Insurers use AI to speed evidence gathering

Insurance companies are putting artificial intelligence to work earlier in the claims process, not at the point of final approval. Insurance Business reported on August 5 that carriers are finding the clearest near-term use for AI in evidence gathering — pulling together documents, photos and other facts before a human adjuster decides what to do with the claim. That approach is gaining traction as insurers face a second problem at the same time: AI-generated fraud. Digital Insurance reported that 98% of insurers said AI editing tools are fueling digital fraud, while only 32% said they were confident they could detect deepfakes today. ### Where are insurers actually using AI first? Insurance Business said the “safest first win” for claims AI is evidence gathering rather than deciding whether a claim should be paid. (insurancebusinessmag.com) The article described AI as useful for getting a file ready for review faster, while leaving the final judgment to people. That distinction matters because claims files are document-heavy. (dig-in.com) Photos, repair estimates, policy records, prior correspondence and third-party reports can all sit inside the same claim, and the operational gain comes from organizing that material before an adjuster makes a liability or payment call. That is the role Insurance Business highlighted in its August 5 report. (insurancebusinessmag.com) ### Why are carriers stopping short of full claims automation? Insurance Business framed the issue around human judgment. Its August 5 report said AI can help claims teams assemble facts faster, but that the decision still needs human judgment. A May 13 Insurance Business report pointed to the same direction more broadly across insurance operations, saying a CEO study found AI was putting human judgment “back at the centre” of insurance rather than replacing it. (insurancebusinessmag.com) That report said insurers were moving from pilots into day-to-day deployment across underwriting, claims and service. ### What is pushing insurers to be cautious? Digital Insurance said AI is expanding the fraud problem even as carriers adopt the technology themselves. Its report said AI editing tools are enabling a wide range of digital fraud threats, and that insurers using AI and automation in security can reduce breach costs by millions. The most telling gap in that reporting was confidence. Digital Insurance said only 32% of insurers were confident in detecting deepfakes, even as 98% said AI editing tools were fueling digital fraud. (insurancebusinessmag.com) That leaves carriers trying to speed claims operations while also screening for manipulated images, documents and identities. An April 1 Insurance Business report, citing Verisk commentary, said increasingly sophisticated AI tools were accelerating insurance fraud and reshaping claims, trust and pricing across the industry. (dig-in.com) That report said the fraud surge could raise costs and slow the claims process. ### What does this change for policyholders? (dig-in.com) Claims teams using AI for evidence gathering could shorten the time spent sorting files and reviewing supporting material, based on the August 5 Insurance Business report. The article’s framing suggested the customer-facing effect is likely to show up first in faster document review rather than in fully automated claim outcomes. (insurancebusinessmag.com) Digital Insurance’s fraud reporting points the other way at the same time. If carriers are less confident in spotting deepfakes, more scrutiny around images, IDs and submitted records may become part of the claims process as insurers try to block manipulated evidence. ### What should readers watch next? August 5 is the key date in the current coverage. Insurance Business’s report on claims workflow and Digital Insurance’s reporting on fraud together suggest the next developments will show up in carrier claims operations, fraud controls and vendor tools built around document review and deepfake detection. (insurancebusinessmag.com) Digital Insurance’s AI and research pages, along with Insurance Business’s U.S. claims coverage, are the clearest places to watch for follow-up reporting from named carriers, claims executives and fraud technology providers. (dig-in.com 1) (dig-in.com 2) (insurancebusinessmag.com)