Agentic AI: Driving the ‘Next Best Action’ (NBA) in Insurance and Financial Services

From fast breaks to fast claims, how digital coworkers are reshaping decision-making at scale.

It’s NBA playoff season—where winning comes down to timing, agility, and knowing the next best move. For insurers and financial services providers, the stakes aren’t much different.

In a world of increased risk, rising expectations, and chronic workforce gaps, the organizations that thrive are those that move with clarity and precision. Whether it’s an underwriter prioritizing submissions, a claims adjuster assessing file completeness, or a financial advisor tailoring recommendations—timing and context matter.

Enter Agentic AI: intelligent digital coworkers trained to surface the Next Best Action (NBA) across complex decision-making workflows. Unlike generic automation or chat-based AI, these agents operate with autonomy, accuracy, and auditability—delivering value not just in productivity metrics, but in real-time business agility.

As the pressure mounts across insurance and financial services, Agentic AI is emerging not just as a tool, but as a strategic advantage. And the organizations that embrace it now are setting the pace for 2025 and beyond.

The Shift Toward Actionable Intelligence

The old AI pitch—“reduce costs and automate tasks”—has evolved. Today’s enterprise leaders are asking bigger questions:

• How can we give adjusters or underwriters what they need before they ask?
• How do we personalize financial services at scale—without increasing headcount?
• How do we reduce decision latency while maintaining compliance?

Agentic AI answers those questions by embedding digital agents directly into workflows. These agents don’t just analyze—they act. They flag anomalies, pre-fill documentation, extract signals from noise, and route exceptions to human reviewers.

Most importantly, they drive timely, contextual decisions—a core requirement in industries where milliseconds, trust, and accuracy intersect.

How Agentic AI Works

Agentic AI is built on a hybrid architecture of:

• Large Language Models (LLMs) tuned for insurance and financial tasks
• Deterministic guardrails to ensure outputs are repeatable and compliant
• Retrieval-Augmented Generation (RAG) for ingesting carrier-specific documentation

Agents operate within scoped thresholds and escalation logic, keeping humans in the loop where judgment is required. All actions are logged for audit, compliance, and training feedback loops.

Think of them as the assist machine on your team…not replacing your players but making every play smarter.

Insurance Use Cases: From Insight to Action

1. Underwriting & Risk Assessment

Underwriting has long struggled with manual intake and bottlenecks. Agentic AI solves both.

• Indico Data deploys agents that read PDFs, forms, and emails to extract key submission details—speeding up triage.
• In California, P&C carriers use AI agents to dynamically adjust wildfire risk models without human recalibration.

Result: Smarter prioritization, faster quoting, and real-time pricing agility during CAT events.
(Source: Insurance Edge, March 2025)

2. Claims Processing

This is where Agentic AI shines brightest—and where it’s already in production.

• Xenonstack reports that up to 70% of routine claims can be resolved autonomously with agents verifying policies and documents.
• Agentech deploys file review and subrogation agents to assist desk adjusters with claim summaries, document checks, and coverage validation.
  “It’s like having a full back-office team working 24/7,” says the VP of Claims at one Pet Insurer, which saw a 60% reduction in cycle time with no new headcount.

• Master of Code shows AI agents can reduce fraudulent claims by up to 40%, leveraging behavioral analysis.
  Outcome: Lighter adjuster workloads, faster settlements, and more consistent claim decisions.

3. Customer Engagement

Agentic AI enables proactive service by analyzing contextual life events such as moves, job changes, new mortgages, and recommending product updates or outreach.

• One deployment saw 17% cross-sell lift and a 30-day early detection of churn signals.
  Win: Human reps spend more time building trust, while digital agents handle timing and relevance.

 Financial Services Use Cases

1. Banking & Wealth Personalization

Citi GPS describes agentic AI as central to adaptive financial services:

• Dynamic loan repricing during market shifts
• Personalized portfolio nudges based on macroeconomic trends

Strategic Edge: Real-time experiences for every customer segment.

2. Fraud Prevention

Today’s fraud isn’t just about stolen identities—it’s synthetic, biometric, and fast.

Agentic AI now integrates with blockchain and biometric layers to detect deepfakes, synthetic personas, and digital onboarding fraud before they escalate.

Result: Fewer false positives, higher security, and faster onboarding.

Operational Metrics: The Stats That Matter

*Deloitte Insurance Labor Outlook, 2024

 Leadership Playbook: What Winning Teams Know

🤝 Human-in-the-Loop Is Non-Negotiable

Indico Data and Agentech both emphasize: AI works best when paired with human judgment.

⚖️ Regulatory Flexibility Is Built-In

Insurance Edge notes that carriers using Agentic AI during CAT events stayed compliant even while adapting pricing on the fly.

❤️ Customer-Centric AI Wins Hearts

Master of Code links AI agent use to a +22% lift in NPS, driven by proactive engagement and faster service.

From Pilot Projects to Production Strategy

In both basketball and business, you don’t win by watching from the sidelines. You win by making the next right move—at the right time.

That’s the essence of Next Best Action. And that’s the power of Agentic AI.

MVP Player: Agentech

Agentech.com deploys over 200 digital AI coworkers across P&C, pet, workers’ comp, and travel lines. Their agents are already reducing claim cycle times, automating file review, identifying subrogation potential, and transforming desk adjuster productivity by up to 4x—with 67% cost savings.

Agentech’s agents don’t replace adjusters. They support them—like the best sixth man in the playoffs.

 Final Buzzer

What’s your next best action?
Whether you’re on the claims floor, in the underwriting suite, or rethinking customer journeys, Agentic AI gives your team the assist they need to win.

The next season of transformation is already underway. Are you ready to lead it?

Sources Cited:

• Indico Data – Underwriting AI (Oct 2024)
• Xenonstack – Claims Automation (Aug 2024)
• Citi GPS – Financial AI Trends (Jan 2025)
• Master of Code – AI in CX (Mar 2025)
• Insurance Edge – Risk Modeling in CAT (Mar 2025)