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Past, Present, and Future of AI in Claims 

AI-powered claims management is evolving beyond efficiency, promising deeper insights while keeping human expertise central.

An artist’s illustration of artificial intelligence

The digital transformation occurring throughout all levels of the claims management industry is not new. It began years ago and is just now beginning to truly shake up this sector. At Sedgwick, we have been focused on the next generation of digital tools, but it's critical to understand where we've been, where we are now, and where we're going. If companies want to ensure they are maximizing this exciting new technology.

Where We've Been

The claims industry has been leveraging analytical AI for years at this point, such as in predictive modeling programs. More recently, the advent, and rapid adoption, of generative and agentic AI have emerged as key differentiators for third-party administrators (TPAs). Understanding how companies can leverage this technology, and creatively and effectively apply it to different lines of business to drive new and improved outcomes, will be a deciding factor in terms of success.

Most companies in our industry started in the same place when generative AI burst on the scene two and a half years ago: document summarization. While we were all starting to recognize the power of generative AI, that technology began to evolve at exponential speed. Everyone learned to fail fast in this space and spent significant time understanding the new features as they came out every month. Many companies introduced initiatives using data extraction and analysis from claims-related documents, while others explored whether large language models (LLMs) could support automated customer support options. Keeping up with AI's advances drove IT teams to prototype rapidly, but generative AI itself prompted companies to re-evaluate their initial use cases every day.

What did we learn? The keys to success haven't changed: Robust data sets, data science maturity to understand what the data means, and industry-leading claims practice are still the critical components to establish a foundation for digital transformation of the industry. Changing an age-old claims workflow is no easy task and cannot be accomplished overnight. Tech-enabled best practices must be paired with specific goals that prioritize efficiency, customer experience, and results to achieve a claims life cycle that is smarter, faster, and more engaging than ever.

Where We Are Now

Generative AI is already changing the way the industry responds to customers and handles the rapid pace of claims. However, most current efforts are now centered on incorporating agentic AI solutions into claim workflows. At a very basic level, the practice of applying this technology leverages a series of small microservices (utility agents) that are driven by the intelligence and logic of generative AI's analysis of new information. An agentic AI system breaks down a workflow into tasks and subtasks, which then use the utility agents in a "squad" to perform a particular function.

Business practices will be working through transformation exercises for years to come as they look at true agentic AI-driven digital transformation opportunities.

The next and the most vital step is looking beyond efficiency and driving valuable insights for claims examiners. The role of professionals in the claims process cannot be discounted and will never be fully automated. With examiners working in remote and hybrid roles, it has become that much harder to train new colleagues. It's critical to transfer institutional knowledge to the next generation of workers, and AI is now able to provide insights and guidance that is often missed in a remote work environment. Sedgwick has introduced tools at the desk level that support our incredible professionals in a way that ensures their success and eliminates administrative red tape. This approach allows our people to spend their time focusing on and speaking with claimants so they know they are in great hands.

This concept reinforces that, as exciting as these advances are, technologists and executives should always remember the people they serve. Our best-case customer journey is that our customers, who are experiencing a difficult time in their lives, will see a rapid resolution to their claim while engaging with caring, real people who solve their problems with accuracy and insight. This goal is perhaps the most important driver that we in the claims industry can deliver.

Where We're Going

Harnessing the power of agentic AI requires a creativity that recognizes long-term strategic goals and short-term tactical bites that guide a claims administrator from A to Z. It is about problem solving in a very human way and allowing our colleagues to take advantage of these incredible tools to broaden understanding and transform the industry forever.

I'm very excited as we think forward to the new capabilities that we expect from generative and agentic AI this year. Virtual agents will finally become proficient in holding real conversations with customers. The pairing of robust data science capabilities with agentic AI frameworks will allow companies to reimagine their claims processes from end-to-end. And tools that drive insight and action at the desk level will become a part of the daily routine as humans work side by side with agents.

This is all to say that the extensive work and experience that got us to where we are today is as important as where we are heading. Through exceptional colleagues, data science, models, the very best in the claims industry, and agentic AI, the claims industry is poised to lead a bright future for clients and claimants around the world.


Leah Cooper

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Leah Cooper

Leah Cooper is the chief digital officer for Sedgwick.

She is a recognized thought leader at national conferences, speaking on the digital shakeup that occurs at all levels of administration, customer experience on the advancements in technology and AI within the insurance industry.

She holds a B.A in economics and theatre from Vanderbilt and a certificate of specialization in entrepreneurship and innovation from Harvard Business School Online.

Solar Farms Face Rising Storm Risks

Severe convective storm losses surge past $50 billion as utility-scale solar farms face mounting weather resilience challenges.

Hundreds of dark solar panels in lines across a field in front of bright green trees and a blue sky

In 2024, insured losses from U.S. severe convective storms (SCSs) exceeded $50 billion for the second consecutive year. This category of peril — which includes tornadoes, hail and straight-line winds — has grown increasingly prominent in recent years, posing significant challenges for risk managers across multiple sectors, including energy, agriculture, insurance, construction and transportation.

The 2024 season began at a rapid pace, with 1,264 preliminary tornado reports from January to June — the second-highest total for this period since 2010. This momentum carried into the second half of the year, culminating in 1,855 preliminary reports for 2024 (Table 1), surpassed only by the 2,240 reports in 2011.

