Senior executive with his team discussing data in a conference room. Working as a Team. OneWebGetty2021
LegalDecember 06, 2023

Five takeaways from our panel on how claims professionals are using AI today

One major focus of ELM Amplify 2023 was to present programming that could help our clients in insurance claims departments return home with practical ways to improve operations. Toward this end, we hosted the panel discussion "Revolutionizing Claims and Litigation: AI's Role in Insurance Transformation", which shed light on the burgeoning relationship between AI and claims management.

Our Vincent Venturella moderated the conversation with guest speakers Kevin Schulte, HQ Claims at The Cincinnati Insurance Company, and Jonathan Weber, Vice President - Group Claims at ACE Group. Here are the top five takeaways from this informative conversation:

Litigation and AI are naturally aligned

Claims litigation management processes generate a huge amount of data within claims departments. AI, meanwhile, works best when it has a large amount of data to make use of. This makes AI a natural technology choice for contextualizing, analyzing, and summarizing data – all tasks that can be time-consuming or error-prone for humans.

When claims departments use AI tools to take more rote tasks off the plates of staff members, they declutter team members’ workdays and introduce efficiencies for claims handlers, who are then able to focus on the higher-value work for which their skills are best suited. The natural affinity between claims management and AI presents a promising avenue for insurance companies seeking to streamline processes and enhance efficiency.

AI is already an established technology

AI is making strides in the legal and claims industry, already in use for broad-based applications across these functions. AI is well-suited to nearly instantaneous analysis and conducting general data synthesis and can reveal a great deal of information about claims and trends in various business lines and jurisdictions. Jonathan, for instance, highlighted the efficacy of AI in bill review processes, emphasizing its ability to enhance human performance and identify patterns more effectively.

The efficiency increases inherent in the use of AI technology improve straight-through processing of claims. When claims teams can get claims processed and paid quickly, it produces a better experience for clients and increases staff efficiency by not using staff members’ time on small claims that would have been paid even with their input.

Generative AI can further increase efficiency

Generative AI (GenAI) has been a hot topic across industries since early 2023. While claims litigation is not an area that has taken the spotlight in these discussions, our presenters see significant potential for it in the insurance claims function. As they see it, the likely impact will not be on the tasks that claims professionals are responsible for but on how they accomplish those tasks.

Microsoft has already announced generative AI features for the MS Office suite, while Wolters Kluwer is currently evaluating the best uses of GenAI for our TyMetrix® 360° and Passport® platforms. As tools like these integrate GenAI more commonly, claims staff members are likely to see growing opportunities to leverage it in creating meeting notes, draft proposals, and other relatively straightforward output.

AI can streamline and improve the bill review process

The discussion extended to how AI, particularly within the context of enterprise legal management (ELM), is transforming the process of legal bill review. ACE uses Wolters Kluwer’s LegalVIEW® BillAnalyzer, an AI-driven legal invoice review solution, to streamline their bill review process and ease the burden of this time-consuming task on their claims staff. On average, BillAnalyzer clients save up to 10% in legal spend and increase billing guideline compliance by up to 20%.

ACE uses the BillAnalyzer Data Service, which scrutinizes invoice line items and provides scoring and recommendations to the company’s bill review team within their existing invoice review processes. For legal and claims departments that want to realize the same benefits with the process conducted externally, there is the BillAnalyzer Expert Service. In addition, BillAnalyzer is now available to companies using non-Wolters Kluwer ELM platforms.

The use of AI in the claims function will only increase

Looking ahead, the panel explored the future trends shaping the use of AI in the claims domain. With AI technology constantly improving and being added to an increasing number of applications and solutions, they expect AI to be even more widely used in claims settings over time.

Notable predictions include an increase in data from connected devices, the prevalence of physical robotics, open-source and data ecosystems shared across industries, and advances in cognitive technology. AI is seen not only as an enabler, empowering attorneys by automating routine tasks but also as a predictive tool, foreseeing costs, outcomes, and jurisdictional favorability.

The panel discussion underscored the transformative potential of AI in the legal sphere, from claims processing to invoice management and beyond. The adoption of AI technologies is not just a trend; it's a strategic imperative for insurance companies looking to stay ahead in a rapidly evolving landscape. As we approach the future, the question won't be whether to embrace AI but how effectively organizations leverage it to generate better outcomes and remain at the forefront of legal and claims innovation.

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