Generative AI

Streamlining Claims with Generative AI

Key Findings

58% of global and 62% of Australian insurers have leveraged generative AI for fraud detection.
88% of Australian insurers use generative AI for claims resolution, marking a 38-percentage point increase from 2024.
64% of Australian insurers are using generative AI to enhance data-driven decision-making.

Generative AI: Transforming insurance operations

Generative AI is rapidly redefining claims management in the insurance industry, offering transformative applications across the claims lifecycle. From intake and triage to fraud detection and customer communication, insurers are leveraging generative AI to improve accuracy, efficiency, and customer satisfaction.

According to our latest survey, 88% of Australian insurers now use generative AI for claims resolution — a significant rise of 38 percentage points compared to last year. Fraud detection remains a key focus, with 58% of global and 62% of Australian survey respondents utilising generative AI to identify fraudulent activities. Globally, insurers are also emphasising generative AI’s role in enhancing customer communication and support, ensuring timely and efficient resolution of claims.

Optimising claims and workforce efficiency

Across regions, insurers are increasingly turning to generative AI to streamline operations and address resource challenges. Reducing operational costs is cited as the greatest value-add globally, with 82% highlighting this benefit. Speeding up claims processing ranks second, demonstrating how generative AI is helping insurers achieve

greater productivity while maintaining high-quality outcomes.

In Australia, the focus shifts slightly, with 64% of insurers identifying enhanced data-driven decision-making as the most significant application of generative AI. This contrasts with the global emphasis on task automation as the primary benefit.

The integration of generative AI is also reshaping workforce dynamics, enabling employees to focus on complex cases while routine tasks are handled more efficiently.^[^1] By adopting these technologies, insurers are positioning themselves to meet growing customer demands and maintain a competitive edge in a fast-paced market.

Future opportunities and collaborating for better outcomes

As generative AI continues to transform claims management, many insurers are finding value in partnerships with organisations that offer both innovative technology and a deep understanding of operational challenges. These collaborations can help streamline processes, integrate generative AI effectively, and enhance the overall quality of claims outcomes — all while maintaining the human touch in customer interactions.

The future of claims management is set to be shaped by advancements in artificial intelligence, with generative AI leading the way.^[²^]As the technology evolves, its applications are expected to expand into predictive analytics, more sophisticated fraud prevention mechanisms, and highly personalised customer experiences. These advancements may enable insurers to anticipate challenges, optimise decision-making, and proactively adapt to evolving market demands. A forward-looking strategy that embraces innovation can help insurers stay competitive and deliver lasting value in an increasingly dynamic industry.

^{[1] “}^{How AI is Shaping the Workplace and Workforce Development}^,”^{HEC Paris}^{, 15 Nov 2024.}
^{[2] Costa, Emanuele, and Nadine Moore. “}^{GenAI Will Write the Future of Insurance Claims}^,”^{Boston Consulting Group}^{, 13 Dec 2023.}

By freeing up more time for our resolutions to focus on claim resolution (vs. more routine tasks), we are enabling our risk managers to provide better service and better claims outcomes for our clients and claimants.

GB's suite of generative AI tools include: