2026-11-09 · Source: Insurance Business Canada
Summary in 3 Points • AI can assist adjusters but cannot take accountability for claims decisions, according to Allianz's Melissa Hill. • Adjusters must validate AI outputs to avoid errors, as AI may misinterpret claim significance. • Risk managers should review insurance policies for AI-related exclusions, which are often generic. --- Melissa Hill, North American head of claims at Allianz, emphasised that while AI can enhance claims processing efficiency, the ultimate accountability for decisions remains with human adjusters. She cautioned against fully automated claims handling, highlighting the technology's limitations and potential for bias, as seen in a case where AI misidentified employees for layoffs due to medical leave. Adjusters must critically assess AI-generated recommendations to prevent errors, especially as AI takes on more administrative tasks. Hill also advised risk managers to scrutinise their insurance policies for AI-related exclusions, which are often vague. Many policies do not specifically address AI risks, potentially leaving firms exposed if operations are disrupted due to AI-related issues. As AI adoption grows in claims operations, the need for human oversight and understanding of AI's limitations becomes increasingly crucial. AI's role in claims processing raises concerns about accountability and bias, necessitating careful oversight by adjusters to mitigate risks in claims handling.
AI's role in claims processing raises concerns about accountability and bias, necessitating careful oversight by adjusters to mitigate risks in claims handling.