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Claims AI’s early wins focus on evidence gathering, not decisions
Industry guidance warns that when AI-generated information is used for important claims decisions, insurers should review it carefully, while Aviva has reported growth in motor claims backed by manipulated images and documents.
Claims teams have a clear, lower-risk entry point for artificial intelligence, according to Insurance Business: using AI to assemble and organize the information that adjusters need, rather than letting a model make high-stakes pay, deny, or settlement decisions. The article says insurers have multiple faster tasks AI can support in claims processing, including reading and summarizing documents, comparing photos, pulling relevant policy language, checking prior losses, and consolidating data that may be spread across different systems.
Regulators also flag the potential downside when AI output moves beyond a support role. Insurance Business cites the National Association of Insurance Commissioners, noting it says AI is already being used in claims processing to estimate repair costs or assess damage using photos and historical data, but that AI-generated information should be reviewed carefully when used for important decisions. The caution is underscored by Aviva’s fraud update, which Insurance Business describes as showing a growing number of claims supported by AI-generated images and manipulated documents, especially in motor insurance, with advanced analytics and AI-enabled tools used alongside human oversight to spot suspicious claims earlier. The piece argues that the safer path is an evidence workbench, where adjusters apply judgment for next steps based on consolidated policy terms, loss history, photos, estimates, weather information, communications, and prior claim notes.