An insightful webinar shared real-world observations of successes and challenges in automating claims handling.

The Insurance News webinar, sponsored by Guidewire, addressed the importance of organisational change, data quality and keeping sight of what customers value when automating.

The evolving nature of claims adjusting and AI use in fraud were also discussed.

Expert speakers were Guidewire’s US-based industry advisory lead for claims Michael Anderson and Sydney-based ANZ business consulting director Adrian Lewis. The discussion was moderated by Insurance News senior journalist Miranda Maxwell.

Mr Anderson told attendees automation is a priority for insurers “whether I am in Tokyo, London, Paris or New York”.

Some organisations already have half of claims fully automated, while others are still prioritising which types to automate and are sorting data.

“Organisations tend to misjudge the complexity of it. It’s not easy ... It’s change in their fundamental operating model to be a digital-first claim organisation. When you approach it that way, you’re going to be much more successful,” Mr Anderson said.

“There’s a lot to it, and I think the organisations that start with, ‘We’re going to do 60% in 18 months’ – that’s a lofty ambition that I haven’t seen achieved.”

Mr Anderson says claims staff are “what make our industry” and automation will help streamline communication and “reshape the industry such that we can deliver better value. I’m pretty excited in the things I see customers doing ... just some incredible innovation that I think the ‘fast followers’ are watching, and they’re going to try to emulate things that work well.”

Mr Lewis says a decision-making framework is an essential part of claims automation.

“If you cannot easily, quickly and consistently explain decisions made through automation, and you can’t reproduce that easily across your organisation, then that’s your first red flag.”

High-impact decisions, claim denials and care for vulnerable customers should not routinely be fully automated, Mr Lewis says.

“Some of that is your secret sauce as an insurer – where you say, ‘These are the decisions I will never automate.’ You want to be talking to someone and explaining.”

Mr Lewis says Guidewire’s insurer customers are “flipping the script” on the hierarchy of technology. “We all talk about a human in the loop. Actually, the human is still our biggest asset – it’s AI and automation in the loop.”

If you missed this informative discussion, the 45-minute webinar is available here.