Blog Information

• Posté par : john holmes
• Posté sur : May 14, 2025
• Vues 6
• Catégorie : Général
• La description : You walk into your regular neighborhood diner. The server greets you by name, remembers your usual order, and asks how your family is doing. Now imagine that same place turned into a self-service kiosk with robotic servers. The service might be quicker, but the warmth and familiarity? Gone.
• Emplacement : USA

Aperçu

• That’s the same kind of shift happening in insurance today. With AI and automation rapidly transforming how automated claims processing are processed, insurers are under pressure to keep up. But in the race toward efficiency, there's one thing they can’t afford to lose: the human touch. Because when people file claims, what they really remember isn’t just speed—it’s how they were treated.

  The Tech Paradox: More Spending, Less Satisfaction

  Over the past few years, insurers have invested more than $8 billion in digital tools to improve the claims experience. But despite the spending, customer satisfaction is falling. According to J.D. Power, claims satisfaction is now at a seven-year low.

  The reason? While digital platforms help speed things up, they often miss what really matters to customers during a claim: empathy, clear communication, and personal support.

  Claims: The Industry’s Biggest Expense

  For property and casualty insurers, claims aren’t just one cost—they’re the cost. About 70% of premium revenue goes directly to paying out and managing claims. That number hasn't changed much, and it puts intense pressure on insurers to operate more efficiently.

  That’s where automated claims processing offers value—but only if it’s balanced with personal service.

  Why Data Quality Matters More Than Ever

  AI and automation rely on accurate data. And if that data is flawed, the whole system can falter. A study from MIT Sloan found that bad data can cost companies between 15% and 25% of their annual revenue. For a $10 billion insurer, that’s up to $2.5 billion lost every year.

  Poor data doesn’t just hurt the bottom line—it leads to bad decisions, pricing errors, and frustrated customers. Without standardized processes for handling and reporting claims, even the best teams are flying blind.

  Your Claims Experience Is Your Reputation

  Customers are paying close attention. In fact, 44% of U.S. consumers research how insurers handle claims before they even buy a policy, according to Deloitte. So if your claims process isn’t meeting expectations, it’s not just a service problem—it’s a sales problem.

  The takeaway? Reputation is built on real experiences, and those experiences are shaped by more than just apps and chatbots.

  Will AI Replace Claims Professionals?

  It’s a common question—and the short answer is no. AI is transforming roles, not eliminating them. It’s handling the repetitive tasks—like document collection or routine claims—so people can focus on the more complex, emotional, or high-stakes situations.

  That shift gives automated claims processing the chance to step into more meaningful work: analyzing risk, preventing fraud, advising customers, and guiding them through some of life’s most difficult moments.

  What the New Role Looks Like

  So, what does this evolution mean on the ground? Professionals might now spend less time on paperwork and more time helping customers understand coverage, resolving tricky disputes, or partnering with underwriting teams to improve policies.

  This isn’t about doing less—it’s about doing more of what matters.

  The Human Touch Is Still the Difference

  Automation helps. It reduces delays, cuts costs, and streamlines operations. But when disaster strikes—when someone’s home floods, or their family is injured—they want more than just speed. They want someone who understands what they’re going through.

  As one Chief Claims Officer put it: “Automation is great for saving time, but when problems arise, real human interaction is still essential.”

  Take catastrophe response teams. In the aftermath of hurricanes or wildfires, no drone or bot can replace the comfort of a person showing up, offering help, and walking someone through their next steps.

  Real-World Examples: Where People Matter Most

  • Aviva’s Personal Touch: Aviva uses a “double helix” approach, blending automation with human support. For cases like personal injury, they lean on real people to deliver empathy and guidance—because that’s what those moments call for.

  • Serving High-Value Clients: At Criterion, a Charles Taylor company, managing complex claims for wealthy clients means more than technical skill. It’s about managing expectations, maintaining strong communication, and ensuring clients feel respected and heard.

  • Avoiding Legal Escalation: Attorney Patrick J. Sodoro warns that when claims professionals don’t connect with claimants, miscommunication increases—and so does litigation. A simple conversation can often resolve issues before they become court cases.

  Final Thought: People First, Always

  AI and automation are reshaping the insurance world. They’re making claims faster and more consistent. But they’ll never replace the human ability to connect, understand, and care.

  The future isn’t about choosing between people and technology. It’s about using technology to give people more time to do what they do best: serve customers with empathy and expertise.

  Because while customers may forget how fast their claim was processed, they’ll never forget how they were treated.