Sedgwick story About Us

fraudulent behaviour, freeing up claims handlers to focus on delivering good customer service. “AI can play a significant role in speeding up the claims process in the insurance industry,” asserts Jason Landrum, Global Chief Information Officer at Sedgwick.

“By using AI-powered algorithms to analyse data and automate tasks, insurers can reduce the time it takes to process claims from initial filing to settlement. AI can also help detect fraudulent claims and provide insights into patterns of behaviour that can improve risk assessment and pricing. In addition, AI-powered chatbots and virtual assistants can improve customer experience by providing quick and efficient support to claimants. Overall, AI has the potential to streamline the claims process, reduce costs and enhance customer satisfaction – making it an important tool for insurers looking to stay competitive in an increasingly digital world.”

Will AI replace humans in the insurance industry?

As AI has become a mainstream technology, a number of concerns have begun to surface. OpenAI’s ChatGPT, launched in November 2022, has been a hot topic of late. But concerns about the privacy and security of data have resulted in a ban in Italy, and other governments are looking cautiously towards the AI sector. The CEO of OpenAI recently told US lawmakers that AI needed to be regulated. Concerns about the future of AI are not limited to privacy and security; there are also fears about the accuracy of information outputted by AI chatbots (ChatGPT itself only claims to be up-to-date to September 2021) as well as the eternal question of whether AI will replace human jobs and cause mass redundancies.

Dikshit believes that AI can work harmoniously with human customer service agents to augment their role. “AI has ushered in a significant transformation in the claims model, shifting it from being led by humans at the forefront to now being driven by AI with humans in the loop,” he says. “For instance, claims teams often struggle to make sense of the overwhelming amount of unstructured data they receive. Moreover, the manual data extraction practices that many companies employ drive significant inefficiencies in cost and time. AI can process unstructured data and rapidly convert it into a structured format, automating claims settlement.

“This shift has resulted in a substantial reduction in the reliance on human reviews and assessments, saving valuable time and effort. AI-powered technologies provide real-time intelligence for tasks such as

Is increased agility in claims processing being driven by consumer demand?

In many ways, insurers are utilising AI to respond to customer needs – faster and more seamless digital experiences, easier claims experiences, and more reliable payment when a loss occurs. It’s clear how AI supports the first two of these missions; reliability is defined in part by an insurer’s ability to gather information, supporting documents, and to understand the nature of a claim, which AI, in conjunction with digital cloud platforms, helps support.

Yet we’ve all been frustrated by an AI chatbot that doesn’t understand our requirements, or feels like a filter to make genuine customer service harder to access. So are insurers using AI in the way that consumers need? “Insurers have recognised that claims can be the primary distinguishing factor influencing customer experience (CX),” says WNS’ Dikshit. “Consequently, insurers are reassessing their claims operating models to enhance their digital strategies while keeping CX at the core. The primary objective is to streamline the entire process, making it simple for customers, minimising wait times, reducing human intervention and ensuring consistent CX across all interaction channels.”

Landrum elaborates: “The demand for quicker claims processing from consumers is likely to force insurers to devise new ways of working and adopt new business models. In today’s digital world, consumers expect quick and efficient services based on their own consumer experiences, and insurance is no exception. Insurers that fail to meet these expectations risk losing customers to competitors that offer faster and more convenient claims processing. To remain competitive, insurers may need to adopt new technologies and automation tools, such as parametric insurance, to speed up claims processing and improve customer satisfaction.” damage assessments, fraud detection, coverage validation, liability determination and total loss evaluation among others. These advancements streamline the claims process lifecycle, reducing time and effort.”

The importance of digital cloud platforms

As well as embracing new technologies, insurance companies have to overhaul the way they do business if they’re to remain relevant. This requires substantial cultural change, and a willingness to transform that cascades down right from the top. After all, there is little point embracing AI in one area of your business – like customer service – if you’re still dependent on incredibly old-fashioned, manual processes elsewhere.

Insurers are beginning to understand the value of cloud-based platforms where customers can make a claim, upload supporting documents and provide information that assists their claim. The entire claims journey, from FNOL onwards, happens in one single ecosystem and removes the convoluted paper trail that previously took place through email or fax. In turn, insurers are able to provide customers with a quicker and more seamless claims experience.

“Having a digital platform where customers can upload documents, provide self-service capabilities (like signing up for direct deposit) and interact with their examiner is now table stakes for insurers and TPAs to stay competitive in the industry,” Sedgwick’s Landrum says. “Such platforms can streamline the claims process, reduce errors and improve customer experience.

“By automating document upload and other features, insurers can reduce manual effort and human error, leading to a faster claims life cycle and help the claimants who are already dealing with a difficult situation feel more connected and cared for. In addition, a digital platform can enhance data security, as sensitive documents are stored securely rather than being circulated physically through the mail. Overall, a digital platform can improve efficiency, reduce costs and improve customer satisfaction, which makes it an essential tool.”

Dikshit continues: “In today’s digital era, where customers prioritise convenience and prompt resolution, the significance of having a digital cloud platform mers is likely to force insurers to devise new ways of working and adopt new business models. In today’s digital world, consumers expect quick and efficient services based on their own consumer experiences, and insurance is no exception. Insurers that fail to meet these expectations risk losing customers to competitors that offer faster and more convenient claims processing. To remain competitive, insurers may need to adopt new technologies and automation tools, such as parametric insurance, to speed up claims processing and improve customer satisfaction.”