Additionally, 2024 experienced above-average large hail activity — historically the leading cause of SCS-related property damage in the U.S. — with 829 preliminary reports. Straight-line wind activity also exceeded historical norms, with 16,701 reports, making 2024 the third most active year since 2010.

Storm clouds over solar farms

One sector facing increasing risk from SCS events is utility scale solar energy — large solar installations that generate electricity for the power grid. This industry has seen rapid growth in recent years, particularly in Texas. Since 2014, solar energy generation in Tornado Alley and Dixie Alley states has increased by almost a factor of 50, from one terawatt hour to 48 terawatt hours. Most of this growth comes from Texas due to its high solar irradiance levels and streamlined process for approving and building solar energy projects.

However, as more solar farms are built in storm-prone states, the risk of large losses for farm owners and insurers is increasing. The risk is heightened by a recent trend toward larger, thinner solar panels, which are more vulnerable to damage. In March 2024, for example, a hailstorm damaged thousands of solar panels at the Fighting Jays Solar Farm in Fort Bend County, Texas. This event resulted in costly panel replacements and reduced energy output. Insurers anticipated paying out $50 million, reaching the farm's hail coverage sublimit.

The risk is not just restricted to the Central U.S. In October 2024, an EF2 tornado that spawned from Hurricane Milton tore through a solar farm in central Florida, also damaging 30 homes in the area.

The property insurance market for utility-scale solar has struggled with high premiums and limited coverage availability. These challenges stem from significant losses in recent years and the unique vulnerability of solar panels, which complicates risk assessment. As a result, utility-scale developers have turned toward improving resiliency through engineering design and innovations in tracking technology.

Harnessing resilience in a changing climate

The most significant natural peril loss drivers for solar projects are hail and named windstorms. The solar panel modules are the primary components that have high vulnerability to windborne debris and hail-related damage, which is dependent on the module glass thickness. While the exposure value of solar modules is project-dependent, they typically account for a significant proportion of the insurable risk.

As a result of the recent increase in SCS loss activity, risk managers for solar projects are increasingly considering a range of mitigation strategies, such as:

  • Stowing solar panel modules at specific tilt angles, decreasing the angle of impact for hailstones and reducing the likelihood of wind-related damage
  • Implementing real-time weather monitoring and automation, automatically initiating protective measures, such as tilting, as storms approach

New and existing solar projects can also benefit from a comprehensive risk assessment, including geographic and historical analyses of hail, tornado and straight-line wind events. WTW works with utility-scale solar developers and operators evaluate and quantify probable maximum losses, considering site-specific engineering design, risk mitigation and tracking system stow strategies for both wind and hail to quantify natural catastrophe risk precisely.

Additionally, understanding how the risk is evolving over time is vital for effective risk management. WTW Research Network partner Columbia University has found a two-to-threefold increase in tornado outbreaks across the southeastern U.S., particularly during winter and spring, over the past four decades.

By combining these risk assessment and mitigation methods into a comprehensive approach, the solar industry can better prepare for severe weather events and navigate an evolving risk landscape.

Geopolitical Tensions Raise Risks for Global Shipping

Geopolitical tensions create challenges for the shipping industry despite record-low vessel losses in 2024.

Aerial View Photography of Container Van Lot

The fast-changing geopolitical landscape is creating risks and challenges for a shipping industry already juggling the energy transition and the legacy of the COVID-19 pandemic, according to Allianz Commercial's 2025 Safety and Shipping Review.

The industry faces an increasingly volatile and complex operating environment, marked by attacks against shipping, vessel detentions, and sanctions, as well as the fall-out from incidents involving damage to critical subsea cables. Furthermore, the ripple effect of increasing protectionism and tariffs threatens to remake supply chains and shake up established trade relations.

Given that 90% of international trade is transported across oceans, those developments are concerning, especially as the industry continues to see the potential for large claims from traditional risks such as fires, collisions, and groundings, which are still the main drivers for total losses of large vessels.

However, there is also good news. The shipping industry has made significant improvements when it comes to maritime safety in recent years. During the 1990s, the global fleet was losing more than 200 vessels a year. This total had halved 10 years ago and is now down to a record low of 27 as of the end of 2024 (from 35 in 2023).

The relevance of political risk and conflict as a potential cause of maritime loss is increasing with heightened geopolitical tensions. Total losses from traditional causes may have reduced, but this positive trend could be offset by war and other political-related exposures. As an industry, we are in a better position with regards to traditional risks, but there is a renewed focus on geopolitical risks.

U.S.-China trade conflict and growing shadow fleet bring challenges

China has been the biggest target of the protectionist measures of the U.S. administration, with tariffs reaching 145%, before both countries agreed to reduce them for 90 days. Developments have significantly affected global maritime trade, with approximately 18% of it subject to tariffs as of mid-April 2025, compared with 4% in early March, and dramatic declines in shipments reported in the immediate aftermath of the "Liberation Day" announcements.

While the future of U.S. trade-focused policies remains uncertain, another phenomenon is posing an increasing challenge for the maritime and insurance industries: the shadow fleet. Since the start of the war in Ukraine, the size of the shadow fleet has grown significantly. Today, around 17% of the world tanker fleet is thought to belong to the shadow fleet: Estimates indicate there are close to 600 tankers trading Russian oil alone. Shadow fleet vessels have been involved in tens of incidents around the world including fires, collisions and oil spills.

