FAQs: AI and the insurance claims process
Generative AI can improve the customer experience within the claims process by providing a faster, more personalised experience. We have compiled some of the most frequently asked questions by our customers regarding the implementation of AI.
I already have a claims management system, are you suggesting that I replace my existing claims solution?
No, Kainos can integrate generative AI into the majority of existing claims solutions. The most common way we do this is through an Application Programming Interface (API). However, we have multiple methods of integration that we can tailor according to your existing solution. We would build an understanding of your environment to ensure the most effective integration with your claims management system and any additional systems you may have.
Who will benefit most from using AI in claims?
The implementation of AI in your claims process benefits customers, employees and operations alike. 48.4% of service complaints by insurance customers relate to turnaround time- AI can automate manual tasks and update customers on the status of their claim, keeping customers in the loop. Vulnerable customers can be identified and monitored closely, so that their interactions with their insurer can tailored to their needs. Claims handlers can spend more time on higher value tasks such as providing emotional support to sensitive claims or analysing complex claims. The overall claims process can be streamlined and ran more efficiently, reducing human error and allowing organisations to process claims at a faster rate.
Is my data secure?
We understand that data security is the top priority for any business, especially when dealing with sensitive information such as claims data. Kainos has achieved the highest level of accreditation for data security, including ISO 27001, Cyber Essentials Plus, and SOC 2 Type II. Kainos also follows the principles of Privacy by Design and Data Protection by Design, ensuring that data security is embedded in every stage of the solution development and delivery.
How do I start evaluating how AI can improve my claims process?
Kainos understands the steps in the claims process and works with you to identify the priority use case to evaluate the impact AI can make. The best way you can start is to book a discovery call with our experts. Through interviews and workshops that Kainos can provide, we can get a deeper understanding of your current claims process, any customer/employee pain points or time-consuming areas that we can optimise with generative AI.
What regulatory standards do I need to consider?
For UK insurers, the FCA's Consumer Duty has set out clear standards of consumer protection across the financial services industry. In simple terms, insurers must act in good faith towards customers, avoid foreseeable harm and support them in pursuing their financial objectives. Insurers should prioritise having an easy to understand and use claims process, which is accessible through multiple channels including digital and human touchpoints, to meet the needs of all individuals using the service.
For Irish insurers, the Central Bank of Ireland has stated that there is a need for regulated financial service providers to do more to support their customers against the backdrop of a rapidly changing landscape. This means that firms must identify and address risks to consumers because of this changing environment either within the firm or outside with consumer behaviour. These risks include poor business practices (e.g. providing short-term incentives for customers over long-term value), weak business practices (lack of communication on claim status or frequent system outages) and technology driven risks (customers not being able to engage with their insurer in person).
We are also keenly aware of ongoing AI regulations and legislation such as the recent AI act from the European Union which will have drastic effects on how artificial intelligence can be used by Irish insurers, in particular those who offer life and health insurance. For UK insurers, the FCA is taking a pro-innovation approach by inviting firms to test innovations using their AI sandbox while continuing to adhere to guidelines such as Consumer Duty. Any additional guidance or rules will be created as necessary.