Automated systems are in high demand, according to a survey conducted by RDT Claims Handlers.
Insurance claims handlers are navigating a significant shift in their roles, driven by the increasing adoption of automation technologies such as artificial intelligence (AI), machine learning (ML), robotic process automation (RPA), and related technologies. While the benefits of automation are undeniable, there is a growing consensus that human judgment and customer engagement are equally important in the claims process.
The benefits of automation are numerous. It offers efficiency and speed, reducing manual effort and paperwork while accelerating claim settlements. AI and ML also improve accuracy and fraud detection, analysing vast datasets with precision. Additionally, AI-powered chatbots and digital platforms enhance customer experience by providing real-time support, guiding customers through claims, and delivering personalised service. Advanced analytics allow insurers to shift from reactive claims handling to proactive risk management, especially after major incidents. Automation also contributes to cost control by reducing operational costs and enabling insurers to manage large claim volumes without proportionally increasing headcount.
However, concerns about automation are also prevalent. Claims handlers may worry about job security as their roles shift towards oversight, exception handling, and customer empathy. There is a risk of over-reliance on technology, which could undermine the value of human judgment in complex, nuanced, or controversial claims cases. Integration challenges can create silos, operational delays, and reduce the quality of insights if data is not harmonised across platforms. Cybersecurity risks increase as claims systems become more digital, potentially disrupting operations and eroding customer trust. Real-time API-driven adjudication and dynamic rule updates by payers can lead to faster denials and tighter appeal windows, requiring claims handlers to adapt quickly.
In response to these concerns, the focus is shifting towards human-centric solutions. Human claims handlers remain essential for complex decision-making, handling exceptions, and providing empathetic customer support. The human touch is critical for sensitive situations, dispute resolution, and ensuring customers feel heard and valued. Advanced insurers are employing "agentic AI," where AI agents and humans work collaboratively—AI handles data analysis and process execution, while humans focus on judgment, relationship management, and ethical considerations. Customers increasingly expect personalised, responsive service. Hybrid models that combine automation with human intervention are seen as the best way to achieve this balance.
The survey by RDT reveals a paradox in the insurance industry where claims handlers want automation but fear its potential impact on their roles. The survey conducted by RDT suggests that claims handlers are seeking ways to streamline their jobs through automation. The new focus seems to be on the role of human-centricity in the digital claims process, rather than the potential impact of automation on roles and control of the claims process.
Joe O'Connor, Deputy CEO of RDT, emphasised the importance of human-centricity in claims management at the TIN Digital Claims Conference. He stated that while AI offers benefits, it should not have the final word on all claims, especially in Personal Injury (PI) claims due to potential emotional trauma. O'Connor reiterated that humans are essential in claims management, as both claimants and handlers are at the centre of the process.
In conclusion, claims handlers recognise that automation—especially AI and ML—delivers tangible benefits in efficiency, accuracy, and customer satisfaction. However, there are clear concerns about job evolution, system integration, cybersecurity, and the potential loss of human empathy. The most effective claims management strategies in 2025 will blend automation’s strengths with the irreplaceable value of human judgment, empathy, and oversight, ensuring both operational excellence and a customer-centric approach.
Technology and events intersect in the insurance industry as advances in AI, ML, RPA, and other related technologies are reshaping claims processing. These technologies contribute to increased efficiency, reduced manual effort, faster claim settlements, and improved fraud detection. However, a significant event, such as the TIN Digital Claims Conference, emphasizes the importance of human-centric solutions in tackling the concerns surrounding automation. Depending on the complexity, sensitivity, or controversies of claims, human judgment and empathetic customer support are crucial components in the digital claims process.
