Nathan Golia

This week, we at Celent released new and updated P&C claims systems vendor reports for four regions:

Third-party distribution is still a critical component of the insurance ecosystem. Rather than look for ways to disintermediate their broker partners with rapidly evolving tech, Brazilian insurance company Akad Seguros leveraged the emerging Generative AI space to assist their brokers in closing business faster. The company was able to develop a suite of tools powered by large language models (LLMs) to enhance their customer support capabilities. These tools rely on various OpenAI API requests and include:

I live in a small town between Charlotte, N.C., and Rock Hill, S.C. Today, schools and businesses in Charlotte are closed after a

Following up from Celent's biennial North American claims admin system review, Celent asked for customer references in order to get feedback on those vendors and systems.

A claims fraud-detection system helps insurance carriers identify fraudulent claims at both the individual and organizational levels. It is typically used by claims teams and in special investigative units (SIU). A variety of business benefits can be achieved from claims fraud-detection solutions, but two of the primary goals are:

The ability to detect claims fraud is, in some ways, easier than ever. With each year, the datasets that insurers have access to are expanded and refined by carriers, vendor partners, and industry groups. It's got to the point where, to the keen investigator with a well-appointed and tuned dashboard, networks of bad actors can seem to jump right off the screen.

As the insurance industry moved through what is now generally agreed upon as a “first wave” of Insurtech, I had several conversations with carriers, founders, venture capitalists and other industry gadflies that were remarkably thoughtful about the realities of the moment. That is, there was a clear understanding that what we were experiencing was a bubble of sorts: There were a lot of companies vying to meet market niches in an opaque and distributed sector, and it was unlikely any insurance “killer app” could emerge given the unique character of our industry.

In the early part of the year, insurance made the news in North Carolina because carriers were asking for up to double the rate along the fragile Atlantic coasts. From the Outer Banks to Oak Island, homeowners – some of second homes, yes, but also many full-time residents – sweated out the potential of doubling their insurance costs for about a month. In February, N.C. insurance commissioner Mike Causey rejected the hike and set a hearing for Oct. 7 – about a week from now.

Despite economic headwinds, the P&C insurance industry is pursuing a strategy of growth. But to do so in the current macroeconomic environment requires transformative efficiency. In order to meet growth objectives by leveraging digitalization, insurers also must make major investments in data management and governance. The swell of excitement around generative AI promises levels of automated decisioning never before seen in the industry. While getting arms around that particular technology from a compliance and use case perspective is difficult, doing the work on data and system architecture to support it will help insurers achieve their goals to grow efficiently and set up for the next several decades of business.

With P&C carriers facing high costs of doing business, taking friction out of business processes is a path to balancing the books without sacrificing growth. The rapidly advancing world of artificial intelligence – in generative and machine-learning forms – is opening the door for insurers to identify and price risks accurately and efficiently in a dynamic market. But to take full advantage, carriers must build digital customer journeys on a foundation of data governance, auditable algorithms, and computing power.