AI Use Cases in Insurance Industry

Introduction

Artificial Intelligence in Insurance Industry is revolutionizing how companies assess risk, handle claims, and enhance customer experiences. AI-powered tools can analyze vast amounts of data to detect fraud, optimize underwriting processes, and automate customer service. “The KPMG 2023 Insurance CEO Outlook also highlights a significant degree of trust in AI with 58 percent of CEOs in insurance feeling confident about achieving returns on investment within five years.” The numerous ways in which AI has become a part of the insurance industry are given below.

Use Cases

  • 1. Decode outdated COBOL or PL/1 software

    In developed countries, many medium and large insurance companies still rely on outdated COBOL or PL/1 software, which has significant limitations. AI systems are now employed to decode these programs by training on input and output data, achieving over 98.5% accuracy. This process reduces manual labor by 75% and prevents errors from being carried over during conversion to modern systems, ensuring a smoother transition. For more details, visit www.scryai.com/datatio.

  • 2. Offer tailored insurance plans

    AI techniques are applied across various insurance types to optimize pricing, manage claims efficiently, and enhance customer satisfaction while cutting costs. Insurance companies group customers with similar characteristics and behaviors to assess risk profiles accurately and offer tailored insurance plans with appropriate coverage and premiums. This approach ensures that customers receive fair pricing based on their specific risk factors.

  • 3. Data conversion, extraction and organization

    Life insurance policies often span over thirty years, with much of the data stored in hard-to-read paper formats. Converting this data to electronic format is labor-intensive and costly, and traditional OCR systems are ineffective. Therefore, companies use advanced Computer Vision and AI techniques to extract and organize data chronologically. This enables AI systems to handle over half of the claims with minimal human involvement, significantly reducing costs and labor. These AI-based Intelligent Document Processing (IDP) systems ensure accurate data extraction and organization, streamlining the claims process.

  • 4. Estimate vehicle damage from accidents

    Insurance companies leverage Computer Vision and Natural Language Processing (NLP) to estimate vehicle damage from accidents. AI tools analyze photos of claims to quickly assess damage and provide repair estimates, which are then sent to insurers for approval and customer confirmation. Some companies are extending these AI systems to automate the entire claims process, ensuring faster and more accurate damage assessments and repair estimates, ultimately improving customer satisfaction and operational efficiency.

  • 5. Accelerate the claim submission process

    AI systems streamline and expedite the claim submission process. Users complete a basic questionnaire and submit accident photos, after which they receive AI-generated quotes and claims. This allows users to quickly and easily choose the option that best fits their needs, enhancing the overall customer experience and reducing the time and effort required for claim submissions.

  • 6. Assist underwriters in accurately assessing risks

    Similar to the banking sector, insurance companies are utilizing AI to assist underwriters in accurately assessing risks. Some AI systems can automatically process over 50% of simple claims, forwarding only the more complex cases to underwriters. This improves efficiency and allows underwriters to focus on more challenging assessments, ultimately enhancing the accuracy and speed of the underwriting process.

  • 7. Match customers with the best coverage

    Healthcare companies are leveraging AI to make purchasing health insurance easier. Customers start by filling out a short form with details such as age, health history, and benefit preferences. The AI system then matches each individual or group with the most suitable benefits plan, often providing several options for customers to choose from. This personalized approach ensures that customers receive the best possible coverage based on their specific needs and circumstances.

  • 8. Improve communication between customers and insurance providers

    Hi Marley utilizes a comprehensive cloud platform to enhance communication between customers and insurance providers. The platform is equipped with AI features that help customer service representatives operate more efficiently. For instance, Hi Marley’s platform can translate text into different languages and provide real-time coaching to improve interactions between representatives and customers. This ensures faster and more effective customer service.

  • 9. Quick and accurate responses to customer queries

    Similar to banks, insurance companies are training open-source Large Language Models (LLMs) and Generative Pre-trained Transformers (GPTs) on internal data. This enables customer representatives to quickly and accurately respond to customer queries, improving the overall efficiency and effectiveness of customer service.

