AI Role in Claims

Takeaways from CLM's recent Tech Talk webinar, "Creating an Early Warning System for Claim Severity and Litigation with Artificial Intelligence - Meet the New Cyber Supervisor"

June 29, 2023 Photo

CLM recently held a Tech Talk webinar entitled, “Creating an Early Warning System for Claim Severity and Litigation with Artificial Intelligence - Meet the New Cyber Supervisor,” which discussed how AI can help fill talent gaps and assist in identifying claims trends. Below are a few takeaways from the presentation.

12:00:00pm

THE SPEAKERS

Richard Lord, Vice President of Claims and the Chief Claims Officer, NLC Insurance Companies

John Standish, Chief Innovation and Compliance Officer, Charlee.ai

12:01:26pm

Richard Lord

“It’s a time, at least in my life in claims, when things are radically different. Some of it is because of the Great Resignation, some of it is the aging claims population, some of it is inflationary pressures, and some of it is desensitization of what a dollar’s worth—so we’re seeing rising jury verdicts.”

12:01:56pm

Richard Lord

“We’re seeing staff with a great knowledge base retiring. We’re able to recruit new people, but they have that knowledge gap. So, it’s made things less stable and less predictable.”

12:02:13pm

Richard Lord

“I think the predictability part [is], we were [previously] able to predict things like severity based on, ‘I’ve seen this before so I can predict this outcome based on what I’ve seen.’ And when you lose that knowledge…you’re left with a gap. And I think…the most effective way to fill that gap is where artificial intelligence comes in.”

12:03:26pm

John Standish

“One thing that keeps repeating itself every time we engage with a new customer is the senior, most accomplished, knowledgeable examiners, they’re retiring…and insurance companies have to work double time to transfer that institutional knowledge into the younger staff. And it’s difficult. They’re acting too late.”

12:04:28pm

Richard Lord

“I think the modeling that AI provides…it’s not going to replace my claims staff—there’s always going to be a people part of it—but it’s absolutely going to act as a backstop, as a workflow director to help [staff] concentrate on claims that need the attention…[and] getting the right talent on the right assignment.”

12:05:10pm

Richard Lord

“I think [AI] is going to be sort of a cyber scholar, or a cyber tutor, that will continue to bring to the forefront [the trends].… We all know, as happens in every claims cycle, trends shift as claimants get more creative, or as risk changes, so the AI will always keep us current on those trends.”

12:05:53pm

John Standish

“AI can be the accomplished and meaningful cyber assistant, especially to newer claims examiners, because it can push out insights to [them]. We know they’re all overworked, there are way too many open claims, things will naturally slip through the cracks…. The cyber assistant can help and show recommendations and alerts.”

12:07:07pm

John Standish

“As you ascend in the leadership and management chairs, then [AI] can become a great cyber supervisor because you can take these insights and have so many levels of view—what would be important to you, versus your first-line level manager of a claims team, down to the claims examiner, and even to the SIU…. It’s all very diversified. But it’s all [based] off your own internal claims data and any third-party data you bring into your business process.”

 

 

 

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About The Authors
Phil Gusman

Phil Gusman is CLM's director of content.  phil.gusman@theclm.org

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