Fires and mis-declared cargo remain a top concern for large vessels

Large vessel fires are still a major concern for hull and cargo insurers. There were seven total losses reported across all vessel types during 2024, the same number as a year earlier. The number of incidents overall was up year-on-year to a decade high of 250, again across all vessel types. Around 30% of these fires occurred on either container, cargo or roll-on roll-off vessels (ro-ros) (69). More than 100 total losses of vessels have been caused by fires in the past decade.

Efforts to mitigate these risks are underway, with regulatory changes and technological advancements aimed at addressing mis-declared cargo, a primary contributor to such fires. This is critical as the electrification of the global economy poses further challenges given the growing number of lithium-ion batteries and battery energy storage systems being transported.

There is little doubt the shipping industry is becoming more resilient against the risks associated with large vessels, although we can by no means say they are under control. However, only 27 total losses during 2024 underlines the positive trend. To put this in perspective: There are over 100,000 ships (100GT+) in the global fleet. 

However, uncertainty and multiple risks persist. Cyber-attacks and GPS interferences are increasing. Ceasefires have raised hopes, but the Red Sea security threat and supply chain disruption will likely remain. Meanwhile, the green transition requires much work. The coming years will be decisive and will determine the path of the sector and global trade.

To read Allianz Commercial's 2025 Safety & Shipping Review, please visit: Safety and Shipping Review.


Rahul Khanna

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Rahul Khanna

Capt. Rahul Khanna is global head of marine risk consulting at global insurer Allianz Commercial

A marine professional with 27 years of experience within the shipping and maritime industry, Capt. Khanna served more than 14 years on board merchant ships in all ranks, including master of large oil tankers trading worldwide.

Top 10 Ways Data Analytics Is Reshaping Insurance in 2025

Data analytics drives insurance innovation, from risk assessment to customer experience, in 2025's digital landscape.

Cables Connected to Ethernet Ports

In 2025, data is the most valuable currency in the insurance industry. From enhancing risk prediction to boosting customer satisfaction, data analytics is transforming how insurers operate, compete, and grow. As digital adoption accelerates, insurance companies that strategically leverage analytics are moving ahead—improving underwriting accuracy, streamlining operations, and redefining customer experiences.

Here are the top 10 ways data analytics is revolutionizing insurance in 2025:

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1. Smarter Risk Assessment and Underwriting

Traditional underwriting relied heavily on static historical data. In contrast, predictive analytics, powered by machine learning and big data, allows insurers in 2025 to assess risks in real time using dynamic variables—from wearable health devices to smart home sensors and driving behavior.

This leads to more accurate pricing, reduced loss ratios, and fairer premiums for policyholders.

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2. Fraud Detection and Prevention

Insurance fraud continues to be a costly problem, draining billions annually. Advanced analytics tools now detect suspicious patterns, flag inconsistencies in claims, and identify fraud networks using AI and behavioral modeling.

By combining structured and unstructured data from claims, social media, and third-party sources, insurers can now prevent fraud.

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3. Enhanced Claims Management

Filing a claim used to be a slow, manual process. Now, automated triage driven by data analytics improves both speed and accuracy. Machine learning algorithms assess claims for severity, legitimacy, and payout eligibility within seconds.

In 2025, many insurers also deploy image recognition to assess property damage from photos, significantly reducing processing time and improving customer satisfaction.

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4. Personalized Customer Experiences

Customers today expect the same level of personalization they receive from digital-native companies. Analytics enables insurers to deliver tailored product recommendations, personalized policy options, and risk alerts.

For example, a customer using a fitness tracker may receive discounted premiums and wellness tips. This level of engagement helps insurers build loyalty and boost retention.

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5. Optimized Pricing and Profitability

Data-driven pricing models allow insurers to optimize premiums based on real-time data and customer behavior rather than relying solely on general demographic data. By doing so, they can avoid underpricing high-risk customers or overpricing low-risk ones.

This granular approach leads to more competitive pricing, improved loss ratios, and healthier profit margins.

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6. Better Customer Segmentation and Targeting

With advanced segmentation models, insurers can group customers based on lifestyle, risk profile, preferences, and behavior. This enables highly targeted marketing campaigns and product bundling strategies.

As a result, insurers can reach the right audience with the right message at the right time—boosting conversion rates and cross-selling opportunities.

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7. Improved Regulatory Compliance

In a heavily regulated industry, analytics helps insurers stay compliant. AI-powered tools assist in automating regulatory reporting, detecting compliance gaps, and ensuring transparency in data usage.

This is particularly crucial with evolving data privacy regulations like GDPR and regional data residency laws.

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8. Streamlined Operational Efficiency

Data analytics drives process automation across underwriting, claims, policy servicing, and customer support. In 2025, most leading insurers use predictive models to forecast workloads, optimize resource allocation, and reduce operational bottlenecks.

This means lower administrative costs, faster service delivery, and a more responsive business model.

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9. Risk Mitigation

Instead of simply insuring against risk, insurers are using data to help customers avoid it. For instance, by analyzing telematics data, an auto insurer can alert customers about unsafe driving patterns.

Property insurers may use weather data and IoT devices to warn homeowners of impending floods or fires, preventing losses. This role deepens customer trust and strengthens insurer-client relationships.

