Revolutionizing Insurance: The Impact of AI on Claims Processing

Authors

  • Balakrishna Sudabathula JNTU, India Author

DOI:

https://doi.org/10.32628/CSEIT251112302

Keywords:

Artificial Intelligence in Insurance, Claims Process Automation, Machine Learning Fraud Detection, Explainable AI, Digital Insurance Transformation

Abstract

The insurance industry is undergoing a fundamental transformation through the integration of artificial intelligence technologies, particularly in claims processing. This comprehensive article examines how AI-driven solutions are revolutionizing traditional claims-handling workflows, from initial submission to final settlement. The implementation of machine learning algorithms, computer vision, and natural language processing has enabled insurers to automate routine tasks while enhancing accuracy and efficiency. These technologies facilitate real-time fraud detection, automated document verification, and intelligent data extraction from various sources. The article explores the technical framework of AI-driven claims processing, system integration challenges, and the crucial aspects of maintaining fairness and transparency in automated decision-making. Additionally, the article analyzes the impact on operational efficiency and customer experience, highlighting how AI implementation has transformed service delivery and customer interaction models. It also investigates emerging trends and future developments, including edge computing and blockchain integration, while addressing the challenges of balancing automation with human oversight in the evolving insurance landscape.

Downloads

Download data is not yet available.

References

Petr Stros, "The future of insurance: Integrating AI for smarter risk assessment," Avenga Magazine, 2024. [Online]. Available: https://www.avenga.com/magazine/integrating-ai-for-smarter-risk-assessment/

Pravina Ladva and Antonio Grasso, "The evolution of AI in the insurance industry," Swiss Re Institute, 2024. [Online]. Available: https://www.swissre.com/risk-knowledge/advancing-societal-benefits-digitalisation/evolution-of-ai-in-insurance-industry.html

Faheem Aslam et al., "Insurance fraud detection: Evidence from artificial intelligence and machine learning," Research in International Business and Finance, Volume 62, December 2022. [Online]. Available: https://www.sciencedirect.com/science/article/abs/pii/S0275531922001325

Maruti Techlabs, "Revolutionizing Insurance Claims Processing with Machine Learning," Maruti Techlabs, Medium, 2023. [Online]. Available: https://marutitech.medium.com/revolutionizing-insurance-claims-processing-with-machine-learning-214b660cf1b3

Mostafa Radwan, "Modernizing Insurance With Cloud-Native Technology," Cloud Native Now, 2024. [Online]. Available: https://cloudnativenow.com/topics/modernizing-insurance-with-cloud-native-technology/

Jonathan Hiett, "Unlocking the Power of Data Pipelines in Insurance: Maximize Value, Minimize Risk," Broadcom Academy, 2024. [Online]. Available: https://academy.broadcom.com/blog/automation/unlocking-the-power-of-data-pipelines-in-insurance-maximize-value-minimize-risk

Lumenalta, "Ethical Considerations of AI," Lumen Alta Insights, 2024. [Online]. Available: https://lumenalta.com/insights/ethical-considerations-of-ai

Dr. Jagreet Kaur Gill, "Explainable AI in Insurance Industry," XenonStack, 2024. [Online]. Available: https://www.xenonstack.com/blog/explainable-ai-insurance-industry

Vera Smirnoff, "The Impact of AI on Claims Processing," EasySend. [Online]. Available: https://www.easysend.io/blog/the-impact-of-ai-on-claims-processing

Restack, "KPI Metrics For Ai In Insurance," Restack, Jan. 2025. [Online]. Available: https://www.restack.io/p/ai-in-insurance-tech-answer-kpi-metrics-cat-ai

Wipro, "Adopting a New Approach to Demystify the Future of Insurance," Wipro. [Online]. Available: https://www.wipro.com/insurance/adopting-a-new-approach-to-demystify-the-future-of-insurance-wit/

Faheem Shakeel, "Top Insurance Claims Transformation Trends in 2024: Is Automation Still the Go-To Technology?," Damco Group, 2024. [Online]. Available: https://www.damcogroup.com/blogs/top-insurance-claims-transformation-trends

Downloads

Published

18-02-2025

Issue

Section

Research Articles