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Some claims can certainly be automated. Not everything requires sending someone out. If, for example, there's a burglary, and a customer submits a list of ite

Some claims can certainly be automated. Not everything requires sending someone out. If, for example, there's a burglary, and a customer submits a list of items stolen and the value is within a certain range, it may be easier and cheaper overall for a company to cut a check rather than have someone spend time trying to verify the claim. There's a higher risk of fraud, but if the personnel savings outweigh it, then the company is likely to accept it.

nvahalik 3y ago
For car insurance, this is already happening and is fairly reasonable. A lot of car claims are handled by desk folks because you take it to a repair shop and they figure it out and negotiate it. But P&C is a different beast. > and the value is within a certain range This is called a deductible. We literally had a guy who got denied on a claim end of last week because it didn't meet his deductible. (He provided the list.) Then literally the next day he re-submits with MORE STUFF. So yeah, the human element, even in a reduced form, will always be required. Stuff that he cannot prove was actually even damaged because he had "thrown it away".
- ethbr1 3y ago
  I was under the impression that most insurance was moving to an efficiency:cost-optimized model. I.e. Creating fraud scoring engines and auto paying claims they greenlight (usually incorporating history and total value as major signs). Essentially saying "there's not enough potential fraud value here for it to be cost effective for us to apply human review." Although someone submitting claims at an abnormal rate would be flagged. But I'm more familiar with healthcare.
  - nvahalik 3y ago
    > I was under the impression that most insurance was moving to an efficiency:cost-optimized model. Can't speak for every avenue, but I can definitely say this is not happening with property insurance. The claim amounts are sometimes big enough that it warrants additional review or subrogation.
- tallanvor 3y ago
  Even for other things. For example, I have pet insurance for my dog. She had a cracked tooth that needed to be removed. I had receipts and documentation from the vet ready to go, but I didn't end up needing any of that. I went through their online form to choose what procedure was done and how much I paid. It then offered me the chance for automatic handling (with the ability to request that it be reviewed by a human if I wasn't happy), and it approved reimbursement minus my deductible, and the money was in my account about 3 days later. Obviously there will always be claims that require human assistance, but if even 50% of claims can be automated, that's still a significant savings for the insurer.

nvahalik 3y ago

For car insurance, this is already happening and is fairly reasonable. A lot of car claims are handled by desk folks because you take it to a repair shop and they figure it out and negotiate it. But P&C is a different beast. > and the value is within a certain range This is called a deductible. We literally had a guy who got denied on a claim end of last week because it didn't meet his deductible. (He provided the list.) Then literally the next day he re-submits with MORE STUFF. So yeah, the human element, even in a reduced form, will always be required. Stuff that he cannot prove was actually even damaged because he had "thrown it away".

ethbr1 3y ago
I was under the impression that most insurance was moving to an efficiency:cost-optimized model. I.e. Creating fraud scoring engines and auto paying claims they greenlight (usually incorporating history and total value as major signs). Essentially saying "there's not enough potential fraud value here for it to be cost effective for us to apply human review." Although someone submitting claims at an abnormal rate would be flagged. But I'm more familiar with healthcare.
- nvahalik 3y ago
  > I was under the impression that most insurance was moving to an efficiency:cost-optimized model. Can't speak for every avenue, but I can definitely say this is not happening with property insurance. The claim amounts are sometimes big enough that it warrants additional review or subrogation.
tallanvor 3y ago
Even for other things. For example, I have pet insurance for my dog. She had a cracked tooth that needed to be removed. I had receipts and documentation from the vet ready to go, but I didn't end up needing any of that. I went through their online form to choose what procedure was done and how much I paid. It then offered me the chance for automatic handling (with the ability to request that it be reviewed by a human if I wasn't happy), and it approved reimbursement minus my deductible, and the money was in my account about 3 days later. Obviously there will always be claims that require human assistance, but if even 50% of claims can be automated, that's still a significant savings for the insurer.