claims professionals increasingly acting as strategic decision-makers who use AI-generated insights while retaining accountability for quality, fairness and outcomes."
As insurers expand automation across the claims journey, Lofkin said firms should resist treating AI primarily as a cost-reduction exercise.
"Insurers should be careful not to view automation solely as a cost-reduction exercise. The most effective uses of AI are those that improve both efficiency and outcomes."
He warned that organisations focused only on removing human involvement risk creating friction in the claims journey, reducing trust and overlooking details that can ultimately affect claims quality and customer experience.
Instead, he argued, automation should be introduced alongside appropriate oversight, transparency and governance, with technology handling routine work while experienced professionals remain responsible for cases requiring judgement, empathy and technical expertise.
"The organisations that succeed will be those that use AI to enhance human expertise, not replace it."
Lofkin said AI will increasingly take on routine tasks such as claims intake, triage and document review, allowing claims professionals to focus on judgement, negotiation and supporting customers through more complex situations.
For the industry, the challenge is no longer simply adopting AI, but understanding where automation adds the greatest value and where human judgement remains indispensable.