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10. Strategic Business Decision-Making

At a macro level, data analytics gives insurers real-time dashboards and actionable insights for better strategic planning. Executives can make informed decisions on market expansion, product development, risk pooling, and capital allocation.

With the power of AI-driven forecasting, insurers in 2025 are increasingly anticipating market trends rather than reacting to them.

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Final Thoughts: Data as a Growth Driver

The insurance industry has always been data-rich—but only in the past few years have insurers truly begun to harness that data for innovation, efficiency, and growth. In 2025, the winners will be those that turn data into insights—and insights into action.

By embedding analytics into every layer of their business—from claims to customer care—insurers are not just adapting to change; they are leading it.

Driving Down Risk Through Predictive Telematics

Telematics transforms insurers from claims payers to prevention partners, revolutionizing management of distracted driving.

Side view mirror of a car against a blurry background of trees on a road

Distracted driving remains one of the deadliest yet grossly underreported causes of accidents in the U.S., contributing to more than 3,000 deaths annually and countless injuries. Despite extensive public awareness campaigns, achieving sustained behavior change requires more precise, targeted interventions. Commercial fleets, positioned uniquely at the intersection of transportation safety and risk management, are emerging as critical players in reshaping how insurers assess, mitigate, and ultimately prevent risks associated with distracted driving through telematics.

Data-Driven Risk Mitigation: Turning Insights Into Action

Telematics technologies gather impressive amounts of data on driving behaviors, offering fleet managers and insurers granular insights into driver habits and route-specific risks. Through predictive analytics, insurers and fleets can identify and address high-risk zones, such as accident-prone intersections, school zones, or congested roadways. This allows for tailored interventions, including targeted safety campaigns, improved signs, adjustments to traffic infrastructure, or increased enforcement efforts in identified high-risk areas.

Data analytics can also highlight often-overlooked dangers contributing to distracted driving, such as outdated driver education. By integrating these less obvious risk factors into their predictive models, insurers and fleets can implement comprehensive prevention strategies that address visible risks and subtler, yet important, driver safety issues.

For example, telematics-driven risk mapping has allowed insurers and fleets to implement preventive measures in historically dangerous locations, reducing accident rates and claims frequency. By focusing efforts precisely where they're needed, this data-driven approach transcends traditional reactive methods, positioning insurers and fleet operators as risk mitigators.

Aligning Pricing With Real-World Behavior

Insurance pricing traditionally relies heavily on broad historical data and generalized risk profiles, often failing to capture the nuances of individual driver behavior. Telematics introduces a shift, enabling insurers and fleet operators to implement behavior-based incentive models. These models reward drivers for consistently executing safer driving habits with real-time feedback and tangible benefits, such as discounted premiums or performance-based rewards.

Insurers encourage sustained improvement in driving practices by creating incentives tied directly to observed behavior. Fleets that use these incentive programs regularly report substantial reductions in distracted driving incidents, resulting in fewer claims and lower insurance costs. Such incentive-driven models thus offer a compelling advantage, transforming insurance from a passive coverage product into an active driver of safer roads.

Predictive Modeling: Preventing Claims

Beyond simply recording current driving behaviors, telematics data enables predictive modeling, allowing fleets and insurers to anticipate and mitigate risks before they materialize into claims. Predictive analytics identify patterns and indicators of potential incidents, such as frequent hard braking events, abrupt acceleration, or erratic lane changes. Recognizing these early signs enables fleet managers to implement targeted training, corrective coaching, and preventative interventions for at-risk drivers.

These examples demonstrate the power of predictive telematics, with fleets lowering their incident rates by addressing risk factors identified through data. Insurers benefit directly from this preventive approach, witnessing reductions in claims frequency and associated operational costs. As such, the predictive capacity of telematics technology shifts the focus from managing claims after the fact to preventing accidents, aligning closely with insurers' business objectives and profitability.

Expanding Safety From Fleets to Communities

Telematics-driven safety initiatives have a ripple effect that extends far beyond fleet vehicles. Professional drivers, consistently monitored and coached through telematics technologies like AI-powered dash cams and real-time, in-cab alerts, often carry improved driving habits into their personal lives. This behavioral transfer improves community safety, reducing the broader incidence of distracted driving in local neighborhoods and personal travels.

This community-level impact provides insurers with an additional layer of risk mitigation. Safer communities translate into fewer accidents and claims, creating safer driving environments for everyone. Insurers benefit from this broader cultural shift toward safer roads, reinforcing their role not merely as providers of financial protection but as partners in community safety.

Navigating Legal and Regulatory Challenges

Increased scrutiny and evolving regulatory landscapes surrounding distracted driving pose challenges for insurers. Predictive telematics offers insurers a valuable tool for managing and mitigating these challenges. Insurers and fleets establish a transparent framework demonstrating their commitment to risk management by maintaining comprehensive, data-driven records.

This approach helps insurers stay ahead of potential regulatory changes and liability issues by providing clear, objective evidence of risk management practices and incident prevention efforts. The transparency fostered by telematics data builds trust among regulators, policyholders, and fleet operators, positioning insurers as responsible, forward-thinking leaders in risk management.

Collaborative Approaches for Long-Term Impact

The successful implementation of telematics-driven safety programs requires close collaboration among insurers, fleet managers, and technology providers. Insurers are critical in advocating for and facilitating the adoption of telematics technologies, providing incentives to fleets through favorable policy terms, discounts, and educational support. Fleets, in turn, must commit to integrating these technologies fully into their operational strategies, embracing driver education and performance monitoring.

