For decades, the mandate of the chief claims cfficer was relatively clear: build a strong organization to investigate claims, control costs, manage litigation, negotiate settlements, and deliver fair outcomes.
That mandate is no longer sufficient.
The 2027 chief claims officer has a much bigger job: build the insurer's ground-truth engine—an AI-native operation that produces superior outcomes, industrializes negotiation excellence, and converts what claims learns into intelligence for the entire enterprise.
This is not simply about using AI to make legacy claims processes more efficient. AI is turning insurance into an information business—and the most important ground truth in that business is generated in claims. Claims reveal what actually happened to the risks the insurer underwrote, what drove the loss, and what ultimately determined its economic outcome.
To compete in an AI world, insurers will need to capture that ground truth, make it machine-readable, and use it to improve underwriting, pricing, reserving, and portfolio management.
That puts claims—and the chief claims officer—on the front line of this unprecedented transformation.
A new competitive environment
Claims officers in traditional claims organizations face urgent and pressing competition from two sources at once. On one side is an increasingly industrialized plaintiff bar. On the other side is a new generation of AI-native insurers, poised to move forward.
On the first side, consider Morgan & Morgan. The personal-injury giant says it has invested roughly $300 million in technology and AI and plans at least $1 billion more over the next decade. Its proprietary MX2 platform supports medical-record extraction, case research, document generation, demand letters, and trial preparation, while Injury.com digitally acquires and qualifies potential claims.
Private equity is adding fuel, investing in personal-injury platforms to scale technology, analytics, marketing and standardized operations.
The plaintiff bar is turning claim development and negotiation from individual craftsmanship into an industrial system.
On the second side, a new generation of AI-native insurers is being built without decades of legacy technology, workflows and organizational baggage.
Companies such as Corgi are attempting to build insurance businesses from inception around modern data architectures, AI agents and technology-speed iteration. McKinsey has warned that AI-native insurance businesses can increasingly build and refine products in weeks while incumbents remain calibrated to annual planning cycles and multi-year transformations.
Legacy insurers are being squeezed from both directions: out-innovated by the plaintiff bar in the contest over outcomes and potentially out-architected by AI-native insurers in the contest over how insurance itself operates.
Claims sits directly in the middle. That changes the requirements of its leader.
1. Level the playing field with the plaintiff bar
The plaintiff bar has largely approached AI as a weapon for improving economic outcomes. Carriers have largely approached it as a tool for workflow efficiency.
AI-powered demand packages are working. Carriers are only beginning to experiment seriously with the corresponding AI-powered offer package. Meanwhile, sophisticated plaintiff organizations are accumulating data, developing proprietary AI and attracting enormous capital.
The plaintiff bar is both the threat and the proof point.
They are investing their own money—and increasing institutional capital—because better case development, persuasion, and negotiation improve their economics.
The CCO must build institutional capabilities that can match increasingly industrialized counterparties.
2. Institutionalize negotiation excellence
Most carriers have some excellent negotiators. That is no longer enough.
If negotiation materially affects indemnity outcomes, it cannot remain an individual skill distributed unevenly across thousands of claims professionals. The organization should know who its elite negotiators are, why they outperform and how those behaviors can be replicated.
Carriers that cannot identify, measure and reproduce negotiation excellence do not really possess a negotiation capability. They possess individual negotiators.
The CCO must turn individual excellence into measurable institutional capability.
3. Stop putting AI band-aids on pre-AI claims operations
Many carriers can produce an impressive list of AI-centric projects: summarize a file, extract information, draft correspondence, analyze a demand, route work, search notes, or give adjusters Copilot.
Those applications can create real value. But old process plus an AI tool means slightly better old process.
McKinsey has warned about layering new technology onto legacy insurance operating models. BCG similarly distinguishes between deploying AI into existing processes and reshaping workflows around AI.
The CCO must redesign the operating model, not merely automate the existing one.
4. Build machine-first claims
The traditional claim file was built primarily for humans. Documents, notes, emails, medical records, and litigation materials accumulate while experienced professionals gradually construct an understanding of what happened.
In an AI-native operation, every claim should progressively become a machine-readable representation of the claim—the people, events, evidence, injuries, allegations, relationships, negotiations and outcomes.
