Facing the Silver Tsunami: How Agentic AI Can Help Carriers Overcome the Adjuster Workforce Crisis with Digital Coworkers

The Retirement Risk is Real

The insurance industry is confronting a significant workforce challenge: the impending retirement of a substantial portion of its claims adjuster population, often termed the “Silver Tsunami.” This term encapsulates the impending wave of retirements among experienced professionals, particularly within claims operations.

Recent data underscores the urgency of this issue. According to Zippia, 62% of claims adjusters are aged 40 and above, with a substantial portion nearing retirement age. This demographic trend is not isolated; the U.S. Bureau of Labor Statistics projects that nearly 400,000 insurance professionals will retire by 2026. Such a mass exodus threatens to create a significant talent gap, particularly in claims operations where institutional knowledge and experience are paramount. Carriers face potential disruptions in claims processing, increased operational costs, and loss of institutional knowledge.

Agentic AI offers a transformative solution for carriers, MGAs, TPAs, IA firms, and even third-party service providers. By automating repetitive tasks and augmenting human adjusters, these intelligent agents can enhance productivity, reduce errors, and ensure continuity in claims operations. Implementing Agentic AI now allows carriers to capture institutional knowledge before it exits the workforce, ensuring a smoother transition into the future.

Implications for Claims Operations

The departure of seasoned adjusters carries several risks:

1. Increased Claim Cycle Times
   As seasoned adjusters retire, the remaining workforce may struggle to manage the volume and complexity of claims, leading to prolonged processing times. Extended claim cycle times not only delay settlements but also diminish customer satisfaction and trust. In an era where consumers expect swift service, delays can result in policyholder attrition and reputational damage.
2. Escalating Operational Costs
   The loss of experienced adjusters necessitates increased spending on recruitment, training, and overtime for existing staff. Additionally, reliance on temporary staffing solutions can lead to higher per-claim costs and inconsistent service quality. These factors collectively strain operational budgets and reduce profitability.
3. Erosion of Institutional Knowledge
   Veteran adjusters possess invaluable tacit knowledge—insights into nuanced claim assessments, negotiation tactics, and customer interactions—that is often undocumented. Their departure can lead to a knowledge vacuum, impairing decision-making and increasing the likelihood of errors. This loss hampers the organization’s ability to train new staff effectively and maintain service standards.
4. Training and Onboarding Challenges
   Onboarding new adjusters is a resource-intensive process. The steep learning curve, compounded by the absence of mentors, can result in prolonged training periods and increased supervision requirements. This scenario diverts experienced personnel from their primary responsibilities, further impacting productivity.
5. Unsustainable Traditional Solutions
   Conventional approaches, such as outsourcing or overburdening existing staff, offer short-term relief but are not sustainable. Outsourcing can lead to quality control issues and misaligned service standards, while overworking current employees risks burnout and increased turnover. These strategies fail to address the root cause of the workforce shortage and may exacerbate operational challenges.

By proactively addressing these challenges, insurance carriers can navigate the impending workforce crisis, maintain operational efficiency, and continue to deliver high-quality service to policyholders.

Attracting the Next Generation

Compounding the issue is the industry’s struggle to attract younger talent. Surveys indicate that a significant portion of millennials have limited knowledge of insurance career opportunities. Factors such as perceptions of the industry being outdated, lack of innovation, and repetitive tasks deter new talent from entering the field. I’m a mom of two adult sons—they expect modern tools to support them in their jobs.

Strategic Imperatives for Carriers

To mitigate these risks, carriers should consider the following strategies:

• Invest in Technology: Implementing advanced technologies, such as Agentic AI, can automate routine tasks, allowing human adjusters to focus on complex claims and customer interactions.
• Knowledge Management: Develop systems to capture and disseminate institutional knowledge, ensuring that critical insights are preserved and accessible to new staff.
• Talent Development: Establish comprehensive training programs and career development pathways to attract and retain new talent, making the profession more appealing to younger generations.
• Workforce Planning: Conduct thorough workforce assessments to anticipate retirements and plan for succession, ensuring a steady pipeline of skilled adjusters.