This collaboration creates a strong ecosystem dedicated to safety measures, data transparency, and continuous improvement. The mutual benefits, lowered claims rates, improved road safety, reduced operational costs, and enhanced community relations showcase the value of a shared approach to risk management.

Insurers as Strategic Partners in Prevention

Insurers are no longer just entities that assist after accidents. With predictive telematics, they're becoming crucial allies in actively working to prevent accidents in the first place. By using live data and intelligent predictions, they're getting involved in making our roads safer for everyone. This forward-thinking approach isn't just the right thing to do; it also strengthens insurers' businesses by improving profits and risk assessment, all while building stronger connections with the people and communities they support.

As distracted driving continues to threaten road safety, insurers armed with telematics technology and fleet-driven safety initiatives are uniquely positioned to lead the charge. This transforms how risks are assessed and managed, ultimately reducing the devastating human and financial toll of distracted driving.


Erin Gilchrist

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Erin Gilchrist

Erin Gilchrist is vice president of fleet evangelism at IntelliShift.

She brings 15 years of experience from Safelite AutoGlass, where she managed a fleet of more than 8,500 vehicles. A long-term member of the Automotive Fleet Leasing Association, she advocates for fleet leaders through her podcast, "Straight Talk on Fleet." 

Overcoming the Insurance Claim Bottleneck

AI-powered tools can slash insurance claims processing time by 80% following natural disasters.

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When a natural disaster strikes, insurance companies face a challenge beyond the physical damage itself—the overwhelming surge of claims that follows. Take Storm Boris in September 2024. After it swept through Central Europe, insurers faced an estimated €2 billion to €3 billion in claims, primarily due to extensive flooding and structural damage. In November, devastating floods in Valencia cost insurers over €3.5 billion, based solely on the first 72,000 claims received.

These storms are a tall order for any insurance firm still relying on traditional claims processing. One simply has to start adding up all the workhours that are required for in-person assessments and manual approvals to realize why so many homeowners and businesses have to wait for weeks or even months for their reimbursements.

At PortalPRO, a service economy platform that helps property managers and owners coordinate repairs more efficiently, we have seen how AI-driven tools can be of great use for insurance companies during peak claims periods.

How bottlenecks strain traditional insurance processing

The insurance claims process hasn't changed significantly for years. Damage is reported, and an adjuster is scheduled for an on-site inspection. Paperwork ten moves between departments, and eventually the payout or repair offer reaches policyholders.

This whole process can take weeks or even months and is often burdened by all sorts of delays. This is especially true after natural disasters, when thousands of claims pour in simultaneously. Considering that insured losses from catastrophic events exceeded $135 billion for the fifth consecutive year, it's easy to understand why the system gets overloaded. It's also clear that it can no longer function as it used to and needs to find a way to process claims faster.

With AI-powered tools, clients can report property damage online by uploading photos and have the damage assessed in seconds.

Last year, we observed this principle being applied to the insurance field after a major storm hit Lithuania. We stepped in to assist one of our partner insurers that was experiencing a spike in claims—more than 300 requests at peak demand. After implementing AI-powered tools, insurers were able to reduce their processing times by 80%. What would've typically taken about 50 days required only a few, and people who had their homes damaged by the storm were able to proceed with repairs much faster. This new insurance damage claims self-service solution became a bridge between insurers, property owners, and repair specialists, ensuring that claims weren't just approved quickly but translated into real action.

Why a smarter approach to claims processing matters

For insurers, streamlining claims means more than just efficiency. It reduces administrative costs, minimizes fraud—which makes up about 10% of all insurance claims costs—and helps policyholders navigate one of the most stressful moments of their lives with greater ease. By integrating structured digital workflows, insurers can cut out unnecessary back-and-forth and ensure claims move seamlessly from reporting to resolution.

The impact is just as important for policyholders. They get quicker access to funds and repairs when they need them most, a smoother claims experience overall, and more transparency throughout the process. And it matters—Accenture found that 83% of customers with easy claims experience are likely to renew their policies. Insurers that don't embrace the advantages such technology provides aren't just falling behind in efficiency; they risk losing customers to faster competitors.

As extreme weather becomes more frequent, insurers face mounting pressure to process a rapidly growing number of claims. The challenge isn't just about keeping up—it's about maintaining accuracy, fairness, and trust in a system that policyholders rely on during their most vulnerable moments. Structured, data-driven solutions that don't just speed up the process but also use the expertise of repair specialists have the potential to remove bottlenecks and significantly improve policyholder's experience.

How Identity Fraud Insurance Protects Businesses

New identity fraud loss insurance empowers businesses to transfer financial risk while preserving capital for growth.

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The cost of identity fraud for financial institutions and businesses is rising at an alarming rate. According to NASDAQ, global fraud reached nearly $500 billion in 2023. In 2024, 40% of financial institutions saw an increase in fraud-related losses compared with the previous year.

Behind these staggering numbers is a fast-evolving threat landscape. Fraudsters are leveraging next-gen technology like generative AI to create more convincing phishing scams, synthetic identities and even deep fakes.

While businesses are investing in stronger fraud detection tools, they can't catch every threat. To stay ahead, it's time for companies to adapt. Enter identity fraud loss insurance, an emerging layer of protection designed to help banks manage the "when" of fraud loss.

