Written by James Cowburn, Claims Specialist, Guardian
Warnings about blindly trusting technology have been around for decades. The 1966 ‘Thunderbirds’ episode ‘Brink of Disaster’ tells the tale of a fully automated monorail that goes wrong due to the builder, Mr Grafton, cutting corners with safety precautions and naively assuming technology can handle the whole system with no human oversight. A rather retro lesson in not being overly reliant on technology, but one that resonates today when we think about using AI in the claims space.
Let me first say that I am not, by any means, a Luddite. I welcome the use of new technology when it makes things better, and there can be no doubt AI will significantly enhance how we handle claims. It’s clear there will be tasks we don’t need to do anymore, or at least less often. History shows us that these monumental shifts in technological development fundamentally reshape how we consume goods and services – and AI offers us the chance to reshape them for the better. However, thinking through where a human touch is still needed is key before diving into radical change.
When asked, AI tools themselves acknowledge that they’re best thought of as ‘assistants’ as opposed to replacements and aren’t always 100% correct. AI hallucinations are a recognised issue at the moment, and it’d obviously be unacceptable to any insurer for a claim decision to be based on a fiction. When using these tools, the assessor should still have oversight and be empowered to question when something doesn’t feel right.
Something as emotive as relaying a claim decision, particularly a negative one, also still needs the human touch. Although AI will help speed up decisions, it can’t replace the personal touches that are so crucial. There may well be fewer touchpoints due to AI – but that makes the ones that remain even more important.
We also need to think about continuity planning and make sure we have enough new assessors coming through into claims teams. Even the most pessimistic prediction about how AI will affect jobs reflects the fact that it’s a proportion of tasks done by a particular job, for example, a claims assessor, that may be taken on by AI, rather than the role being removed entirely.
Assessors’ time and effort will inevitably be increasingly focused on the more complex tasks or claims that AI can’t handle, but it’s only possible to gain the knowledge and experience to deal with these cases by starting from the ‘first rung’ of the ladder. We can’t expect budding new assessors to step straight into managing multi-faceted income protection claims with, for instance, numerous income sources and a subjective medical condition. It’ll be important we don’t forget this when deciding on AI-use cases, or we risk a shortage of talent in the future. We should consider how AI can support more junior roles in the industry, rather than replace them.
Vulnerable and less digital savvy customers are also something to consider as we look at how AI can support the claims experience. While it might help assessors complete their work more efficiently, we should always make sure claimants have the opportunity to simply talk to another human. We want to build trust and rapport with claimants, and that’s difficult to do via the use of chatbots or AI autogenerated responses.
While it’s important to acknowledge the risks, we should also recognise the significant opportunities AI can bring to the claims space. When applied thoughtfully, AI has genuine potential to strengthen customer outcomes. Intelligent triage and document‑handling tools can streamline information gathering and reduce end‑to‑end times, helping deliver quicker and more consistent decisions. Crucially, automation frees assessors to focus on the human moments that matter – supporting vulnerable claimants, handling complex cases, and building trust through personal conversations. Used responsibly, AI can support better outcomes – particularly for vulnerable claimants – which must remain the core objective of claims handling.
AI offers exciting new possibilities and should absolutely help us improve the claims experience – particularly end-to-end times. But it’s important that we keep central the personal touch our roles rely on so much to keep customer experience at the heart of what we do – but as the unfortunate Mr Grafton’s (albeit fictional) experience showed us back in the optimism of the space age in 1966, I don’t think it should replace what we currently do entirely.
