The journey of a commercial claim with AI

As the world of claims continues to evolve, AI will become even more important, driving new insights and breakthroughs. (Photo: Shutterstock)

Across commercial insurance, from auto liability to workers’ compensation, claims that involve a bodily injury tend to follow a common lifecycle from the moment a claim is opened until the date it is resolved. As claims evolve through stages in this journey, a growing set of data gets added to the claim file, pulled from bills, notes, images, payments and other files. For complex claims, the journey can extend for years and involve updates and files from adjusters, nurse case managers, providers, attorneys and others. When AI is added, the data in this journey becomes visible, forming a more predictable trajectory that enables adjusters and supervisors to effectively manage the claim, reduce costs, and enable better outcomes for all involved. 

Traditionally, much of this data is not fully used, either stored beyond the reach of claims teams or overlooked by busy adjusters just trying to stay on top of their caseload. But now, image and language processing can aggregate and organize that data and machine learning can be applied to generate insights and predictions about the likelihood of future events. All of that gives adjusters a powerful new tool to help claimants get back to health faster — and reduce costs for all parties involved.