The Limitations of Current Fraud Risk Strategies

Recent innovation means fraud risk management strategies have come a long way in recent years. Businesses now have access to multi-factor authentication, identity verification, anomaly detection and other solutions to build a robust risk monitoring program.

But fraud still slips through.

When fraud happens, the consequences extend beyond reputational harm—they hit the bottom line. Though technology can improve monitoring and prediction strategies, none of the previously mentioned solutions transfers the risk of fraud off a business's balance sheet. That's where identity fraud loss insurance comes in, offering a critical layer of protection that transfers financial risk away from businesses and toward the insurers.

What Is Identity Fraud Loss Insurance?

Identity fraud loss insurance is new to the market but is gaining traction quickly. Integrating AI-powered fraud risk detection with insurance-backed protection shifts financial liability for identity fraud away from businesses, freeing their risk capital reserves. This means organizations can protect their bottom line while preserving risk capital for strategic initiatives.

The benefit? It safeguards revenue without adding operational friction. Businesses can confidently scale customer acquisition efforts without proportionally increasing their exposure to fraud loss risk.

An Untapped Opportunity for Brokers

In 2023, account takeover fraud surged to nearly $13 billion in losses, up from $11 billion the previous year. New-account fraud reached $5.3 billion, rising from $3.9 billion in 2022. Meanwhile, a 2023 report from Thomson Reuters estimated the financial losses due to synthetic identity fraud to be between $20 million and $40 million annually.

These growing threats highlight a critical need: Businesses and financial institutions require more than temporary fixes—they need a strategic, long-term solution that allows them to scale.

In a saturated risk management market, identity fraud insurance gives brokers a true differentiator. It fills a crucial gap in traditional fraud mitigation strategies by directly transferring financial liability off the balance sheet.

It also opens the door to more value-driven conversations with existing clients, especially for high-risk businesses like banks, credit unions, payments providers and lenders.

Implementing for Success

Identity fraud loss insurance can unlock significant value. However, to maximize its benefits, brokers should guide their clients through a thoughtful evaluation process before implementation. Key steps include:

  • Understand current fraud exposure: Ensure the client has a firm grasp on their existing fraud risk and loss, as well as potential vulnerabilities.
  • Evaluate policy details: Carefully assess policy coverage, exclusions, claims processes and alignment with existing compliance and fraud prevention frameworks to ensure they're partnering with the right provider.
  • Verify data capture capabilities: Check that the solution's transaction audit features automatically gather the data required to file fraud loss claims and reduce claim adjustments.
  • Prioritize fast, reliable claims processing: Look for a solution with electronic claims processing capabilities of the fraud loss insurance provider and 30-day or less claims payment guarantees.

These steps ensure that the policy delivers real value and that clients are fully prepared to act when fraud strikes.

Identity fraud is an unavoidable in today's digital landscape, but businesses no longer have to bear the financial burden. Identity fraud loss insurance offers a strategic layer of protection that empowers businesses to grow confidently and onboard more customers without expanding their fraud risk exposure.

As this new-to-market solution gains traction, brokers have a unique opportunity to be at the forefront of change – helping clients stay ahead of emerging threats while delivering measurable value and building deeper trust.


Sunil Madhu

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Sunil Madhu

Sunil Madhu is founder and CEO of Instnt. 

Prior to Instnt, he founded and built Socure, now a $5 billion identity verification and fraud prevention business. He has several patents and has helped set risk and compliance industry standards through OASIS, NIST and W3C.

Why to Hire Female Retirees

Insurance companies can and should tap experienced female retirees for project work amid retirement inequality.

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I've never considered myself a flag-waving women's rights advocate. My philosophy has always been simple: Put your head down and do the work, and things will work out. For much of my career, I believed that hard work alone would even the playing field, regardless of gender.

But as I've learned more about workforce dynamics—especially in the insurance industry—and looked more closely at the data, one reality has become increasingly clear: Women, particularly those nearing or in retirement, are up against a set of challenges.

Sadly, the retirement landscape is very different for men than women. Women, on average, earn less than men throughout their careers, which directly affects their ability to save for retirement. According to the U.S. Census Bureau, women working full time in the insurance industry still earn just 82.7 cents for every dollar earned by men. This gap widens for women of color and as women advance in the ranks. Over a lifetime, this pay disparity can amount to hundreds of thousands of dollars in lost earnings.

Don't worry, this is definitely not an article that will try to sort that out! There are  some easons for the disparity, such as taking time off to raise kids and caring for aging parents. The fact is, though, these income differences have lasting consequences. Research from the Transamerica Center for Retirement Studies reveals that the median retirement savings for women is just $43,000, less than the $91,000 for men. More strikingly, nearly 50% of women aged 55 to 66 have no personal retirement savings at all.

The real kicker is that women live longer. On average, women in the U.S. outlive men by about five years. That means women must stretch their fewer financial resources across more retirement years, increasing their risk of outliving their savings.

Rather than viewing this as a societal problem to fix, insurance companies ought to see it as a strategic opportunity. The hiring of female retirees to do project work isn't about charity—it's about performance. From underwriting to actuarial work, claims to compliance, this industry rewards institutional knowledge, professional discipline, and detail-oriented thinking. Female retirees offer all of that, along with years and sometimes decades of practical experience.

