Insurance Claims- how AI can help and hinder, Mike Daly

Claims leaders would not want to have to answer to the UK's FCA, or in USA State regulators and NAIC on which human was responsible for rejecting a claim or worse still a judge for a high value claim litigation case. As I explain in articles below Claims Directors, CTOs etc cannot blame a rogue agent - a human must have authorised any decision and be accountable.

Neverthess the wole range of AIs must be leveraged-just know why, when, where, how.

The first part of this compilation of articles explains the limitations and opportunities AI tools offer to transform claims. The second part is a detailed look at building your own claims transformation platform . Some arduous reading but the devil is in the detail.

Part One - Digital Agents & AIs- opportunities and pitfalls

Beyond Digital FNOL- innovation across claims Market Opportunity, Vendor Landscape and a Composable Platform Strategy to Compete Across the Claims Ecosystem Contents The Strategic Landscape The Full Claims Lifecycle- where AI fits best The Innovation Gap Designing a Composable Core and... Read more Share via: LinkedIn | X | Facebook

Human in the loop is just not enough for insurers to avoid litigation! An article by Elol Jacoby, co-founder and CPO at Notch, adds more depth to the article I published yesterday of the dangers of digital agents proliferating across the insurance value chain. If a large claim has been rejected by digital... Read more Share via: LinkedIn | X | Facebook

When automous digital agents fight each other and forget an insurer's goals and intent This article is a warning not to disappear like Alice through the AI looking glass into the world of the Red Queen who initially seems rational only for Alice to later realise she hallucinated about the Red Queen and manages to control her... Read more Share via: LinkedIn | X | Facebook

Allianz leads the pack as insurers race to turn AI investment into real competitive advantage Interesting 2026 analysis by Evident Insights of 30 US and European insurers using publicly available information to help avoid distortion by hype and marketing not just by AI and LLM endors but by insurers themselves! It supports the... Read more Share via: LinkedIn | X | Facebook

World Property and Casualty Insurance Report 2026 I would recommend that CEOs have their teams read this report prior to a business planning and strategy session. It raises questions that must be answered if insurers are to leverage AIs (including Digital Agents). Read the full report so the... Read more Share via: LinkedIn | X | Facebook

AI and the End-to-End Claims Process: Options, Vendors and the State of Play AI and the End-to-End Claims Process: Options, Vendors and the State of Play The Strategic Landscape The insurance industry is past the question of whether to apply AI to claims — the conversation has shifted to how fast and how deep. A majority... Read more Share via: LinkedIn | X | Facebook

AI agents are already inside your digital infrastructure- where's the trust layer? Say there are between 4 and 40 AI agents acting on behalf of every human in an enterprise. The ‘human-in-the-Loop’ safety math simply doesn't work at large scale. At a scale of millions, manual human oversight becomes physically impossible,... Read more Share via: LinkedIn | X | Facebook

Part 2 The articles above advise time to think, strategise and resource/direct teams

These next articles are a detailed look at developing claims tech and scaling AI.

Article 8 includes links to articles 1-7 and in some ways is a good intro to the whole series.

8. A practical roadmap for AI and Insurance Claims I value reading the comprehensive reports and guides that McKinsey, BGG, Bain and others publish on the way to deploy AI in all its guises, including Agentic AI across an insurer. They neverless can leave confusion as readers try and... Read more Share via: LinkedIn | X | Facebook

1. Agentic AI & Insurance Claims Steve Walker and Camelot Consultants published a challenge and opportunity- ‘Strategic Claims Management: Taking Claims From an Operational Necessity to a Strategic Asset’ which is well worth a read. Just follow the link to see why the author... Read more Share via: LinkedIn | X | Facebook

2. The Claims Spectrum- how it impacts AI deployment Authors: Chris Brown - The Build Paradox , Mike Daly - Insurtech World This is the second in a series about claims innovation and leveraging AIs - planning and execution. You will find article One in Further Reading (after... Read more Share via: LinkedIn | X | Facebook

3. Fools rush in where angels fear to tread'. Defining Agentic AI Image: Getty This is the third of six articles that Chris Brown and I are publishing to offer a framework for planning, scaling and operationalising claims transformation leveraqing AI. The first two are linked here: - Agentic AI & Claims... Read more Share via: LinkedIn | X | Facebook

4. Scaling and operationalising AI across insurance claims “Don't count you chickens until they hatch” is the metaphor to describe this article. The demo worked brilliantly. The pilot impressed stakeholders. The vendor’s case studies are compelling. Have you been in that position? But now someone’s... Read more Share via: LinkedIn | X | Facebook

5. Data, data everywhere nor any byte to digest Part 5 of the series: Agentic AI in Insurance Claims: AI-ready data 'The Ryme of the Ancient Mariner' by Samual William Coleridge in 1798, tells of a mariner who killed an Albatross which had lead his ship out of icy Antarctic waters;... Read more Share via: LinkedIn | X | Facebook

6. Why Perfect Accuracy in AI Claims Handling Is the Wrong Target This is the sixth in a series Christopher Brown and I have published to help plan and implement AIs across the claims value chain. The previous articles can be read on Insurtec World. This week we discuss accuracy and a key question- how... Read more Share via: LinkedIn | X | Facebook

7. AIs, Insurance Claims & the Automation Trap There is a seductive vision in some AI vendor pitches: automate claims end-to-end, reduce headcount, let the AI handle everything. Scale without limits. Transform your cost base permanently. This vision has a fatal flaw, and it is not the... Read more Share via: LinkedIn | X | Facebook

Why not contact me on LinkedIn to discuss any topic discussed above?Claims leaders would not want to have to answer to the UK's FCA on which human was responsible for rejecting a claim or worse still a judge for a high value claim litigation case. As I explain in articles below Claims Directors, CTOs etc cannot blame a rogue agent - a human must have authorised any decision and be accountable.

Neverthess the wole range of AIs must be leveraged-just know why, when, where, how.

Part One -Beyond FNOL with Digital Agents- opportunties and pitfalls

Part 2 The articles above advise time to think, strategise and resource/direct teams

These next articles are a detailed look at developing claims tech and scaling AI.

Article 8 includes links to articles 1-7 and in some ways is a good intro to the whole series.

Why not contact me on LinkedIn to discuss any topic discussed above?

The average homeowner waits 44 days from first notice of loss to final payment, according to the J.D. Power 2025 U.S. Property Claims Satisfaction Study, based on 5,178 homeowner claims filed over the past year. The longest recorded wait since the study began in 2008. Catastrophic event volume explains part of the pressure: 27 CAT events in 2024, 28 the year before, layered on top of ongoing repair backlogs and premium increases. But volume alone doesn't account for a cycle time that keeps climbing. Michael Krikheli Founder & CTO Five Sigma