AI by industry

AI for insurance

A claim is reported on a Friday evening. On Monday, the accident report, the invoice and two photos are missing. The file waits. The customer calls back on Wednesday, then Friday, then writes to the insurer directly. The task that costs here is not the settlement — it is everything that drags on before it becomes possible.

5 tasks documented below1 limit no settlement, no decline, no adviceSourced answers every status cites its document2 to 6 weeks before the first system is open
Chase the missing report
Open the claim file
Answer ‘where is my claim’

The tasks we remove first in this industry

The cost

What this industry pays when nothing moves.

Ranges, not promises. They come from tasks we meet in this industry and orders of magnitude we measure in the survey — yours may fall outside, in either direction.

Changing nothing
Delay before an incomplete file is chased5 to 15 days
Files waiting on a document, at any given time30 to 50 %
‘Where is my claim’ calls, per handler per day10 to 25
Opening a claim file20 to 40 minutes
Total time to handle a simple claim3 to 8 weeks
Customers writing to the insurer directly, for lack of an answerfrequent
The claims handling system, opened
Delay before an incomplete file is chasedunder 24 h
Files waiting on a document, at any given time10 to 20 %
‘Where is my claim’ calls, per handler per day2 to 6
Opening a claim file3 to 5 minutes of review
Total time to handle a simple claim1 to 3 weeks
Customers writing to the insurer directly, for lack of an answerrare
Five tasks

What we remove, and what we leave.

Each task is described with what the agent takes on and what stays with a person. If the second column is empty, we have not understood the industry.

01

Open a claim file

What the agent does
It reads the notification — email, form, photos — extracts the policy, the date, the nature, and pre-fills the opening with the list of documents expected.

What stays with a person
The qualification of the claim and its cover. It prepares the file ; the handler qualifies it.

02

Chase missing documents

What the agent does
As soon as a document is missing, it drafts the request naming exactly what is expected, and chases again at the due date if nothing arrives.

What stays with a person
The tone and frequency, set at the start. And any exchange beyond ‘this document is missing’ goes up to the handler.

03

Answer ‘where is my claim’

What the agent does
Stage, date of the last event, document expected from whom : in writing, with references.

What stays with a person
Any question about the outcome, the amount, the settlement date. The agent describes the status, never what will be decided.

04

Prepare a quote or a comparison

What the agent does
From the stated need and the rate tables you designate, it prepares the template and flags missing information.

What stays with a person
The advice. Recommending a policy, a cover, an excess is a regulated act — the broker makes it, not the agent.

05

Track renewals and expiry dates

What the agent does
It spots policies coming up for renewal, prepares the renewal letters, and flags those whose documents have expired.

What stays with a person
The decision to renew, amend or cancel. It reminds ; it does not decide.

What we do not do

No settlement, no decline, no advice is produced by an agent.

Insurance intermediation is a regulated activity : advising, qualifying a cover, deciding on a payout are acts that carry a responsibility and an authorisation. The agent observes, chases, assembles and cites. The diagram below shows where its perimeter stops.

A customer message comes in — a diagram, not a screenshot
1Email or form receivedtrigger
2File identified, status readreading
?Is the request about the file’s status or about a document?condition
if yes
4Written answer: stage, date, document expecteddraft
5Sent, copy to the handlerauto
otherwise
6Queued for the handler, file attachedescalation

Any request containing an amount, a cover, an ‘is this covered’ goes right, to an authorised person.

The method, in one sentence

Ten systems, one survey, one system opened at a time — the one with the shortest payback. Read the full method, or go back to the AI agency page.

The tools

What we open it with, and why here.

The choice of tool comes last, and it is reversible. But in this industry, three constraints keep coming back and steer the choice before we even start.

A closed perimeter, first
A claim file contains personal data, sometimes health data. Where it lives, who has access, for how long : set in the workshop, written into the quote.
A log an auditor can read
Every chase, every answer, every status is traced with its source. It is part of the file, not a technical log.
A model set to describe, never to recommend
It cites the document and the stage. As soon as a request touches a cover or an amount, it hands over. A ‘probably covered’ does not exist.
The objections

What we hear in this industry, before we start.

Could a customer believe they have been promised a payout ?

No, because the agent never talks about the outcome. It says ‘the invoice is missing’ or ‘your file has been with the loss adjuster since this date’. Everything else goes to the handler — a rule of the circuit, not an instruction.

Files sometimes contain health data.

That is why the perimeter is the first decision of the workshop, before any use : hosting chosen for it, named access, retention period. And nothing is used to train a model.

Will our principal insurer accept this ?

An agent that decides nothing, cites every document and leaves a readable trace is easier to audit than a handler in a hurry. The log is available to them on request.

We are a small firm. Is it worth it ?

That is where the gap is widest. A handler spends half the day chasing documents and answering ‘where is my claim’. A single task opened changes their week.

Where this industry concentrates

The areas where we are called most for this.

Related industries

The same tasks, in neighbouring industries : AI for banking, AI for real estate, AI for healthcare.

First call — fifteen minutes

We will tell you which system to open first.

Describe the task that costs you the most. We will tell you what is feasible, how long it takes and what it costs. If the answer is no, you will leave with the two reasons why.