Reimagining Claims with AI: A Practical Path from Manual to Autonomous Workflows

Claims processing is undergoing a profound evolution—from manual, analog workflows to intelligent, autonomous systems driven by artificial intelligence. While some insurance operations still rely on sticky notes and physical files, others have embraced digital tools, yet remain overwhelmed by disjointed systems and inefficient processes. Now, the true transformation lies in autonomy, where AI-powered digital agents can collaborate with adjusters to streamline, augment, and enhance the claims lifecycle.

The urgency for AI integration is clear: with a shrinking workforce, rising claim complexity, and growing customer demands, insurers must leverage technology to maintain performance and deliver high-quality service. But successful adoption requires more than selecting a few vendors or running small pilots. A robust AI strategy must align with business objectives, integrate into existing operations, and focus on long-term value creation.

This article outlines the three waves of AI adoption—automation, augmentation, and workflow transformation—guiding insurers through their current stage and into a more efficient future. Real-life AI claims agents, such as Clyde and Ingrid, showcase how intelligent automation can handle tasks like claimant verification and data intake around the clock, allowing human adjusters to focus on complex decision-making and customer communication.

Ultimately, AI should not replace adjusters—it should empower them. By reframing the adjuster’s role, building operational resilience, and fostering collaboration between people and machines, insurers can lead the shift toward a future-proof claims model. The time to move from analog to autonomous is now.