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In the Press


Monday, 07 May 2018

Technology will take your Life Insurance Claims job!

by Paul Murphy
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In some cases within the Insurance industry, this may well be the case. What we saw as futuristic not that long ago is fast becoming a reality. If you still think that machines replacing jobs within Claims is way into the future then reading this may make you sit up and take note!!

Artificial intelligence (AI) is here and it’s already impacting Claims jobs within the Insurance industry. The launch of Lemonade in the United States in 2015 has seen Claims revolutionised. In fact in 2016 Lemonade say they managed to pay one claim ( for a $979 jacket) within THREE SECONDS, yes you read that right….. THREE SECONDS. They did this without any paperwork or human intervention at all. Within three seconds the Lemonade claims bot (Jim) reviewed the claim, checked eligibility from the policy, ran 18 anti-fraud algorithms, approved the claim, sent payment and informed the customer their claim was paid. Impressive is an understatement.

But that’s in the States right? AI is not impacting Australia? Wrong! Suncorp has already introduced IBM’s artificial intelligence platform – IBM Watson,  to its Motor Claims Division; enabling their customers to complete the claims process online without the need to speak or have the claim touched by a human. As long as the claim meets certain criteria it can be assessed and approved in as little as five minutes with 90 per cent accuracy in determining liability. A motor claim processed in less than five minutes and with no human involvement in the process and it’s already here in Australia!!!

But both my examples are simple right? A jacket, a car; it’s not like a complex Life Insurance claim that brings a multitude of medical complexities that will always need the skill of an experienced Claims professional? Wrong again!! Earlier this year a Japanese Life Insurer Fukoku Life made 34 employees redundant with the implementation of the IBM Watson technology described as “cognitive technology that can think like a human”. The technology is determining insurance payouts after scanning medical information provided by the customer, extracting data on the injury and cross referencing against the customer's medical histories and procedures. Fukoku anticipates a 30 per cent increase in productivity from the implementation however, final payments will still be processed by a human.

AIA and TAL are also embracing AI in their businesses. In a recent trial AIA reported that IBM Watson technology had, within two weeks, been making decisions equivalent to the accuracy of an Assessor with five years experience on Medical Claims assessment. With such examples, it’s clear that AI is not futuristic at all and it’s here already. Whilst slightly confronting, the news surrounding AI in Life Insurance is not all doom and gloom. Both TAL and AIA have stated that AI is likely to enhance and NOT replace employees within the Claims function and is likely to have a positive impact to customers during their Claims process.

Looking objectively it’s clear to see that AI is going to have a considerable impact on the role of the Claims Assessor in Life Insurance in the coming years but human interaction is still going to be needed in the process.

It is even more likely that we will see new jobs created within Claims teams as machine-learning grows, creating new opportunities for experienced Claims professionals looking to take their careers forward.

Without a doubt, machines will be able to do some tasks faster and with greater accuracy but it seems the Insurers are committed to the quality of the conversation a human can have with a customer at Claims time.  

So what does this mean for today’s Claims Assessor? Now more than ever it’s going to be important to have the very best technical and soft skills within Claims. Machine-learning is fast but there are always going to be certain situations that the robot will not deal with but they are likely to be highly complex in nature and so technical expertise will be highly regarded. The softer skills in Claims management will also remain in high demand for some years to come. In my opinion, as customers, we are not yet ready to take a decision on our Life Insurance from a robot and so the human element of Life Claims will remain both important and in demand by Insurers. The key to a long and great career in Claims is to have the best skills in the market, learn your profession well and never stop learning…….the robots won’t!!!


Paul Murphy is the Managing Director of Ensure Recruitment.


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