Insurance
For resilient, customer-first carriers. Accelerate FNOL to payout, reduce leakage, and deliver proactive service across P&C, life, and health.
Auto
Health
Property
Automation
Claims
Growth
Industry Overview & Outlook
Mid-sized carriers are modernizing the policy and claims lifecycle. AI turns messy documents, photos, and notes into decisions—faster, fairer, and explainable.
In the next 3–5 years, expect straight-through processing (STP) expansion, low-severity automation, and GenAI copilots across underwriting, claims, and service.
Margin Pressure
Loss cost inflation and CAT volatility squeeze combined ratios; L&R must fall.CX Expectation
Policyholders want instant FNOL, transparent status, and fair, fast outcomes.AI Opportunity
Document AI, vision models, copilots, and analytics reduce leakage, risk, and fraud.Key Stats
$7T+
Global premiums (’24)6–8%
Claims inflation (’24–’25)40–60%
Low-severity STP by ’2715–25%
LAE reduction with AI25–35%
Faster cycle time10–15pts
CSAT/NPS upliftKey Trends
Straight-Through Processing
STP for low-severity claims and endorsements using rules + ML.GenAI Claims Assist
Copilots draft summaries, next steps, and compliant outreach.Fraud & Leakage Control
Anomaly detection, link analysis, and subrogation opportunities.Telematics & UBI
Behavioral data improves pricing fairness and retention.Explainable Compliance
Audit-ready notes and model justifications.Parametric & CAT Analytics
Event, IoT, and satellite data enable faster, rules-based payouts and surge planning.CX Challenges in Insurance
Slow FNOL & Adjudication
Manual intake and evidence collection extend cycle time.High Loss Adjustment Expense
Fragmented tools and escalations raise LAE.Fraud & Leakage
Skilled data and networks miss fraud patterns and recoveries.Legacy Silos
Policy, billing, and claims systems slow change and migration.Regulatory Burden
Extensive capture and reporting consume adjuster capacity.CAT Surge Readiness
Sudden spikes overwhelm teams and degrade outcomes.AI Solutions for Insurance
AI FNOL & Smart Triage
Maps to: Slow FNOL
Automate intake, classify severity, and route to STP or expert review.
Adjuster Copilot
Maps to: High LAE
RAG-powered guidance, compliant notes, and next-best actions.
Fraud & Dispute Intelligence
Maps to: Fraud & Leakage
Graph + anomaly detection flags fraud and recoverables early.
Document & Evidence AI
Maps to: Legacy silos
OCR/Vision extract facts from docs, photos, bills; prefill estimates and notes.
Case Studies
Regional Auto Insurer
Challenge: Long cycle times and rising leakage in auto PD claims.
AI Solution: FNOL chatbot + photo triage + adjuster copilot with guided estimates.
-29%
Cycle time-17%
Leakage+7pts
CSATMulti-State Health Plan
Challenge: Prior authorization backlogs and member abrasion.
AI Solution: Document AI for clinical notes + compliance copilot for determinations and appeals.
-38%
PA turnaround+10pts
Member NPS-16%
Admin cost