Story 6 – Shaping the Future of Claims

Welcome to Story 6 – the penultimate ‘story’ of IPTF’s 7 Claims Stories initiative. As we explore the role of artificial intelligence in protection claims, it’s impossible not to reflect on just how dramatically our working world has changed over the past quarter of a century, without us really realising it. The pace of transformation has been so steady and so constant that many of the shifts barely registered at the time, yet looking back, the contrast is striking.

There was a time when claims work meant being permanently office‑based, surrounded by paper files, desk phones, and manual processes that now feel almost quaint. Many assessors will remember marking key pages of medical evidence with little coloured tags or reaching for a medical dictionary.  I believe Mosby’s was the dictionary of choice when an unfamiliar condition appeared on a claim. Internet access wasn’t widely available in most workplaces, so information gathering was slower, more physical, and often far more laborious than anything we experience today.

Fast forward to today and the landscape is almost unrecognisable. The tools we use, the way we communicate, and the speed at which information moves have all shifted dramatically. Processes that once relied on paper, post, and physical presence have mostly evolved into something far more streamlined and digitally enabled. And while there are still exceptions, the claims journey has mostly become faster, more flexible, and more accessible. Now, with artificial intelligence accelerating at pace, we stand on the brink of yet another profound shift – one that promises new efficiencies and insights, but also raises important questions about risk, fairness, and the enduring need for human connection.

To explore this evolving landscape, three respected industry professionals have each shared their own stories and views on different aspect of AI’s role in protection claims. Their reflections offer a balanced, grounded view of where we’ve come from, where we’re heading, and what we must consider along the way.

And because this conversation belongs to the whole industry and we’d love to hear your views, we are asking our readers to complete a short survey kindly created by Monica Garcia of Monica Garcia Consulting.  It will take less than 3 minutes to complete and will help us really gauge the effect AI is having on our industry. We will of course, share the insights once the survey is completed.

Part One – Sally Phillips, Technical Claims Lead, LV=

In this article, Sally Phillips reflects on how income protection claims have evolved from paper files and postal processes to streamlined, phone-based and digitally supported assessments. It’s a thoughtful look at how far claims has come and why this once “Cinderella” function is now stepping into a new era of progress and investment.

Part Two – Andy MacIver, Claims Technical Specialist Lead, Legal & General

From paper files to AI-powered tools, digitisation is transforming the way claims are handled and experienced. Read Andy MacIver’s article to explore how the industry can embrace innovation while protecting the human touch that matters most.

Part Three – James Cowburn, Claims Specialist, Guardian

From a 1960s Thunderbirds tale of runaway automation to today’s fast-moving AI debate, James Cowburn explores why claims teams shouldn’t hand over the controls completely and how technology can accelerate progress without replacing the human judgement and trust at the heart of great claims handling.

Summary & Reflections – Phil Deacon, Phil Deacon Consulting

Story 6 brings together three thoughtful and experienced voices to explore one of the most significant developments facing the protection industry – the rise of AI and what it means for claims. Across their reflections, a clear picture emerges – one of enormous potential, balanced by the need for caution, clarity, and humanity when considering the implications for claims teams and the customers they support.

The opportunities are compelling. AI can streamline medical evidence collation, summarise complex information, support decision consistency, and help identify holistic risk factors earlier in an income protection claim. These tools could free assessors from time‑consuming administrative work and allow them to focus their expertise where it has the greatest impact. In some cases, this could prevent short‑term absence from becoming long‑term, supporting customers back to work sooner and improving outcomes for all involved.

But the contributors also highlight the risks of moving too quickly or too confidently. Over‑reliance on automation, the loss of early‑career learning opportunities, digital exclusion, and the erosion of human touchpoints all pose real challenges. Claims arise at moments of vulnerability, and no algorithm – however sophisticated – can replace the reassurance of a compassionate conversation or a carefully explained decision.

There are also deeper questions to consider. As AI becomes more capable of searching and interpreting large volumes of medical information, could it one day pre‑populate application data with a level of accuracy that removes the risk of misrepresentation altogether? And if so, what would that mean for underwriting, claims, and the customer journey as a whole?

While the articles focus on the opportunities and challenges of AI, they also hint at a familiar tension in our industry. We all understand why front‑end investment often takes priority – growth, distribution, and new business are obviously vital. But claims shouldn’t be left behind. If we truly want to put customers at the centre of what we do, then investing in the part of the journey where our promises are delivered becomes essential. Strengthening claims through thoughtful use of AI not only improves outcomes for customers, it also builds trust in the protection industry as those outcomes are felt and shared across the industry as a whole. There can be no more excuses for poor claims performance.

What’s clear from this story is that the future of protection claims will not be defined by technology alone. It will be shaped by the choices we make about how to use it – responsibly, thoughtfully, and by choosing to keep the end customer in mind. In the end, innovation and empathy must evolve together!