That structured claim becomes the substrate on which specialized AI agents can continuously reason. Instead of occasionally asking AI to summarize a file, machines continuously read, structure, monitor, compare, detect, and prepare.
The CCO must make claims machine-readable while elevating, not diminishing, human judgment and action.
5. Build and lead a hybrid workforce
The future claim officer will have two kinds of capacity at their disposal: human expertise and machine intelligence.
AI agents will increasingly read, structure, monitor, research, compare, detect, analyze and prepare. Humans will increasingly concentrate on judgment, investigation, strategy, creativity, empathy, supervision, accountability and negotiation.
That will make exceptional claims professionals more important, not less.
Imagine an elite negotiator supported by agents that continuously understand the evidence, medical history, venue, plaintiff counsel, negotiation history, and comparable outcomes.
The machine handles much of the cognitive preparation. The human concentrates on what exceptional humans do best: think, strategize, persuade, read the counterparty, exercise judgment, and negotiate.
The CCO must become the architect of human and machine capacity—designing how each works together to produce better outcomes.
6. Make every negotiation a learning event
A sophisticated plaintiff demand should eventually meet an equally sophisticated carrier response. But the bigger opportunity comes afterward.
Every demand, analysis, strategy, offer, response, counteroffer, and outcome must become institutional knowledge in the same way that the plaintiff bar is institutionalizing these events.
Which plaintiff firms consistently outperform? Which strategies work against them? Which facts change settlement value? Which negotiators outperform expectations? Where does the organization systematically overpay?
Every negotiation should make the next negotiation smarter.
The CCO must ensure every claim and negotiation makes the organization smarter.
7. Elevate claims into the insurer's ground-truth engine
This is where the transformation extends beyond claims.
Underwriting begins with hypotheses about risk. Pricing quantifies them. Reserving updates them. Claims discovers what was actually true.
Claims learns what caused the loss, how injuries developed, what evidence mattered, how attorneys behaved, which defenses and negotiation strategies worked, and what the risk ultimately cost.
Yet much of that knowledge remains trapped in PDFs, notes, litigation files and the heads of experienced claims professionals.
Claims should continuously produce structured intelligence that flows into underwriting, pricing, reserving, risk, reinsurance and portfolio management.
The claim is no longer simply something to resolve and close. It is one of the insurer's richest proprietary information assets. The CCO must turn claims knowledge into enterprise intelligence—making the claims organization the feedback loop that allows the entire enterprise to learn.
8. Don't let claims become the transformation bottleneck
This may be the requirement that matters most to the rest of the C-suite.
A legacy insurer can modernize distribution, underwriting, pricing and portfolio management. But if its richest source of ground truth remains trapped inside a document-centric, human-first claims operation moving through multi-year transformation cycles, the rest of the enterprise eventually hits a wall.
AI-native competitors do not have to unwind decades of organizational architecture before redesigning how humans, machines and data work together. Incumbents do. That makes speed itself a competitive capability.
The modern CCO must protect the integrity of a massive, consequential operation while simultaneously making it capable of continuous change.
The plaintiff bar is moving at technology speed. AI-native competitors are being built for technology speed. Claims cannot continue moving at insurance speed.
The CCO must ensure claims leads rather than constrains the insurer's AI transformation.
The mandate has changed
None of these requirements eliminates the traditional responsibilities of the CCO. Claims still must be handled fairly; customers, regulatory obligations, litigation, reserves and operational discipline still matter.
But those responsibilities are increasingly table stakes.
Sophisticated plaintiff organizations are industrializing the pursuit of settlement dollars while AI-native insurers are being architected as technology-speed information businesses. Between them sits a claims organization that, at many incumbents, was designed for another era.
That creates both a threat and an extraordinary opportunity.
Carriers that generate that ground truth better, negotiate from it more effectively, make it machine-readable and distribute it throughout the enterprise will possess something more valuable than a more efficient claims department. They will possess a continuously learning insurance enterprise.
As chief claims officers enter 2027, the question is no longer whether their departments will use more AI. It is whether they can transform their departments into a competitive advantage rather than the bottleneck preventing the enterprise from changing with it.
