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How the application of artificial intelligence is affecting claims professionals

Artificial Intelligence (AI) and its capabilities has improved leaps and bounds since its initial conception in the early to mid-1900s. As the technology continues to progress, so then does its integration into many industries—including insurance and insurance claims.

What is Artificial Intelligence?

Artificial Intelligence is a concept involving a machine’s ability to replicate some human cognitive processes. AI tasks might include:

  • Analyzing data
  • Solving problems
  • Answering questions
  • Making decisions

Essentially, Artificial Intelligence now has the capability to do a lot of work previously done only by people. This new reality affects everyone—individuals, companies, and industries, but some more than others.

Artificial Intelligence and the Claims Industry

Over the years, the advances made in the world of Artificial Intelligence have created major business development opportunities for insurance agencies. The advances in AI computing power, memory capacity and cloud capabilities now allow machines to accomplish more than people can—and at a faster pace at that.

Insurance companies, being notoriously behind the times when it comes to leveraging new technologies, are now beginning to understand the extent of AI capabilities and, in turn, are realizing the potential for those technologies—and what aspects of the industry might be influenced.

AI and Client Risk Analysis

Experts say that Artificial Intelligence has the potential to vastly alter the landscape of risk analysis—or underwriting—in the insurance industry. AI technology now has the ability to use external data to develop risk assessments for potential clients. Rather than insurance underwriting being about fixing damage already done, with Artificial Intelligence it is becoming about preventing that damage altogether.

Customer Service

As a younger generation moves into adulthood, the client demographics for many businesses are changing. The fact is, younger generations are accustomed to the instant gratification that comes with their higher online presence. This means their customer service expectations are higher. Organizations can now leverage AI to answer questions and solve problems more rapidly than a traditional human-to-human interaction.Faster customer service means higher customer satisfaction which is a win for any business.

With this in mind, Insurers are investing in virtual assistants, called chatbots. Chatbots are a digital service that can hold a normal-sounding conversation with human beings in order to do things such as: answering questions, giving advice, checking billing information, etc.

Insurance AI and Big Data

In marketing the idea (and sometimes the use) of big data is commonplace. Big data essentially means leveraging customer data to market the right information to the right people. Artificial Intelligence is making it possible for this to be done with little to no actual work because it has the ability to identify data trends in order to appeal to a certain audience. Similarly, insurance providers can leverage AI and Big Data to market certain products or packages to very specific groups of people based on their specific needs, demographics and more.

Fraud Detection

Machine learning is a concept most of us have heard. It’s the use of Artificial Intelligence coupled with big data that allows a machine (computer algorithm) to learn and improve upon the data it consumes. This concept is particularly useful when it comes to fraud detection in the insurance industry. Machines now have the ability to notice patterns in data. Similarly, they have the ability to notice deviations from those patterns which makes fraud detection and fraud reduction much more feasible.

Humans (not AI) at US Claims Solutions

Nothing can ever replace the need to have an adjuster assesses and validate a claim. While we believe in the advancements being made in Machine Learning and Artificial Intelligence, we highly value the human-to-human interactions with our clients.

Founder and president of US Claims Solutions, Greg Church, has worked in the claims industry for over 30 years. He and his team are constantly working towards cultivating a more efficient workplace—one which will benefit both employees and customers.

Our team of highly qualified individuals would love to help you in any way we can. We are available for questions 24 hours a day, 7 days a week. Email us at or give us a call at (888) 701-1153. You can also visit our website at for more information on what we do!

Written by Greg Church

President, US Claim Solutions

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