From Analog to Autonomous: Building a Claims-Centric AI Strategy for Insurance Leaders
Introduction: From Sticky Notes to Smart Agents
We’re standing at a turning point in claims. An era defined not just by new tools, but by an entirely new way of working. We’ve journeyed from analog (paper files, fax machines, and hallway handoffs), into digital (PDFs, emails, APIs), and now we’re stepping into the age of autonomy—a space where intelligent digital coworkers augment every aspect of the claims process.
Some still live in the analog past—a place of handwritten notes, sticky reminders stuck to desktops, and binders so thick they could insulate Santa’s workshop. Others have embraced digital—more organized, yes, but now drowning in PDFs and multiple systems. But it’s autonomy where real transformation happens. And it’s here.
We already use digital assistants in our homes. Our phones respond to our voices. Our cars drive themselves. Why, then, should we settle for claims systems that can’t even talk to each other? It’s time for insurance executives to lead the shift.
Why Now: The Urgency for AI in Claims
AI is no longer on the horizon; it’s reshaping insurance operations in real-time. Consider the macro pressures: a shrinking adjuster workforce, rising claim volumes, more complex policies, and increasing customer expectations for speed and transparency.
According to industry forecasts, we could face a shortfall of over 400,000 retiring insurance workers by 2036. With an aging workforce and limited pipelines for new talent, many carriers are already struggling to fill open roles. Meanwhile, claim complexity and severity continue to climb. AI is not just a solution—it’s a necessity to maintain operational performance, reduce risk, and meet regulatory and customer expectations.
But adopting AI isn’t about being trendy. It’s about building something sustainable. The biggest risk isn’t change…it’s failing to harness AI’s full potential. Incrementalism won’t save us. Nor will it propel us forward.
The Evolution: From Automation to Augmentation
The insurance industry is mid-transformation. We’re seeing the rapid evolution of how claims are handled. Where automation once ruled (“How can we make this faster or cheaper?”), augmentation is now the name of the game.
I remember launching WeGoLook over a decade ago. We built a platform using the gig economy to deliver field data quickly and affordably to desk adjusters. It was revolutionary for its time. But today, we’re talking about autonomous agents that do more than collect data—they route claims, verify identity, prefill forms, and surface decision points for humans to evaluate.
AI has the power to unlock new service models. This isn’t about efficiency alone—it’s about opening entirely new ways of delivering claims services.
The Three Waves of AI Adoption
To understand where you are in your AI journey, let’s look at the three waves of AI adoption:
- Wave 1: Time & Cost Savings – Automating routine tasks to improve speed and reduce cost. Think: FNOL triage, document processing, basic workflow automation.
- Wave 2: Quality & Consistency – AI that improves decision-making, reduces errors, and enhances compliance. Here, you’re surfacing insights, highlighting red flags, and standardizing outcomes.
- Wave 3: Workflow Transformation – Rethinking how claims are handled entirely. This is about embedding digital coworkers alongside adjusters to handle most of the administrative heavy lifting—enabling a truly new way of working.
Where is your organization today? Are your teams stuck optimizing yesterday’s workflows, or are you building tomorrow’s operating model?
What a Real AI Strategy Looks Like
Let’s be clear: AI strategy is not a list of vendors or shiny pilot projects. A good AI strategy is:
- Rooted in your business objectives (e.g., margin improvement, cycle time reduction)
- Designed around people and process, not just tech
- Measured by its impact, not its novelty
Start by organizing your strategy around three questions:
- How can AI help us deliver on our current goals faster, better, and more affordably?
- How can AI help us build new offerings, products, or services that weren’t possible before?
- What foundational capabilities (data, governance, change management) do we need to succeed?
Successful organizations will identify 100+ ways AI could create value and then focus on the handful that matter most and align to current and future BTIs and OKRs.
Leading Change: Aligning Humans, AI, and Operations
Tech alone isn’t enough. Humans alone are exhausted, especially during catastrophic insurance events. Advantage lies in orchestration; a collaboration between skilled humans, intelligent machines, and operational discipline.
AI is fast. It works in seconds. People operate in hours or days. Organizations? They move in months. Successful leaders recognize these different “clock speeds” and build bridges between them.
To lead in the AI era, you must:
- Set a clear vision (e.g., “We use AI coworkers to support our people”)
- Create space for experimentation and iteration
- Align with legal, IT, compliance, and HR from day one
The secret? Don’t over-orchestrate too early. Build proof points. Share wins often. Let the results drive adoption.
Reframing Roles: The Adjuster of the Future
AI shouldn’t replace humans. It should elevate them.
Think of today’s adjusters not as clerical processors, but as editors and strategic decision-makers. Their time is best spent communicating, resolving, and guiding—not hunting through PDFs or rekeying the same data twice.
AI isn’t a decision maker, it’s a facilitator. It surfaces patterns, highlights risks, and automates the repetitive. It becomes connective tissue across systems, insights, and decisions.
At Agentech, we’ve built a digital roster of 200+ AI claims agents. Each trained to specialize in key tasks like claimant verification, flagging and pursuing subrogation opportunities, document summarization, and scheduling. Many adjusters are now supported by multiple agents per claim, creating a new ratio of human-to-AI collaboration that boosts productivity by up to 4x.
AI in Practice: Clyde and Ingrid
Take two of 200+ real-world digital coworkers on Agentech’s roster:
- Clyde is your claimant identity and verification agent. He runs fraud checks, validates policy details, and ensures every file is secure and accurate.
- Ingrid is your intake assistant. She captures structured data from emails, voice transcriptions, and web forms, flags duplicates or gaps, and pre-fills system records so nothing is missed.
These agents work 24/7. They don’t take vacations. And they never forget a step. This is the level of operational resilience AI unlocks.
Company-Level Benefits
AI delivers at both micro and macro levels. Organization-wide, it brings:
- Operational Resilience – Work progresses after hours, weekends, holidays.
- Cost Containment – Do more without adding headcount.
- Less BPO Dependency – Keep control, speed, and data integrity in-house.
- Next-Gen Talent Magnetism – Young professionals want to work with smart tools, not legacy systems.
Empowering the Team
For claims teams, the upside is personal:
- Less burnout from repetitive admin
- More time for empathy and judgment
- Better support from systems that don’t drop the ball
- Career evolution that grows with technology, not against it
Training is key here. Demystify AI. Involve frontline staff in pilots. Encourage them to identify processes ripe for automation.
Human + AI = The Future of Claims
As we embrace this future, let’s remember the equation: Human judgment + AI precision = the claims engine of the future.
AI should never adjudicate files that require licensed professionals. It should only present the most relevant, context-rich data for the human to decide.
The goal isn’t automation for automation’s sake. It’s impact. Precision. Empowerment. And scale.
Final Thoughts: Build the Future Now
You don’t have to be an AI expert. But you must be an AI-literate leader.
Start by building a vision. Empower your team. Identify a few key claims functions to transform. Then pilot. Measure. Refine. Scale.
Transformation is a choice. And AI is your path to something better-for your adjusters, your customers, and your company.
The shift from analog to autonomous has already begun. Will your team lead it?