Like their male counterparts, female retirees often require less onboarding and can make immediate contributions. Male and female retirees alike can serve as mentors to younger professionals, helping to bridge the generational gap. In an industry where critical knowledge is often undocumented or informally passed down, this transfer of knowledge is crucial.

Additionally, diverse teams are smarter, more innovative, and more resilient. In fact, a 2015 McKinsey study of 366 companies found that those with diverse management were 35% more likely to have financial returns above their industry mean.

Hiring female retirees to take on project work is more than an HR initiative—it's a smart business strategy. It aligns with the insurance industry's core strengths: assessing risk, planning for the long term, and building trust. These women have navigated complex careers while balancing family lives and households. They're now ready to continue contributing by helping companies achieve their goals.

Insurance companies have an enormous opportunity to look at retirement not as an ending but as a new beginning. By hiring women for project work, companies can support meaningful second chapters for women while enriching their organizations with valuable talent.


Risa Ryan

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Risa Ryan

Risa Ryan is CEO and founder of UnRetire Group

She has over two decades of executive and strategic leadership in the insurance and reinsurance landscape. Her career has spanned executive roles at Munich Re America, QBE, Swiss Re and Sompo International.

 

How Many More Children Have to Die?  

Preventable childhood deaths are surging as vaccination rates plummet amid persistent health misinformation.

Person Holding Syringe and Vaccine Bottle

How many more children must die because of misinformation and downright lies about childhood vaccinations? The flu has resulted in 216 childhood deaths across the country so far this year, the highest number in 15 years due to the failure of many parents to get their children the flu shot.

National data shows the percentage of children getting vaccinated for the flu has fallen from 64% to 49% in the past five years. I have had college-educated people tell me they do not get vaccinated because they got the flu from the flu shot. That is scientifically impossible. They had the flu before they got the shot. Also, just as with the COVID vaccine, you may still get the flu after the flu shot but with dramatically less severe symptoms.

The worst measles outbreak in 30 years across the country has resulted in over 900 cases, 650 in Texas alone, with three deaths and serious illness among highly contagious children. The reason is, there are parents who believe the measles vaccine is more dangerous than the measles. Most children are not vaccinated based on the false belief that the measles vaccine causes autism.

The original link between autism and the measles vaccine was the most discredited "study" in the history of public health. (See, To Be or Not to Be Vaccinated, ITL, April 28, 2015.) In fact, international health officials called the supposed link to the MMR (measles, mumps and rubella) vaccine "the most dangerous public health hoax in the past 100 years."

The original researcher was found to have serious conflicts of interest, including accepting money from attorneys involved in lawsuits against vaccine manufactures, manipulating evidence and breaking ethical codes of conduct. Yet this outright lie lives on.

The measles is so dangerous that a single person can spread the disease to between 11 and 18 people, and an unvaccinated person has a 90% chance of infection. The real danger is that parents who don't get their children vaccinated put other people at risk, such as infants less than a year old and children and adults with weak immune systems.

There is also now a surge in whooping cough cases in the country. There are over 8,000 reported cases already, more than double the number in 2024. Whooping cough or pertussis is a very dangerous disease and can spread rapidly, especially for infants one to two years old. Infants are too young to have had all their shots. Whooping cough begins as a common cold and can progress to violent coughing that can be fatal. There were two infant deaths reported in Louisiana in the last six months.

We need a national public health campaign for parents who need to get their children vaccinated for the flu, the measles and other childhood vaccinations.

All these childhood deaths this year due to the measles, the flu and whooping cough were 99% preventable. It is heart-breaking that in today's social media and political environment public health officials feel they are under attack by people spreading false information and downright lies about the safety and protection provided by childhood vaccinations.

(I would like to dedicate this article to my niece Chandler, co-author of the original ITL article, "To Be or Not to Be (Vaccinated)" 4/28/15. She is now Chandler Berke, MD, and about to embark as a resident for the next seven years at Ohio State University's Wexner Neurosurgical program.)


Daniel Miller

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Daniel Miller

Dan Miller is president of Daniel R. Miller, MPH Consulting. He specializes in healthcare-cost containment, absence-management best practices (STD, LTD, FMLA and workers' comp), integrated disability management and workers’ compensation managed care.

Best Practices for Conversational AI

As conversational AI transforms from novelty to necessity, error and bias mitigation becomes mission-critical for enterprise success.

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According to McKinsey, 71% of organizations already use generative AI in at least one business unit, up from 33% in 2023. Meanwhile, a survey by Tidio finds that 82% of consumers would rather chat with a bot than wait in a support queue, underscoring a sharp shift in service expectations. These rapidly multiplying conversational AI statistics show the technology's evolution from novelty to enterprise necessity—and they highlight why error and bias mitigation can no longer be afterthoughts.

Large language models (LLMs) remain prone to hallucinations and systemic bias. A recent medical‑question benchmark reports a 29% hallucination rate for GPT‑4, 40% for GPT‑3.5 and 91% for Bard (PubMed). Bias persists, too; the U.S. National Institute of Standards and Technology warns that reaching zero bias is impossible, but says that structured audits can meaningfully reduce it. Enterprises that skip governance face reputational risk, regulatory scrutiny and customer churn.

Best Practices for Cutting Errors and Bias

The most reliable conversational agents pair technical guardrails with human oversight, updated continuously rather than retrofitted after launch.

