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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.”

Sean Harper is the CEO and Co-Founder of Kin Insurance, an insurtech that aims to simplify the process of attaining home insurance, making it more affordable in highrisk areas prone to severe weather. Kin was conceived after Harper recognised that the home insurance sector still relied on outdated practices, including local broker distribution, legacy IT systems and physical paperwork. Attempting to innovate the home insurance industry, Kin Insurance has raised US$410.2m since Harper co-founded it in 2016. Today, Harper is supported by a team of over 100 professionals, prioritising customer service, intelligent coverage options and the promotion of insurance literacy.

The Co-Founder and CEO of Lemonade, Daniel Schreiber, has helped revolutionise the insurance landscape by leveraging AI and behavioural economics to offer fast underwriting and pricing for renters, homeowners, and car and pet owners.

Lemonade has raised a total of $481m since its founding in 2015, paving the way for insurtechs to seek market gaps and challenge legacy institutions under Screiber’s innovative leadership. With a background in the technology sector after founding Powermat Technologies, Schreiber made a name for himself by harnessing the power of wireless charging technology. Focused on social responsibility, Schreiber is also involved in several philanthropic initiatives.

John Clark Higgins is the Co-Founder and CEO of insurtech Steady Technologies, a company that has raised US$506m since its founding in 2017. Steady Technologies offers a suite of tailored financial and insurance products designed to reduce the risk for property managers’ generating ancillary revenues. Prior to launching Steady Technologies, Higgins founded Nobadeer Advisors, a company that provides business development, corporate strategy and capital markets expertise. Higgins’ career has also seen him take the positions of Director of Strategic Partnerships at Prosper Marketplace, Director at Topwater Capital Partners and Director of Investor Relations at Doubloon Capital.

Named Mid-Atlantic Entrepreneur of the Year for 2020, Swigart has been responsible for overseeing the insurtech since its founding in May 2017. Based in Washington DC, Pie Insurance is in the top 5% of surrounding companies and the top 5% of similar-sized companies in the US capital. Before picking up the mantle as Pie’s CEO, Swigart served on the executive team of Esurance for 13 years, leading financial functions before becoming the company’s CMO. With a deep understanding of current trends, Swigart has been in charge to see a total of US$621m invested into the company. The insurtech provides workers’ compensation insurance exclusively to small businesses.

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Max Simkoff is the CEO of San Francisco-based Doma, an insurtech designed to drive solutions that instantly close mortgages. Initially founded as States Title, the company was designed to instantly underwrite title insurance before expanding to handle all aspects of closing and escrow. The insurtech became Doma after a merger with special purpose acquisition company (SPAC) Capitol Investment Corp took the company public in a deal valued at US$3b. Prior to Doma, Smikoff was Founder and CEO of Evolv, an enterprise predictive analytics software company, which went on to be acquired by Cornerstone. Under Simkoff’s leadership, Doma has raised a total of US$679m.

Health

Ali Diab serves as the Co-Founder and CEO of Collective Health, a globally recognised platform for administering employer health benefit plans. With over 25 years of expertise in spearheading technology organisations in rapid growth phases, Diab has established himself as a prominent figure in the industry.

Prior to co-founding Collective Health, he held the position of VP of Product Management and Business Operations at AdMob, a subsidiary of Google. Diab has also held executive and management roles at renowned companies such as Goldman Sachs, Microsoft and Yahoo!. Today, Collective Health has raised a total of US$719m.

Alex Timm Co-Founder & CEO

Root Insurance

As the Co-Founder and CEO of Root Insurance, Alex Timm has contributed to the disruption of traditional insurance models by leveraging innovative technology and data analytics. Under his guidance, Root Insurance has become a prominent name in the insurtech sector, offering personalised auto insurance rates based on individual driving behaviour. Timm has also helped Root Insurance expand its embedded insurance offerings through strategic partnerships. Headquartered in Ohio, the insurtech has raised US$827.5m since its founding. In June 2021, Timm released a report detailing how fatherhood has helped change his leadership approach.

Guy Goldstein Co-Founder & CEO

NEXT Insurance

Founding NEXT Insurance in 2016, Guy Goldstein was a national finalist at the Entrepreneur of the Year awards for 2022 for his leadership of the company, which has raised US$881m to date. With a one-stop-shop platform that leverages AI technology, NEXT Insurance now serves over 1,300 classes of business, including restaurant owners, accounts, fitness professionals and general contractors.

Under Goldstein’s leadership, NEXT Insurance received an ‘A-Excellent’ rating from AM Best, reimagining the servicing process for providing SME insurance to make policy offers bespoke to each organisation. With over 20 years of industry experience, Goldstein has previously served as CEO of mobile payment company Check, as well as in executive positions in corporate development.

Wand Co-Founder

Hippo Insurance

Founding Hippo Insurance alongside Eyal Navon back in 2015, Assaf Wand’s insurtech has since made a name for itself as a company that covers the homes and possessions of policyholders, as well as liability from accidents in insured properties, via AI and data to price policies.

Coming from a background in finance, Wand says he has a passion for revolutionising antiquated industries, recognising the need for a simplified home insurance experience. Under Wand’s guidance, Hippo has gained recognition for its smart home coverage, leveraging data and analytics to provide proactive protection for homeowners. Since its founding, Hippo Insurance has raised a total of US$1.3bn.

The company’s current CEO is Rick McCarthon, after Wand took up the position of Executive Chairperson in October 2022. Despite stepping back, Wand has shown that he continues to inspire and reshape the industry as a whole by driving significant investment in Hippo Insurance.

Mario Schlosser founded Oscar Health alongside his classmates at Harvard Business School, Josh Kushner and Kevin Nazemi. Since being founded in 2012, Oscar Health has raised a total of US$1.6b, with lead investment coming from its parent company Thrive Partners III, owned by Jared and Joshua Kushner – Jared Kushner rose to fame as the son-in-law of former US President Donald Trump. Recently, Schlosser stepped down as CEO of Oscar Health to be replaced by former Aetna executive Mark Bertolini. Nevertheless, during his time as CEO, Schlosser oversaw the company’s expanded membership from 16,000 members in its first year of operations to over 1.1m members by 2020. Schlosser has helped reimagine healthcare insurance by leveraging technology and data analytics, helping create Oscar Health’s user-friendly platform that simplifies the insurance experience.