AI can support ‘seamless claims’ but there’s ’no substitute for human skills’ – Sedgwick

Loss adjustor and claims management firm Sedgwick has been deploying artificial intelligence (AI) to provide a “seamless claims experience” for customers, but has also warned that ”there is no substitute for human skills” in this process.

That was according to Richard Sheridan, strategy development director at Sedgwick, who told Insurance Times that AI can be leveraged to automate aspects of claims information collection. 

For example, he noted that data analytics, combined with behavioural science, could help the company “better understand and predict a customer’s needs”, allowing it to design systems that “anticipate and proactively respond”, rather than simply reacting to a customer request. 

Sherdian added: ”Most customer claims are relatively straightforward. [Sedgwick] currently use chatbot technology, where 70% of queries are successfully dealt with automatically, and any more complex issues are quickly referred to a relevant claims handler.”

The firm has also deployed an image recognition AI tool to provide a self-service digital claims settlement option for low-value flooring claims, which can automatically recognise specific carpet specifications and provide instant replacement costs. 

AI use case

Sheridan explained that AI was a valuable tool for both company and customer, but could only succeed if firms could leverage already-held data or obtain it elsewhere.

He said: “We can use AI to automate parts of claims information gathering where we already have the data or it’s available through various external sources. This speeds up the process and avoids customers having to provide us with details we can obtain automatically.

“Sophisticated omnichannel communication platforms also ensure that customers can seamlessly move between online, phone or self-serve channels, with a full view of all interactions with claims handlers.”

“AI is brilliant at processing repetitive tasks. It can interpret rules, share data across different functions and carry out a wide range of basic administration tasks.”

The most valuable function of AI, according to Sheridan, is that the technology frees up staff to focus on problem solving, creative thinking and engaging with customers.

Crucially, he added that while AI was an ”important tool in providing a seamless claims experience” by streamling much of the repetitive workload, ”there is no substitute for human skills.”

Human option

The explosion in the use of AI technology has also come during a period when customers are increasingly seeking more digital claims journeys. 

Sheridan’s comments came after Aviva’s head of customer experience and insight Ellie Shepherd said earlier this year (15 June 2023) that the transition to digital “really changed” during the Covid-19 pandemic .

For example, it was noted that the pandemic had fast-tracked the adoption and implementation of touchless claims – which refers to a claim filed with very little contact from a human, often via an app – during a roundtable hosted by Future Processing in the same month.

Bill Brower, vice president of industry relations at Solera, explained that, prior to the pandemic, consumer adoption of touchless claims was “pretty slow,” with only a 10% uptake.

However, Brower noted lockdowns had made this type of claims processing a necessity.

Despite this necessity for digitalisation, Sheridan was keen to point out that, when customers make use of AI for claims, “they must have the option to deal with a person, whether over the phone or by email or chat”.

He added: “Digital isn’t for everyone and some customers find the online experience challenging, so speaking to a claims handler in person must always be an easily accessible option.”