By proactively addressing these challenges, insurance carriers can navigate the impending workforce crisis, maintain operational efficiency, and continue to deliver high-quality service to policyholders.

The Rise of Agentic AI Coworkers: Transforming Insurance Claims Operations

As the insurance industry grapples with an aging workforce and increasing claims volumes, Agentic AI emerges as a transformative solution. These intelligent digital coworkers are designed to augment human adjusters, handling routine tasks and enabling professionals to focus on complex decision-making and customer engagement.

Understanding Agentic AI

Agentic AI refers to autonomous digital agents capable of performing specific tasks within the insurance claims process. Unlike traditional automation tools, these AI agents can learn and adapt over time, improving their efficiency and accuracy with each interaction.

At Agentech.com, our digital coworkers are not here to replace the experienced adjuster—only to support and boost productivity. We recommend keeping humans in the loop and only leveraging AI for overall efficiency gains.

Sample Functions of Agentic AI in Claims Processing:

• First Notice of Loss (FNOL) Intake and Claim Setup: Automating the initial reporting of claims, ensuring accurate and timely data capture. This can include adjuster triage, based on peril and experience.
• Document Review and Policy Verification: Rapidly analyzing claim documents and cross-referencing them with policy details to determine coverage eligibility. This is also a fantastic digital agent group to provide key claim updates (versus the claim handler spending 10–15 minutes becoming reacclimated with the claim and looking for new events).
• Subrogation, Salvage, and Fraud Identification: Identifying potential recovery opportunities and flagging suspicious claims for further investigation. Most adjusters do not properly document or report potential subrogation or salvage opportunities.
• File Preparation and Summary Generation: Compiling comprehensive claim summaries to assist adjusters in decision-making. This can take the human adjuster or claim handler 45–90 minutes, whereas their digital coworking team of AI agents spends only a few minutes to provide the summary and present relevant information back.

By automating these tasks, Agentic AI reduces the administrative burden on human adjusters, allowing them to concentrate on tasks that require human judgment and empathy. These digital coworkers also operate 24/7, ensuring consistent and efficient claims processing.

Compound Benefits Over Time

The integration of Agentic AI into claims operations yields significant benefits that compound over time:

• Increased Adjuster Productivity: Automating routine tasks enables adjusters to handle more claims efficiently. For instance, Agentech’s deployment of Agentic AI has led to a fourfold increase in pet claim throughput (P&C results will be shared soon).
• Reduction in Manual Processing Costs: By decreasing reliance on manual labor, carriers have observed up to a 67% reduction in pet claims handling costs (P&C results will be shared soon).
• Enhanced Accuracy and Compliance: Consistent processes implemented by AI agents minimize errors and ensure adherence to regulatory standards.
• Scalability: AI agents can handle increased claim volumes without the need for proportional increases in staffing, providing carriers with the flexibility to scale operations as needed.

These benefits not only improve operational efficiency but also enhance customer satisfaction by reducing claim processing times and increasing the accuracy of claim settlements.

Real-World Application: Agentech’s Success

Agentech’s implementation of Agentic AI showcases the practical benefits of this technology. By deploying over 200 AI-powered agents to work alongside adjusters handling claims across various lines of business—including property and casualty (P&C), pet, and workers’ compensation—Agentech has transformed its clients’ claims operations.

Strategic Benefits for Carriers

Implementing Agentic AI offers several strategic advantages:

• Talent Retention: By reducing mundane tasks, adjusters experience increased job satisfaction.
• Scalability: AI systems can handle increased claim volumes without the need for proportional staffing increases.
• Knowledge Preservation: Capturing workflows and decision-making processes ensures institutional knowledge is retained.
• Enhanced Customer Experience: Faster and more accurate claims processing leads to higher customer satisfaction.
• Operational Flexibility: AI systems can be adjusted to meet changing business needs and regulatory requirements.

These results demonstrate the tangible advantages of integrating Agentic AI into claims workflows. The adoption of Agentic AI in insurance claims processing addresses critical challenges posed by an aging workforce and increasing claim volumes. By automating routine tasks, enhancing accuracy, and enabling scalability, Agentic AI empowers carriers to improve efficiency and customer satisfaction. As the industry continues to evolve, embracing such innovative technologies will be essential for carriers aiming to maintain a competitive edge.