  • 10. Detect fraudulent claims

    AI systems are employed to detect fraudulent claims, which are prevalent in the insurance industry and result in higher premiums for honest customers. Life insurance fraud is particularly widespread, costing companies $74.7 billion annually, with approximately 15% of claims being fraudulent. Policyholders also commit $35.1 billion in fraud each year by lying on their insurance applications to get better rates. AI systems are integrated into decision support systems to identify potentially fraudulent claims, which can then be thoroughly investigated by insurance company analysts.

  • 11. In-depth assessments of properties

    AI and Data Science are utilized to conduct in-depth assessments of over 100 million properties, taking into account variables such as wind direction, proximity to flood zones, wildfire zones, and highways. These systems provide valuable insights to insurance companies, homeowners, and local fire departments, especially in cases of vegetation overgrowth that may lead to wildfires. Customers can take pictures and short videos, which AI systems analyze using Deep Learning Networks and Computer Vision techniques to assess potential risks. This helps insurance providers determine coverage and allows homeowners to understand what actions they can take to lower their premiums.

  • 12. Identify risks associated with potential customers

    Life insurance companies, similar to banks and diversified financial industries, are leveraging AI to understand risks associated with potential customers and to reach new customers. They use both traditional and non-traditional data, such as AI-based credit scoring models, to make better predictions. The primary goal is to help companies boost underwriting profits while mitigating risk, ensuring more accurate and profitable underwriting decisions.

  • 13. Create unified data related to property, claims, and risk management

    Insurance companies are utilizing Large Language Models (LLMs), Computer Vision systems, and detailed property reports to expedite the underwriting process. These AI systems offer underwriters a holistic view of unified data related to property, claims, and risk management. This comprehensive perspective enables underwriters to deliver more accurate and efficient assessments, improving the overall underwriting process.

  • 14. Pair customers with the right customer service representatives

    AI systems, particularly Large Language Models (LLMs), utilize past data to pair customers with the most suitable customer service representatives. This approach enhances customer satisfaction by improving the quality of conversations, as customers are matched with representatives based on the best fit rather than call order. This personalized matching ensures more effective and satisfactory customer interactions.

  • 15. Deliver personalized customer service

    AI assistants, powered by AI systems, deliver efficient and personalized customer service. These AI assistants help customers find answers to their questions and locate critical documents through chatbots or onscreen avatars that engage in human-like conversations with insurance agents. This technology enhances the customer experience by providing quick and accurate assistance.

  • 16. Detect and prevent risky behavior in drivers

    AI systems are being developed to mitigate distracted driving. Equipped with cameras, Computer Vision, and proprietary algorithms, these systems monitor how drivers interact with their vehicles and the road. They can detect and prevent potentially risky or sleepy behavior in real time, enhancing road safety and reducing the likelihood of accidents caused by distracted driving.

  • 17. Assess the level of risk associated with insurance policies

    Collect internal and external data, including market information and individuals’ medical data, to assess the level of risk associated with insurance policies. This data is used to calculate the expected internal margin, ensuring that policies are priced accurately and reflect the true level of risk. This comprehensive data collection helps insurance companies make informed decisions and manage risk effectively.

  • 18. Decision support for pricing insurable risks

    Assess product types, medical information, and continuous variables (e.g., weight, height, employment salary) to provide decision support for pricing insurable risks. Suggest the likelihood, margin level, and competition risk associated with the suggested pricing. Perform sensitivity analysis to identify the variables that impact the revenue generated by the policy. This comprehensive assessment ensures accurate pricing and helps insurance companies understand the factors influencing their revenue.

  • 19. Enhance technical pricing and loss prediction modeling

    Enhance technical pricing and loss prediction modeling by utilizing non-linear models and external data to develop the most accurate AI models. Use these AI models to create explainable or interpretable models that act as “surrogates” and can satisfy local government requirements. This approach ensures that the AI models are not only accurate but also transparent and compliant with regulatory standards.

  • 20. Process scanned or PDF claim documents

    Utilize IDP to process scanned or PDF claim documents, matching their details, value, and complexity with existing records in the database. This enables real-time approval or rejection of claims, streamlining the claims processing workflow.

  • 21. Instantly assess uploaded claims

    Leverage IDP and AI models to assess uploaded claims instantly, evaluating them for potential fraud and eligibility against set criteria. This ensures quick and accurate claim assessments, enhancing fraud detection and eligibility verification.

  • 22. Determine the eligibility for a claim using a picture

    In real-time, determine the eligibility, insurance coverage, and payout for a claim using a picture, like a damaged car. This is done using an algorithm trained on a large dataset of images showing different damage levels and their corresponding payouts. The claims management process is further supported by an electronic workflow that handles task routing, prioritization, monitoring, and escalation of exceptions.

  • 23. Direct denied claims into a designated workflow

    Direct denied claims into a designated workflow, which automatically sends an email to the client detailing the reasons for denial and suggesting possible remediation actions. This ensures clear communication and guidance for clients on how to address the denial.

  • 24. Early prediction of claim severity

    Early prediction of claim severity allows for efficient triage and handling, including scenarios like total loss, subrogation, or litigation. This also helps in predicting the necessary reserves, ensuring better resource allocation and management.

  • 25. Enhance the onboarding process

    Enhance the onboarding process by using an automated workflow that handles task routing, prioritization, monitoring, and escalation of exceptions. This ensures a smooth and efficient onboarding experience for new clients.

  • 26. Gather client data

    Enrich client profiles by gathering data from social media and other public web sources. Use workflows to guide clients through the onboarding process and help them select appropriate services. Additionally, leverage LLM-based chatbots to assist clients in choosing the right policies, enhancing their overall experience.

  • 27. Ensure secure client connections

    Ensure secure client connections using voice recognition and other biometric authentication methods. Address customer queries related to services, transactions, and account details through a self-service digital platform that utilizes LLM-based chatbots, providing quick and efficient support.

  • 28. Predict customer churn

    Use demographic and transactional data to identify variables that most accurately predict customer churn. Define profiles of churners, determine the root causes driving churn, and develop strategies to prevent it. This includes creating tailored campaigns and offers delivered through the most effective channels to retain customers.

  • 29. Create customer categories and analyze consumption patterns

    Analyze transactional and demographic data to create detailed customer categories and understand their consumption patterns. Utilize AI-based recommendation systems to personalize product offerings and promotions, thereby enhancing clients’ lifetime value and driving business growth.

  • 30. Identify the next insurance product

    Analyze customer data, including services and products used, demographic information, transactional behavior, and contact history, to identify the next insurance product to offer. This targeted approach helps in meeting customer needs more effectively and increasing sales opportunities.

Conclusion

Insurance firms are immensely benefitting from the various capabilities of AI systems. These technologies enable more accurate risk assessment through predictive analytics, allowing companies to tailor policies and pricing to individual customer profiles. AI-driven tools streamline claims processing by automating routine tasks, reducing processing times, and enhancing accuracy. Additionally, AI enhances fraud detection by analyzing patterns and anomalies in data that might go unnoticed by human analysts.

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    • If we provide social media features with certain content, you may take such actions as are enabled by such features.

    You must not:


    • Modify copies of any materials from this site.
    • Delete or alter any of the copyright, trademark, or other proprietary rights notices from copies of materials from this site.

    You must not access or use for any commercial purposes any part of the website or any services or materials available through the Website.

    If you print, copy, modify, download, or otherwise use or provide any other person with access to any part of the Website in breach of the Terms of Service, your right to use the Website will stop immediately and you must, at our option, return or destroy any copies of the materials you have made. No right, title, or interest in or to the Website or any content on the Website is transferred to you, and all rights not expressly granted are reserved by the Company. Any use of the Website not expressly permitted by these Terms of Service is a breach of these Terms of Service and may violate copyright, trademark, and other laws.

