Following earlier articles exploring the fundamentals and effective prompting and risks of AI, this article turns to the tools available to claims professionals throughout the claims handling process.
Artificial intelligence is moving rapidly from concept to practical application across insurance claims. We spoke to three major providers of claims management systems – DOCOsoft, Guidewire and Charles Taylor – to hear their thoughts on how AI is shaping the claims profession and where value can be delivered.
While technology is often discussed in terms of efficiency gains, the conversations with providers suggested the impact could be far broader. From automating administrative tasks and improving claims triage to unlocking portfolio-level intelligence, AI is increasingly being viewed as a strategic enabler rather than simply another technology tool. At the same time, all three providers stressed that human expertise, judgement and accountability remain fundamental to effective claims handling.
How AI is reshaping the claims profession
The strongest consensus among the three providers is that AI will fundamentally change how claims professionals spend their time.
Routine and repetitive activities such as document review, workflow management and triage are expected to become increasingly automated. This shift will allow handlers to focus more of their time on customer engagement, negotiation, decision-making and complex case management. Charles Taylor has described AI as becoming “a core component of the claims operating model rather than a standalone technology”, supporting claims teams by taking on repetitive administrative work and improving overall customer experience.
DOCOsoft believes the increased support from AI for routine activities will be particularly valuable given the talent challenges facing the London Market, as identified in the recent LMA Claims Talent Survey. By reducing the burden of repetitive administrative work, AI can help organisations make better use of scarce expertise while creating more engaging and rewarding roles for claims professionals.
Guidewire anticipates a significant shift in the London Market and specialty sector, where large amounts of time are currently spent reviewing bordereaux, policy schedules, endorsements, broker correspondence, and expert reports. The company expects AI to assume much of this “reading and reconciling” work, enabling specialists to concentrate on strategy, negotiation, and client advocacy. Looking further ahead, Guidewire sees agentic AI taking on multi-step activities such as requesting missing documentation, validating third-party data and drafting communications.
Beyond operational efficiency, there is a broader vision emerging. DOCOsoft feels that AI’s biggest long-term impact may come from unlocking information that has traditionally been held within unstructured documents such as emails and reports, allowing claims professionals to identify claims patterns and insights, transforming claims data into strategic intelligence that can inform underwriting, pricing, reserving and risk management decisions across the business.
Where AI delivers value today
AI can have application across the entire claims lifecycle, however, DOCOsoft highlights “the key is to apply the technology to the right problems, with clear objectives and measurable outcomes so that organisations can define what success looks like and assess whether real value is being delivered”.
The most immediate benefits are often seen during claims intake and triage. AI can process incoming emails, reports, claim notifications and supporting documents, extracting key information and routing claims appropriately. All providers highlighted the ability of AI to remove routine and repetitive tasks, and classify, prioritise, and triage work based on risk, urgency and complexity to help organisations deploy resources more effectively.
Claims understanding and summarisation were also identified as major opportunities. Claims handlers frequently handle files containing extensive correspondence, reports and historical activity. Guidewire stated that AI can deliver value by consolidating this information into concise, role-specific summaries, reducing the time needed to understand a claim’s status, history and outstanding actions.
The growing importance of portfolio-level analysis was also highlighted by all providers. DOCOsoft sees significant value in using AI to analyse claims data at scale, identifying trends, correlations and claims leakage that would be difficult for humans to detect manually, arguing that even small improvements in claims outcomes can generate substantial financial benefits when applied across large books of business.
Guidewire similarly emphasised AI’s role in reserving, settlement strategy, and leakage control. By applying predictive analytics across large datasets, insurers can improve reserve accuracy, identify potential fraud or subrogation opportunities, and gain early visibility of emerging risks. They also believe AI will strengthen claims oversight by giving managers near real-time insight into portfolio performance, complaints trends and litigation risks.
Charles Taylor suggested that AI could remove routine and repetitive tasks, allowing the claims handlers to spend more time on customer engagement, but also echoed the management advantages of AI-driven insights, highlighting that AI can help improve visibility into claims trends, operational bottlenecks, leakage and performance metrics, supporting more informed business decision-making
Available AI capabilities
While the industry’s ambitions for AI are significant and plans continue to evolve, many valuable capabilities are already available.
Guidewire
Guidewire has focused on embedding AI directly into claims workflows. Its capabilities include predictive analytics through Claims Intel models, which generate risk and severity scores to support claims prioritisation and more accurate reserving decisions. The company also offers agentic claims summarisation, allowing claims handlers to familiarise themselves quickly with complex files. Claim handlers can also benefit from an embedded knowledge assistant to query organisational guidance and procedures using natural language.
DOCOsoft
DOCOsoft’s AI capabilities focus on applying technology to real-world practical challenges faced by claims handlers. These have been developed over many years, with close ongoing partnership with leading carriers. Their current offering includes the ability to extract key information from documents and emails, categorise incoming material and flag issues requiring attention from the claims handler, claim prioritisation and triage based on factors such as urgency, complexity and risk, claims summarisation, support for faster, better-informed human decision-making, and analysis of claims at scale to identify patterns, emerging trends and potential leakage.
Charles Taylor
Charles Taylor has recently undertaken workshops with more than 60 users to understand the market demand. Claims summarisation, knowledge transfer, intelligent triage and prioritisation, analytics, portfolio oversight and the enrichment of structured and unstructured data emerged as the key priorities. Working with Microsoft as a trusted partner to bring these ideas to life, development is underway and The company indicated that further announcements were expected later in 2026 and in early 2027.
Across all three organisations, a common theme is that the objective is not simply to introduce new technology, but to improve the way claims professionals work within their existing environments.
Why human expertise remains essential
Despite the advances in AI, the three providers are united in their belief that some aspects of claims handling should remain firmly under human control.
Coverage decisions, settlement strategies, reserving judgements and disputed claims all involve significant legal, financial and reputational consequences. While AI can help gather information, identify relevant evidence and highlight possible outcomes, the providers agreed that accountability for these decisions should remain with human claims professionals.
Charles Taylor identified customer support, complex judgement, settlement negotiations and regulatory oversight as areas where human expertise remains indispensable, advising they see the role of AI as “augmenting, rather than replacing claims professionals”.
DOCOsoft stressed the importance of explainability, traceability and effective human oversight. The company argues that claims professionals must be able to understand and challenge AI outputs before relying on them in decision-making, while also sharing Charles Taylor’s thoughts on customer support, highlighting the importance of empathy, communication and relationship management, particularly in complex or sensitive claims situations. Guidewire points specifically to the complexities of London Market business, where bespoke wordings, multi-carrier placements and long-standing broker relationships require nuanced judgement. Although AI can provide support, they believe that at least in the intermediate term, coverage and wording decisions, major loss strategy and negotiations, client care during difficult claims, and decisions involving sanctions, contentious declinatures or ESG considerations will remain firmly human-led
Conclusion
A clear picture of the future is emerging. AI is likely to take on more of the processing, organisation and analysis of claims information, helping insurers improve efficiency while generating deeper operational and portfolio-level insights. Claims professionals need not see these developments as a threat: judgement, negotiation, empathy and accountability will remain central to successful outcomes.
Rather than replacing claims professionals, AI has the potential to make them more effective. To realise these benefits, insurers will need to combine technology with human expertise, using AI to reduce administrative burdens while enabling claims teams to focus on work that creates the greatest value for customers, brokers and the business
Acknowledgements and provider contacts
The LMA thanks Charles Taylor, DOCOsoft and Guidewire for contributing their perspectives to this article.
Up next: “Trust, but Verify” explores the key areas in which claims professionals should exercise care when using AI.