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How Does AI Work for Casualty Claims

How Does AI Work for Casualty Claims?

In the realm of insurance, embracing new technologies can often feel like stepping into uncharted territory, especially when it comes to something as cutting-edge as artificial intelligence (AI). 

For risk managers and claims professionals at insurance carriers, understanding how AI can truly revolutionize claims management is paramount in staying ahead of the curve. Along with rising social inflation and competition for talent, AI is one of the defining trends of the current insurance landscape. 

If you’re curious about how AI can transform claims management, you’re not alone. Let’s dive into some of the most pressing questions about this game-changing technology.

Why is it important for claims professionals to work with AI partners?

Claim costs are increasing rapidly, becoming a significant and seemingly unpredictable expense for companies. 

At CLARA, we champion the concept of AI as augmented intelligence—not artificial. Augmented intelligence helps claims professionals understand where and why losses are happening. Predictive analytics can help us identify loss patterns and prevent them. Working with partners and vendors can simplify our work and help us make better decisions.

With the rise in litigation, claims and risk managers simply don’t have time to do everything they need to stop a claim from escalating. AI simplifies their work and helps them be more effective.

How does CLARAty.ai learn about casualty claims?

CLARA’s AI solutions—all part of our platform CLARAty.ai—derive their power from a robust contributory database engineered to offer precise, insurance-centric insights. Unlike newer AI solutions, CLARA’s contributory database has been steadily growing since 2017, learning from an ever-growing number of casualty claims outcomes.

While each casualty claim presents its own unique complexities, CLARA’s solutions excel in identifying patterns and similarities within the database, thereby furnishing claims professionals with invaluable insights.

Do I have to contribute my data to use CLARA?

While customers are not obliged to contribute their data, the majority of insurers opt to do so for enhanced returns on investment. The rationale behind this is simple: The more data AI has access to, the lower the likelihood of bias and inaccuracies creeping into its analyses.

Moreover, privacy remains a paramount concern for both CLARA and its customers. All claims data is meticulously anonymized, ensuring the utmost confidentiality. CLARA’s adherence to SOC2 and HIPAA compliance standards underscores its commitment to data security.

What if my data is in bad shape?

Your data doesn’t need to be perfect to start seeing benefits from CLARA or to start contributing. Our cloud-based platform can be up and running in 8-12 weeks after historical data is received, including model tuning, alert configuration, and hands-on training for adjusters.

CLARA will work with you to clean up your data.

How does AI help fight social inflation?

In an era plagued by social inflation, AI emerges as a formidable ally for insurers seeking to make informed, data-driven decisions. By harnessing AI-powered analytics, insurers can glean insights from both their own historical claims data and broader industry trends.

Furthermore, AI equips insurers with the tools necessary to combat the rising tide of nuclear verdicts orchestrated by plaintiff’s attorneys. With adversaries leveraging AI to bolster their legal arsenal, insurers must harness AI to level the playing field and stay competitive.

Will AI replace claims professionals?

Many claims professionals are currently under resourced and working at maximum capacity. Contrary to popular belief, AI isn’t poised to supplant risk managers; rather, it serves as a catalyst for augmented intelligence. AI liberates risk managers to focus on strategic decision-making by automating routine tasks and elucidating complex data interactions.

At CLARA, we champion the concept of AI as augmented intelligence, recognizing that its true power lies in supporting, not replacing, the claims adjuster of tomorrow. Our platform, designed with this vision in mind, serves as a valuable ally in training new adjusters and bolstering the capabilities of seasoned professionals. 

How does AI support claims professionals?

CLARAty.ai helps analyze claims and provides insights into industry-wide trends. The platform has a wealth of knowledge about past cases and proven effective strategies, making it a valuable resource for anyone dealing with a liability situation.

Where can insurers get started using AI to support claims management?

  • Analyze extensive claims data such as health records, demographic information, and lifestyle habits
  • Stop fraud by identifying anomalies or unusual patterns in vast amounts of data
  • Offer customers personalized recommendations and provide convenient and efficient channels for interaction with insurance providers
  • Optimize pricing and profitability by evaluating substantial amounts of data to evaluate risk levels and pricing accordingly
  • Improve industry benchmarking by participating in the contributory database to better train models that move the industry forward.

As the insurance industry continues to evolve, embracing AI-powered solutions like CLARA becomes not just a choice but a necessity. By leveraging AI to unlock unprecedented insights and efficiencies, risk managers and claims professionals can chart a course toward a brighter future for claims outcomes. 

Continue learning about AI’s role in casualty claims—explore our AI guide for claims professionals. 

Tyler Jones

Tyler Jones, Chief Customer & Marketing Officer of CLARA Analytics, is an experienced leader in using data, analytics and AI to solve complex business problems. He oversees the company’s customer success team whose primary goal is to drive customer AI adoption and measure the value generated by CLARA's leading commercial casualty insurance models.

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