What’s Next for Insurance Claims Automation? Moving from Small Wins to Big Challenges

The Next Big Challenge

For the past two decades, digitalisation has brought big changes to the insurance industry. Today, most insurers in the Nordic region have successfully automated their “volume claims”. This automation has made the process faster and more efficient, benefitting both insurers and policyholders. But with this achievement comes a new question: what’s next?

Decades of improving volume claims sets the foundation for future operational claims efficiencies

For the past two decades, digitalisation has brought big changes to the insurance industry. Starting with basic software and data tools, insurers have made steady progress in automating the claims process. Today, most insurers in the Nordic region have successfully automated their “volume claims”—everyday claims like theft, minor property damage, or travel losses. This automation has made the process faster and more efficient, benefitting both insurers and policyholders. But with this achievement comes a new question: what’s next?

The answer lies in tackling “complex claims”—those large, intricate cases involving significant losses from events like fires, floods, and storms. These claims are more challenging and often require multiple parties, such as restoration companies, to work together. Automating these claims offers huge potential benefits in terms of time, cost, and efficiency, but it won’t be easy. Here’s a look at what’s driving this new phase of automation, the challenges it brings, and the path forward for insurers.

Why Automate Complex Claims?

Several factors are pushing insurers to automate more than just routine claims. First, customer expectations are higher than ever. Today’s policyholders expect a quick, smooth, and transparent process when filing a claim. Cost is also a big driver—automating more complex claims could significantly reduce expenses for insurers. And with climate change causing more extreme weather events, insurers face rising volumes of high-value, complex claims. Automation can help them handle these claims more efficiently.

The Challenges of Complex Claims Automation

While volume claims were well-suited to automation, complex claims come with their own set of challenges. For one, they often involve legacy systems that are incompatible with modern technology. Data quality is another hurdle—without structured, accurate data, automation can actually create more problems than it solves. And unlike simpler claims, complex cases often benefit from a human touch. Claims handlers bring empathy and experience to these situations, which is something that algorithms can’t fully replicate.

Opportunities for Innovation

Despite these challenges, automating complex claims holds exciting potential for the industry. Insurers who embrace digital tools to collect and structure data could significantly speed up the process and make it more accurate. Platforms that enable real-time collaboration between claims handlers, third-party providers, and policyholders could also streamline communication and reduce duplicate work. Over time, data from complex claims could fuel predictive models, helping insurers identify patterns, forecast costs, and ultimately make the process even smoother.

Laying the Foundation

To make complex claims automation work, insurers need the right foundations. This includes modernising their tech infrastructure, ensuring high data quality, and creating digital partnerships with third-party providers. Internally, they also need to secure buy-in from staff, many of whom may feel uncertain about these changes. Making sure the whole team is on board is crucial, as it’s the claims handlers who bring the expertise needed to adapt these tools effectively.

Looking Ahead

Automating complex claims is no small task, but the potential payoffs are huge. Insurers who lead the charge in this next wave of digitalisation will position themselves as frontrunners in a rapidly changing industry. By combining data-driven tools with human expertise, they’ll be able to deliver faster, more transparent service even for the toughest cases, creating a better experience for policyholders and greater efficiencies for themselves.

In the world of insurance, digitalisation is an ongoing journey. Insurers who embrace both the challenges and opportunities of complex claims automation are laying the groundwork for a future where speed, accuracy, and empathy go hand in hand.