AI
A recent survey by Gallagher Bassett , featured in “ The Carrier Perspective : 2024 Claims Insights ” report , indicates that 83 % of UK insurers have either implemented or are in the process of implementing AI chatbots or generative AI to enhance claims resolution .
Greg Cole , Head of Claims at AND-E UK , provides insight : “ With the right generative AI ( Gen AI ) capability , virtual agents can respond to customers in a natural and conversational manner , while delivering precise answers whenever they need them . AND-E UK has seen 36 % of calls successfully directed to virtual agents , freeing up human agents to deal with the more complex customer needs .
“ When combined with live voice transcription , AI can listen and provide handlers with answers and next best action recommendations in conversations with customers . This ensures that handlers have the information they need to provide timely and accurate support , directly contributing to positive customer outcomes as mandated by the Consumer Duty .”
AI algorithms are being employed to detect fraudulent claims with unprecedented accuracy . A recent study by The Coalition Against Insurance Fraud ( CAIF ) indicates that insurance fraud can cost US consumers US $ 308.6bn yearly . That amount includes estimates of annual fraud costs across several liability areas , including life insurance ( US $ 74.7bn ), property and casualty ( US $ 45bn ), workers compensation ( US $ 34bn ) and auto theft ( US $ 7.4bn ).
Alan adds : “ Full automation of fraud detection is unrealistic in the short-term .
“AI revolutionises risk assessment and underwriting by analysing vast data sets ”
DANIEL COLE SENIOR MANAGING DIRECTOR , FINANCIAL SERVICES AND INSURANCE PRACTICE , PUBLICIS SAPIENT
It needs the right mix of human skills , data and technology . Digital forensic tools using AI can be used to identify pixel and image manipulation , even spotting fake images created by Gen AI .
“ The future of fraud detection will therefore continue to rely on the ‘ gut feel ’ of an experienced claims professional but there will be more and more tools ( especially AI and generative AI ) so that those current basic rules are not as restrictive and become more flexible depending on the type of claim .”
Daniel adds : “ AI is pivotal in detecting and preventing insurance fraud by leveraging advanced analytics and machine learning . It identifies patterns and anomalies in vast amounts of claims data , flagging suspicious activities for further investigation . Behavioural analysis compares current claims against historical behaviours to spot inconsistencies , while predictive modelling assesses risk factors to prioritise high-risk cases .”
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