Curate and debias training data

Accenture urges teams to "systematically strip biased or low‑quality data before fine‑tuning." Start with a data inventory: Flag personally identifiable information, duplicate entries and out‑of‑date documents. Next, run demographic‑parity tests and syntactic‑diversity checks to detect skew. Removing or reweighting problematic slices before training cuts both hallucinations and discriminatory outputs downstream.

Apply RLHF or RLAIF

Reinforcement learning from human (or AI) feedback has become the dominant alignment method. An OpenReview study shows multi‑turn RLHF can halve toxic completions compared with single‑turn tuning. Organizations should gather domain‑specific preference data—think safe medical advice or financial disclosure accuracy—and iterate reward models every quarter to keep pace with evolving norms.

Set up guardrails and policy filters

Rule‑based moderation is not outdated; it is the front line against jailbreaks and prompt injections. The 2024 Safety4ConvAI workshop cataloged pattern‑matching guardrails that blocked more than 90% of unsafe responses in a red‑team test without degrading helpfulness. Combine static rules with classification models to catch disallowed content in real time.

Continuous automated evaluations

A live scoreboard is more useful than a quarterly PDF. The Hugging Face hallucination leaderboard records GPT‑4 at a 1.8% hallucination rate on standard tasks; new model checkpoints can be benchmarked immediately, alerting engineers when regression creeps in. Plug such automated suites into your CI/CD pipeline so every deployment pushes fresh metrics to dashboards.

Human‑in‑the‑loop review

McKinsey finds firms that blend expert reviewers with automation cut total error rates by up to 50% within six months. Schedule random audits of conversation logs, tag edge cases and feed them back into RLHF loops. Human reviewers remain indispensable for subjective judgments such as tone, cultural nuance and brand alignment.

Publish transparent system cards

Before release, OpenAI posts model‑specific system cards detailing jailbreak tests and residual biases (OpenAI). Anthropic follows a similar disclosure protocol for Claude 3, noting lower scores on the BBQ bias benchmark (Anthropic). Adopting the same practice builds regulator and user trust, and it clarifies known limitations for downstream integrators.

Implementation Checklist

1. Baseline your model. Run hallucination and toxicity benchmarks on the unmodified LLM to establish starting metrics.

2. Sanitize data. Apply automated deduplication, profanity filters and demographic balancing.

3. Fine‑tune with RLHF. Use domain experts to label high‑risk prompts; train reward models on multi‑turn dialogs.

4. Embed guardrails. Deploy rule‑based filters at both input and output layers; monitor latency impact.

5. Automate evaluations. Schedule nightly hallucination, bias and jailbreak tests; trigger alerts on drift thresholds.

6. Insert humans. Rotate reviewers across time zones; audit flagged exchanges and feed insights back to engineering.

7. Publish transparency reports. Release system cards that document methods, known gaps and mitigation plans.

Obstacles and How to Overcome Them

Compute cost. RLHF and continuous testing are resource‑intensive. Mitigate by distilling smaller inference models or batching evaluation workloads during off‑peak hours.

Tooling fragmentation. No single platform covers data labeling, testing and deployment. Adopt open standards (e.g., OpenTelemetry traces for model metrics) and modular APIs to ease integration. To avoid getting locked into fragile or siloed setups, it's important to invest in open standards and modular architecture early on. For example, using standardized telemetry tools like OpenTelemetry can help you capture consistent metrics across training and inference stages. APIs should be designed to support pluggable modules so that tools for labeling, evaluation, or deployment can be swapped out as needs evolve. A modular mindset also future-proofs your stack against inevitable shifts in vendors, frameworks, or compliance requirements.

Regulatory flux. AI‑specific rules vary by region. Build a governance layer that maps local regulations to technical controls—such as data residency toggles—to avoid retrofits later. What's compliant in one region may be flagged in another. Emerging regulations touch on everything from explainability and algorithmic fairness to data localization and the handling of personally identifiable information. This patchwork environment creates uncertainty for teams that want to deploy AI products globally.

Rather than waiting until after a rule is finalized to adapt, build flexibility into your compliance stack from the outset. One effective approach is to create a governance layer that maps regulatory requirements to specific technical controls within your system. For example, implement configuration options that allow you to toggle data residency or anonymization rules depending on user location. If a region mandates additional model explainability or bias mitigation, your governance layer should be able to route those workflows dynamically without rebuilding core components. Proactively aligning your development process with evolving legal frameworks helps avoid costly retrofits later—and positions your team as responsible AI stewards.

Outlook

Analysts at Accenture forecast the conversational‑AI market will triple by 2028, driven by guardrailed, bias‑checked agents that replace first‑generation chatbots. Visual benchmarking sites predict rapid convergence toward single‑digit hallucination rates as evaluation loops tighten and policy filters mature. Expect native multimodal models to introduce fresh bias vectors—image, video, even sensor fusion—but the same best‑practice framework will apply: clean data, continuous tests and transparent cards.

Conversational AI is racing from pilot to production, and with scale comes scrutiny. Teams that embed rigorous data hygiene, reinforcement learning, guardrails and human oversight into every release cycle will slash errors, tame bias and build the trust needed for the next wave of AI‑driven dialogue.


Roman Davydov

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Roman Davydov

Roman Davydov is a technology observer at Itransition.

With over four years of experience in the IT industry, Davydov follows and analyzes digital transformation trends to guide businesses in making informed software buying choices.