    User Submissions and Submission Standards


    The Website may provide you with the opportunity to create, submit, post, display, transmit, public, distribute, or broadcast content and materials to us or in the Website, including but not limited to text, writings, video, audio, photographs, graphics, comments, ratings, reviews, feedback, or personal information or other material (collectively, "Content"). You are responsible for your use of the Website and for any content you provide, including compliance with applicable laws, rules, and regulations.

    All User Submissions must comply with the Submission Standards and Prohibited Activities set out in these Terms of Service.

    Any User Submissions you post to the Website will be considered non-confidential and non-proprietary. By submitting, posting, or displaying content on or through the Website, you grant us a worldwide, non-exclusive, royalty-free license to use, copy, reproduce, process, disclose, adapt, modify, publish, transmit, display and distribute such Content for any purpose, commercial advertising, or otherwise, and to prepare derivative works of, or incorporate in other works, such as Content, and grant and authorize sublicenses of the foregoing. The use and distribution may occur in any media format and through any media channels.

    You represent and warrant that:


    • You own or control all rights in and to the User Submissions and have the right to grant the license granted above to us and our affiliates and service providers, and each of their and our respective licensees, successors, and assigns.
    • All of your User Submissions comply with these Terms of Service.

    We do not assert any ownership over your Content. You retain full ownership of all of your Content and any intellectual property rights or other proprietary rights associated with your Content. We are not liable for any statement or representations in your Content provided by you in any area in the Website. You are solely responsible for your Content related to the Website and you expressly agree to exonerate us from any and all responsibility and to refrain from any legal action against us regarding your Content. We are not responsible or liable to any third party for the content or accuracy of any User Submissions posted by you or any other user of the Website. User Submissions are not endorsed by us and do not necessarily represent our opinions or the view of any of our affiliates or partners. We do not assume liability for any User Submission or for any claims, liabilities, or losses resulting from any review.

    We have the right, in our sole and absolute discretion, (1) to edit, redact, or otherwise change any Content; (2) to recategorize any Content to place them in more appropriate locations in the Website; and (3) to prescreen or delete any Content at any time and for any reason, without notice. We have no obligation to monitor your Content. Any use of the Website in violation of these Terms of Service may result in, among other things, termination or suspension of your right to use the Website.

    These Submission Standards apply to any and all User Submissions. User Submissions must in their entirety comply with all the applicable federal, state, local, and international laws and regulations. Without limiting the foregoing, User Submissions must not:

    • Contain any material that is defamatory, obscene, indecent, abusive, offensive, misleading, harassing, violent, hateful, inflammatory, or otherwise objectionable.
    • Promote sexually explicit or pornographic material, violence, or discrimination based on race, sex, religion, nationality, disability, sexual orientation, or age.
    • Infringe any patent, trademark, trade secret, copyright, or other intellectual property or other rights of any other person.
    • Violate the legal rights of others or contain any material that could give rise to any civil or criminal liability under applicable laws or regulations or that otherwise may be in conflict with these terms of service and our Privacy Policy.
    • Be likely to deceive any person.
    • Promote any illegal activity, or advocate, promote, or assist in any unlawful act.
    • Cause annoyance, inconvenience, or needless anxiety or be likely to upset, embarrass, alarm, or annoy any other person.
    • Impersonate any person, or misrepresent your identity or affiliation with any person or organization.
    • Involve commercial activities or sales, such as contests, sweepstakes, and other sales promotions, barter, or advertising.
    • Give the impression that they emanate from or are endorsed by us or any other person or entity, if this is not the case.

    Our Rights


    We have the right, without provision of notice to:

    • Remove or refuse to post any User Submission for any or no reason in our sole discretion;
    • Take any action with respect to any User Submission that we deem necessary or appropriate in our sole discretion, including if we believe that such User Submission violates the Terms of Service, including the Submission Standards, infringes any intellectual property right or other right of any person or entity, threatens the personal safety of users of the Website or the public, or could create liability for the Company;
    • Take appropriate legal action, including, without limitation, referral to or cooperation with law enforcement or regulatory authorities, or notifying the harmed party of any illegal or unauthorized use of the Website; and
    • Terminate or suspend your access to all or part of the Website for any or no reason, including, without limitation, any violation of these Terms of Service.

