72 The Swiss insurtech startup Legal-i illustrates what this can look like in practice. Its agentic AI platform reasons over complex medical records to support underwriting and claims assessments. Legal-i turns PDF records into interactive patient histories and pulling key information from doctors’ reports, lab results and admin documents, Legal-i helps insurers handle cases up to 80 per cent faster, with greater accuracy and more consistent decisions. “Agents parse broker emails, ACORD [Association for Cooperative Operations Research and Development] forms and attachments; enrich submissions with internal and third-party data; and present prioritised worklists based on risk, value and complexity,” says Williams. “For complex risks, agents synthesise engineering, financial and medical documentation into concise, auditable briefs with clear source attribution, enabling faster and more consistent decisions across teams.” Meanwhile in claims, the balance between automation and human oversight is particularly sensitive. Agents can resolve low-complexity cases end to end, while claims managers retain control of complex, high-impact scenarios where judgment, empathy and regulatory accountability matter most. “Humans retain responsibility for outcomes, while AI expands operational capacity,” says Williams. AI agents can also coordinate across care networks, benefits and support services, reserving human interaction for moments that demand empathy. They personalise communications in language, format and timing, while preserving transparency and consent. “In insurance, trust is not an abstract principle,” says Jones. “It is an operational asset that must be earned transaction by transaction. Innovation and governance are not competing priorities. They succeed only when they are embedded together inside the systems insurers use every day. That’s why the next generation of insurance platforms are designed with AI, auditability and regulatory transparency built directly into operational workflows.” Real-world deployments already demonstrate impact. Sedgwick’s Sidekick Agent, developed in collaboration with Microsoft, has improved claims processing efficiency by more than 30 per cent through real-time guidance and decision support. Meanwhile, one major insurer deployed more than 80 AI models in claims, cutting FEATURE “ Three to five years from now, frontier insurers will look fundamentally different” Photo: iStock/piranka
RkJQdWJsaXNoZXIy NzQ1NTk=