A claim to excellence
EXL says its combination of AI and human agents can help insurers cope next time disaster strikes
By John Deex
In the aftermath of the devastating 2022 floods, the major insurers were forced to answer a host of difficult questions, many of which centred on one crucial service area: claims handling.
How, they had to consider, can claims teams used to handling a certain number of cases per day for 99% of their time suddenly cope with a surge of perhaps 10 times or more – many involving people struggling through the worst days of their lives?
They needed answers fast, partly to meet customers and MPs’ demands for action, and partly because, as climate impacts worsen, they knew the next record-breaking catastrophe could be right around the corner.
The majors such as Suncorp and IAG have since introduced a range of measures to improve catastrophe claims handling, from rapid-reaction command centres to geospatial mapping and high-tech triaging tools.
Now, according to tech company EXL Service, artificial intelligence is ready to take even more of the strain from under-pressure claims teams.
It plans to establish a Resilience Centre of Excellence in Australia – essentially an external claims handling hub offering insurer partners an AI-human hybrid approach to helping customers in their hours of greatest need.
“It wasn’t really possible to create this centre, for example, two years ago or five years ago, because the technology to handle this kind of activity just did not exist,” EXL’s global chief executive and chairman Rohit Kapoor says.
“It’s possible to create it now. We can have conversational AI and we can have agentic AI, so … the lodgement of claims and the servicing of those claims … can all take place much quicker, at a much higher volume in a collapsed time frame than if we tried to do it all by human agents.”
EXL accepts some claimants may be less than thrilled at engaging with a bot when their home is knee-deep in water or their roof has been torn off by a hurricane, which is why the centre will have humans on hand for the “highly complex, nuanced situations”.
The facility is on track to launch with 30-40 staff, with plans to scale up depending on insurer demand.
“If somebody has got vulnerabilities, if somebody has got some distress, I think that’s [when] you need to have a human agent involved,” Mr Kapoor tells Insurance News. “It’s a combination, as opposed to just using one or the other [point of contact].”
He says Australian insurer partners have been receptive to using the centre, which is also expected to serve as a back-up facility for other peril-prone markets such as the Philippines. EXL says it is in talks with two major insurers, and the centre is “expected to be operational by the end of Q1 2026”.
In a post-catastrophe situation – when speed of decision-making is critical – Mr Kapoor says about 80% of claims will be relatively simple, with clear-cut causes, costs, coverage and payouts. Insurers need to “isolate out those instances where there are signals for it either being a very complex claim or a propensity [for] fraud, and have that go through a completely manual journey”.
EXL’s AI tools can do that, he says. They could also be used to simulate mass-claim scenarios, “so we don’t need to wait for a catastrophe to occur or a flood to occur to see how this will play out”.
And Mr Kapoor suggests the facility could become a “knowledge centre”, educating other markets on best practice in disaster response.
Data analytics and digital tool specialist EXL has tens of thousands of staff worldwide supporting its insurance division, which provides about 45% of total revenue, according to Mr Kapoor, who spoke to Insurance News while visiting Australia from the US.
He says Australia is a “key” territory for the group. “We’ve been in this region now for the past 10 years, and we’ve been building up our presence and our capability out here. We’re very pleased that we work with the top five insurance carriers.
“We do think that we can continue to add value and continue to build and grow here. And I think our push is always going to be about embedding more AI into the workflow.”
He says legacy systems are a barrier to transformation in Australia, but there is now a move towards cloud platforms and “the adoption of these new technologies means that every cycle is becoming shorter and shorter, and therefore the ability to make change is going to become faster.
I think the insurance industry in Australia is also very progressive. It is embracing AI, and it is embracing change pretty actively.”