    You waive and hold harmless company and its parent, subsidiaries, affiliates, and their respective directors, officers, employees, agents, service providers, contractors, licensors, licensees, suppliers, and successors from any and all claims resulting from any action taken by the company and any of the foregoing parties relating to any, investigations by either the company or by law enforcement authorities.

    Third Party Links and Sites


    For your convenience, this Website may provide links or pointers to third-party sites or third-party content. We make no representations about any other websites or third-party content that may be accessed from this Website. If you choose to access any such sites, you do so at your own risk. We have no control over the third-party content or any such third-party sites and accept no responsibility for such sites or for any loss or damage that may arise from your use of them. You are subject to any terms and conditions of such third-party sites.

    Social Media Features


    This Website may provide certain social media features that enable you to:

    • Link from your own or certain third-party websites to certain content on this Website.
    • Send emails or other communications with certain content, or links to certain content, on this Website.
    • Cause limited portions of content on this Website to be displayed or appear to be displayed on your own or certain third-party websites.

    You may use these features solely as they are provided by us and solely with respect to the content they are displayed with. Subject to the foregoing, you must not:

    • Establish a link from any website that is not owned by you.
    • Cause the Website or portions of it to be displayed on, or appear to be displayed by, any other site, for example, framing, deep linking, or in-line linking.
    • Link to any part of the Website other than the homepage.
    • Otherwise take any action with respect to the materials on this Website that is inconsistent with any other provision of these Terms of Use.

    The Website from which you are linking, or on which you make certain content accessible, must comply in all respects with the Submission Standards set out in these Terms of Service.

    You agree to cooperate with us in causing any unauthorized framing or linking immediately to stop.
    We reserve the right to withdraw linking permission without notice.
    We may disable all or any social media features and any links at any time without notice in our discretion.

    Disclaimers, Liability and Indemnification


    You understand and agree that your use of the website, its content, and any goods, digital products, services, information or items found or attained through the website is at your own risk. The website, its content, and any goods, services, digital products, information or items found or attained through the website are provided on an "as is" and "as available" basis, without any warranties or conditions of any kind, either express or implied including, but not limited to, the implied warranties of merchantability, fitness for a particular purpose, or non-infringement. The foregoing does not affect any warranties that cannot be excluded or limited under applicable law.

    You acknowledge and agree that company or its respective directors, officers, employees, agents, service providers, contractors, licensors, licensees, suppliers, or successors make no warranty, representation, or endorsement with respect to the completeness, security, reliability, suitability, accuracy, currency, or availability of the website or its contents or that any goods, services, digital products, information or items found or attained through the website will be accurate, reliable, error-free, or uninterrupted, that defects will be corrected, that our website or the server that makes it available or content are free of viruses or other harmful components or destructive code.

    How We Limit Our Liability to You


    Except where such exclusions are prohibited by law, in no event shall the company nor its respective directors, officers, employees, agents, service providers, contractors, licensors, licensees, suppliers, or successors be liable under these terms of service to you or any third-party for any consequential, indirect, incidental, exemplary, special, or punitive damages whatsoever, including any damages for business interruption, loss of use, data, revenue or profit, cost of capital, loss of business opportunity, loss of goodwill, whether arising out of breach of contract, tort (including negligence), any other theory of liability, or otherwise, regardless of whether such damages were foreseeable and whether or not the company was advised of the possibility of such damages.