Build vs. Buy—Why Carriers Should Invest in Agentic AI Solutions

As insurance carriers confront the dual challenges of an aging workforce and escalating claims volumes, the decision to build or buy Agentic AI solutions becomes pivotal. While developing in-house AI capabilities may seem appealing, several factors underscore the advantages of purchasing established Agentic AI platforms.

1. Rapid Technological Evolution
   Agentic AI technologies are advancing at an unprecedented pace. Maintaining an in-house solution requires continuous updates, integration of emerging models, and adaptation to evolving regulatory standards. This constant evolution can strain internal resources and divert focus from core business objectives.
2. Scarcity of Specialized Talent
   Building a competent in-house AI team necessitates recruiting and retaining professionals with expertise in machine learning, data science, and insurance operations. Given the competitive market for such talent, this endeavor can be both challenging and costly.
3. Opportunity Costs
   Developing AI solutions internally can lead to significant delays in deployment, resulting in missed opportunities for efficiency gains and customer satisfaction improvements. In contrast, purchasing ready-to-deploy solutions allows carriers to realize benefits more quickly.
4. Budgetary Constraints and Development Queues
   Internal IT departments often face budget limitations and extensive development backlogs. Allocating resources to build AI solutions may not be feasible, especially when immediate operational enhancements are needed.
5. Focus on Core Competencies
   By purchasing Agentic AI solutions, carriers can concentrate their internal engineering efforts on areas that differentiate them in the market, such as product innovation and customer experience, rather than diverting resources to complex AI development projects.
6. Integration and Compliance
   Established Agentic AI platforms are designed to integrate seamlessly with existing systems and comply with industry regulations. This reduces the risk of non-compliance and ensures smoother implementation compared to building solutions from scratch.

Investing in proven Agentic AI solutions offers insurance carriers a strategic advantage by enabling rapid deployment, reducing operational risks, and allowing focus on core business areas. As the industry continues to evolve, leveraging external expertise in AI can be a critical factor in maintaining competitiveness and achieving long-term success.

The Case for Immediate Adoption

Implementing Agentic AI now, while experienced adjusters are still in place, allows for effective knowledge transfer and smoother integration. Delaying adoption increases the risk of operational disruptions and the loss of invaluable expertise. Moreover, building in-house AI solutions presents challenges such as the rapid evolution of AI technology, the high cost of hiring and retaining specialized talent, and the opportunity costs associated with delayed deployment.

Strategic Advantages of Agentic AI

• Rapid Deployment and Scalability: Agentic AI solutions can be integrated swiftly, providing immediate enhancements to claims processing capabilities.
• Cost Efficiency: By automating routine tasks, carriers can achieve significant reductions in manual processing costs.
• Enhanced Accuracy and Compliance: Consistent processes implemented by AI agents minimize errors and ensure adherence to regulatory standards.
• Focus on Core Competencies: Outsourcing AI capabilities allows internal teams to concentrate on strategic initiatives and areas of differentiation.

Conclusion: Seizing the Moment—Agentic AI as the Strategic Imperative

The insurance industry stands at a pivotal crossroads. The impending “Silver Tsunami,” characterized by the projected retirement of nearly 400,000 insurance professionals by 2026, poses significant challenges to claims operations, including potential disruptions, increased operational costs, and the erosion of institutional knowledge. However, this challenge also presents a unique opportunity to modernize and future-proof claims operations.

Agentic AI emerges as a transformative solution, offering intelligent digital coworkers that augment human adjusters by automating repetitive tasks across the entire claims workflow. By integrating Agentic AI, carriers can enhance adjuster productivity, reduce errors, and ensure continuity in claims operations.

What is Your Organization’s AI Strategy

The convergence of an aging workforce and increasing claims complexity necessitates immediate action. By embracing Agentic AI, carriers can not only mitigate the risks associated with the legacy industry professionals but also position themselves at the forefront of innovation in claims processing.

To explore how Agentic AI can transform your claims operations and ensure long-term resilience, visit Agentech.com.