How GB is Leveraging AI to Improve Claim Outcomes  

Generative artificial intelligence (Gen AI) has become a popular buzzword, capturing attention across various industries, especially with the release of advanced GPT models. However, those who are well-informed know that AI has been a secret partner for years. Forward-thinking organizations have recognized its potential as a silent partner in making critical decisions that greatly influence claim outcomes. Nevertheless, there are still lingering questions about how this technology can be effectively utilized to benefit carriers and enhance claims management processes.  

Joe Powell, SVP — Analytics & Innovation, takes us behind the scenes to explore the benefits, challenges, and future possibilities of AI in claims management. Discover how Gallagher Bassett (GB) is leveraging AI today and learn about the steps that organizations can take to capitalize on this opportunity, improving operational efficiency and solidifying their competitive edge. 

How has claims management technology evolved over time, and what role is AI playing in the way claims are managed today? 

Joe Powell (JP): AI has the potential to change nearly every aspect of claims management, with early adopters like GB already seeing significant lift from AI. AI can help claims experts to make better decisions; to communicate more effectively with claimants and clients alike; to prioritize their day; to become more efficient, freeing up time to focus; and ultimately to drive better claim outcomes for our clients and related stakeholders. 

Historically, optimizing and improving outcomes has depended on the quality of experts—both the claims adjuster and, less visibly, a team lending support to adjusters behind the scenes. From reserving to clinical intervention, provider selection to litigation avoidance, and subrogation to return to work, AI has played a role for a long time, quietly guiding key decisions and improving outcomes.  

Can you explain the concept of Gen AI and how it is being implemented by GB?  

JP: AI has been embedded in the operations of many innovative organizations, strategically informing key decisions and improving claim outcomes. However, the future holds even more potential as AI agents evolve from individual spokes feeding information back to a human hub to a cohesive team that can communicate and collaborate with each other. This paradigm shift in claims management promises a blend of AI efficiency and human expertise, where AI agents work together to empower human adjusters with the information required to make critical decisions.  

Over the past several months, GB’s team of data scientists and claims professionals have partnered to develop our game-changing Gen AI roadmap. GB has expertise in Gen AI and a unique approach to bring its benefits to clients, claimants, and injured workers, aligning with our goal of achieving superior outcomes. Our AI journey has begun, and we look forward to sharing its potential with our partners.  

In May at RIMS (now RISKWORLD), what kind of feedback did the GB team receive from clients and prospects regarding their AI demonstrations?  

JP: This year marked my 8th RIMS conference, and in that time GB has made strategic technological investments in areas that benefit our clients the most. In fact, the annual RMIS Report from Redhand Advisors has recognized Luminos as the most comprehensive product offering in the bundled TPA space for seven consecutive years. We also implemented an entire suite of machine-learning decision-support tools, called Waypoint. Despite those accomplishments and innovations, each touted in a past conference, I can’t recall a RIMS with quite as much anticipation and excitement as there was this year, the year of Gen AI.  

RIMS was our first opportunity to share this vision and the initial phases of the rollout (including interactive demos) with our clients, prospects, and frontline claim staff. The positive feedback we received was overwhelming. Specific feedback from a broker partner expressed that our capability demonstration was “the most thoughtful and comprehensive” they had witnessed in the industry. They commended our creative approach, from identifying relevant use cases to involving claims experts in the functionality and design process.  

How are GB’s Resolution Managers and supervisors responding to the implementation of Gen AI?  

JP: In addition to client and prospect excitement, an even greater response to GB’s Gen AI vision came from GB’s Resolution Managers (RMs) and supervisors who attended the conference to demonstrate the importance GB places on our frontline talent.   

By leveraging GB’s Gen AI to rapidly summarize claims and documents or answer questions, the possibilities to positively impact the day-to-day work of our claims professionals are tremendous. The RMs were excited to see this functionality utilized more broadly as they recognized its potential to meet their needs and free up time, allowing them to focus on delivering exceptional service to injured workers and claimants.  

Can you provide examples of how AI agents can work together as a team and the potential benefits of this collaboration to carriers?  

JP: We are continuing to develop AI agents that can communicate with one another, working as a team and ultimately presenting human experts with a cohesive plan. That plan will support the claims adjuster with recommendations and supporting information in making the critical claims—decisions which, for the foreseeable future, will remain in the expert hands of human adjusters.  

After seeing our vision at RIMS, some attendees suggested their own ideas for how these agents could interact, with one example being an email-based AI agent passing key information from an attachment to a claim summarizer AI agent. We are just at the beginning of what is possible as these tools begin to work together—a key component of our Gen AI vision.  

Overall, the pursuit of building and leveraging the right tools and technology to ultimately enhance the experience of our staff, clients, claimants, and injured workers continues, and we are committed to delivering on our own high expectations.   

If you would like more information about GB’s Gen AI journey, download our overview here.  

Joe Powell

SVP — Analytics & Innovation

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