    Indemnification


    To the maximum extent permitted by applicable law, you agree to defend, indemnify, and hold harmless Company, its parent, subsidiaries, affiliates, and their respective directors, officers, employees, agents, service providers, contractors, licensors, suppliers, successors, and assigns from and against any claims, liabilities, damages, judgments, awards, losses, costs, expenses, or fees (including reasonable attorneys' fees) arising out of or relating to your breach of these Terms of Service or your use of the Website including, but not limited to, third-party sites and content, any use of the Website's content and services other than as expressly authorized in these Terms of Service or any use of any goods, digital products and information purchased from this Website.

    Dispute Resolution


    At Company’s sole discretion, it may require you to submit any disputes arising from these Terms of Service or use of the Website, including disputes arising from or concerning their interpretation, violation, invalidity, non-performance, or termination, to final and binding arbitration under the Rules of Arbitration of the American Arbitration Association applying Ontario law. (If multiple jurisdictions, under applicable laws).

    Any cause of action or claim you may have arising out of or relating to these terms of use or the website must be commenced within 1 year(s) after the cause of action accrues; otherwise, such cause of action or claim is permanently barred.

    Privacy Policy


    Your provision of personal information through the Website is governed by our privacy policy located at the "Privacy Policy".

    Governing Law


    The Website and these Terms of Service will be governed by and construed in accordance with the laws of the Province of Ontario and any applicable federal laws applicable therein, without giving effect to any choice or conflict of law provision, principle, or rule and notwithstanding your domicile, residence, or physical location. Any action or proceeding arising out of or relating to this Website and/or under these Terms of Service will be instituted in the courts of the Province of Ontario, and each party irrevocably submits to the exclusive jurisdiction of such courts in any such action or proceeding. You waive any and all objections to the exercise of jurisdiction over you by such courts and to the venue of such courts.

    If you are a citizen of any European Union country or Switzerland, Norway or Iceland, the governing law and forum shall be the laws and courts of your usual place of residence.

    The parties agree that the United Nations Convention on Contracts for the International Sale of Goods will not govern these Terms of Service or the rights and obligations of the parties under these Terms of Service.

    Severability


    If any provision of these Terms of Service is illegal or unenforceable under applicable law, the remainder of the provision will be amended to achieve as closely as possible the effect of the original term and all other provisions of these Terms of Service will continue in full force and effect.

    Entire Terms of Service


    These Terms of Service constitute the entire and only Terms of Service between the parties in relation to its subject matter and replaces and extinguishes all prior or simultaneous Terms of Services, undertakings, arrangements, understandings or statements of any nature made by the parties or any of them whether oral or written (and, if written, whether or not in draft form) with respect to such subject matter. Each of the parties acknowledges that they are not relying on any statements, warranties or representations given or made by any of them in relation to the subject matter of these Terms of Service, save those expressly set out in these Terms of Service, and that they shall have no rights or remedies with respect to such subject matter otherwise than under these Terms of Service save to the extent that they arise out of the fraud or fraudulent misrepresentation of another party. No variation of these Terms of Service shall be effective unless it is in writing and signed by or on behalf of Company.

    Waiver


    No failure to exercise, and no delay in exercising, on the part of either party, any right or any power hereunder shall operate as a waiver thereof, nor shall any single or partial exercise of any right or power hereunder preclude further exercise of that or any other right hereunder.

    Notice


    We may provide any notice to you under these Terms of Service by: (i) sending a message to the email address you provide to us and consent to us using; or (ii) by posting to the Website. Notices sent by email will be effective when we send the email and notices we provide by posting will be effective upon posting. It is your responsibility to keep your email address current.

    To give us notice under these Terms of Service, you must contact us as follows: (i) by personal delivery, overnight courier or registered or certified mail to Scry Analytics Inc. 2635 North 1st Street, Suite 200 San Jose, CA 95134, USA. We may update the address for notices to us by posting a notice on this Website. Notices provided by personal delivery will be effective immediately once personally received by an authorized representative of Company. Notices provided by overnight courier or registered or certified mail will be effective once received and where confirmation has been provided to evidence the receipt of the notice.

    Contact Us


    To request a copy for your information, unsubscribe from our email list, request for your data to be deleted, or ask a question about your data privacy, we've made the process simple:

    Email us