Get the Juice: Enhancing Claims Litigation Processes with AI

ClaimDeck Founder Dwayne Hermes
 

By Dwayne Hermes

Is There More Juice in That Lemon?

Last week, two friends and professional colleagues sent me the news article that Lemonade had broken a “world record” by settling an insurance claim using AI and machine learning within two seconds.  (Who is keeping track of world records of this type?)  I took that as a “prompt” to comment (it doesn’t take much), so here are some thoughts.

Lemonade Logo

This use of AI is an inspiring benchmark for those of us devoted to facilitating technology to improve the claims-handling process.  It is another example of an eye-catching piece of news, in alignment with the fanfare around ChatGPT.

So what are some takeaways I see from this–

We should continue to adjust our thinking as to how

    • “quickly” a claim can be resolved

    • “responsive” we can be to our customers

    • “much” of the handling of a claim can be automated/AI-enabled, and therefore how much savings can be achieved in adjusting claims

And the adjustment should be toward “MORE”–more quickly, responsive, and savings.

We should remain consistent with our thinking that

    •  “Human Judgment” will continue to be required for many claims to be adjusted properly

    • small, repetitive savings on a per-claim basis add up to significant savings, whether the claims themselves are big or small

    • litigation management technology empowered by AI is needed to achieve the “more”

Lemonade achieved its improvement on a “routine” claim. While this does not diminish the achievement, the opportunity for more financially impactful, that is, more juice, improvement exists on the more complex claims where more significant dollars are at stake.  We should continue to look at every activity and expenditure and ask if there is a better and cheaper way. We expect the answer to be “YES” with the assistance of claims and litigation management tools and AI.

How to Get the Juice in Litigated Claims

One of the challenges in bringing greater efficiency, measured by “quicker”  handling of litigated claims, is that they involve additional parties beyond the insured and the carrier.  So instead of the carrier moving quickly with their insured - two parties with a contractual relationship - the carrier faces interaction between at least six parties: the carrier, the court, the insured, the defense counsel, the claimant, and the claimant’s attorney.  An insurance agent/broker, TPA, mediator, experts, other layers of coverage, and lienholders may also be involved.  Moving all of these entities to resolution as quickly as possible is challenging.  With the additional challenges come additional opportunities for improvement and the use of technology to assist in achieving that improvement.

Consistently meeting the needs of these interested parties are required to move to an efficient and early resolution.  The data captured by ClaimDeck confirms the old industry adage that “no claim gets better with time.”  Good business process management aided by technology is required to maximize improvement opportunities.  ClaimDeck drives the business processes in litigated claims and assists the claims professional and defense counsel to “get the juice” available through enhanced efficiency.


ClaimDeck™ eliminates claims litigation leakage for carriers while driving process into the law firm, modernizing the litigation process.


Contact Dwayne at dwayne@claim-deck.com.

Follow Dwayne Hermes, ClaimDeck, and Hermes Law on LinkedIn.

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