Gartner Innovation Insight For Artificial Intelligence in Life and P&C Insurance 2019-02

Licensed for Distribution
This research note is restricted to the personal use of Vivek Jasuja

(vivek.jasuja@mphasis.com).
Innovation Insight for Artificial

Intelligence in Life and P&C Insurance
Published 7 February 2019 - ID G00383930 - 18 min read
By Analysts Kimberly Harris-Ferrante
Adoption and maturity of AI are increasing among insurance early

adopters as they test new use cases and technologies. Insurance
CIOs can benefit from greater awareness of AI fundamental use
cases and the impact of AI to help guide innovation.
Overview
Key Findings
■ Adoption of artificial intelligence (AI) has risen from single digits in
2017 to 11% by P&C and life insurers in 2018, with another 25%
currently deploying AI. This rate will steadily increase during the next
two years as the linkage between digital transformation and AI
becomes more well-known among insurance CIOs.
■ Some of the hottest use cases in insurance include no-touch claims

processing, automated underwriting and automated customer service
via chatbots.
■ Some early adopters have shown that AI can reduce manual work and
staff, improve customer experiences, improve decision-making
accuracy, speed up transaction processing and help with information
discovery.
■ No single AI technology will meet all of a CIO’s business objectives. To

meet the needs of their business counterparts, insurance CIOs look at
a variety of vendors and technologies to fit their use case and drive
the desired business impact.
Recommendations
Insurance CIOs driving financial services digital business strategy and
innovation:
■ Avoid falling victim to the AI hype. Assess the technical needs for
each use case by determining what needs AI and what can use
technologies such as RPA and advanced analytics.
■ Create a use case library that identifies short- and long-term

opportunities where AI can be deployed with tangible ROI such as in
customer experience, underwriting and risk selection, or claims.
■ Plan a roadmap to develop the technical foundation for insurers not

ready to implement AI in 2019 by including accessible clean data,
testing facilities and staffing/skills in model execution and machine
maintenance.
■ Build a prototype for small and less complex use cases and
technologies (such as chatbots) by partnering with insurtechs and
other technology firms that have developed point solutions.
Strategic Planning Assumption(s)

By year-end 2019, 30% of online insurance sales and service will be
supported by AI and cognitive computing.
Analysis
AI is proving to be one of the most powerful, transformational
technologies to enable new business models, customer experiences,
product/service offerings and business ecosystems in P&C and life
insurance. However, many insurance CIOs fail to understand how to best
use AI technology across the value chain, the opportunities AI offers to
support digital transformation and the overall impact AI will make on the
industry over the long term. For example, 32% of insurance CIOs in the
2019 Gartner CIO study identified AI as a top “game changing”
technology (see “2019 CIO Agenda: Insurance Industry Insights”
(https://www.gartner.com/document/code/368371?
ref=grbody&refval=3900964) ). 1 The insurance industry has been slowly
adopting AI for a number of years, having large use of machine learning
in the actuarial or analytics departments of P&C and life insurers alike.
However, the exploration of new use cases and more advanced
technology still is immature and limited; use in Tier 2 and smaller
insurers is lacking all together.
Insurance CIOs can use this research to more clearly understand the
short- and long-term value of AI in transforming customer experiences,
underwriting, claims, billing and back-office processes. It is critical to
know the range of technologies comprising AI, including machine
learning (ML), natural-language processing (NLP), chatbots and other
conversational AI tools. It is also important to understand where to best
deploy AI to maximize value and to meet emerging business objectives
(e.g., customer-facing tasks versus transaction processing support).
Today, insurance organizations that apply AI throughout the value chain
will find strategic advantage through 2025. However, long-term AI will be
a critical success factor and reach mass adoption by 2030 (see “Hype
Cycle for Digital Insurance 2018”
ref=grbody&refval=3900964) ). Insurance CIOs should speed up their
testing and piloting of AI in innovation labs and live deployments. This
will enable them to learn how these technologies work and to obtain
early-mover advantage, especially in improving customer experiences
and in assessing the HR element (i.e., identify what skills are needed and
how to manage the staffing requirements for AI projects).
Definition
Artificial intelligence applies advanced analysis and logic-based
techniques, including ML, to interpret events, support and automate
decisions, and take actions. It is based on learning principles that are
able to detect new patterns, make decisions and enable automation
without human involvement (see “Artificial Intelligence Primer for 2019”
ref=grbody&refval=3900964) ).
Description
AI includes a variety of technologies that use advanced analytic
techniques for complex and often real-time decisions driven by learning-
based methodologies and allow users to optimize processes. Some are
customer- or user-facing, which can streamline and optimize customer
experiences for staff, agents/partners, consumers and policyholders
using learning-based techniques. Others are being used for back-office,
decision support or core business transactions such as actuarial/pricing,
claims, underwriting or billing (see Figure 1). Overall, it can be used for
several scenarios including:
■ Automation of insurance processes (back-end and customer-facing)
■ Decision support (such as an underwriting assistant)
■ Decision automation (such as exception processing or no-touch

claims handling)
■ Real-time decisioning (such as fraud detection)
■ Big data analysis using structured and unstructured data for complex
analysis
The debate over the terminology used among the vendors also creates
confusion among CIOs and complicates the buying process.
Figure 1. Range of AI Technologies

Source: Gartner (February 2019)
Today’s focus on front-office technologies generates more attention in

insurance than back-office technologies as business leaders look to
strengthen direct-to-consumer interactions through improved
automation and customer intelligence. As a result, conversational AI,
including chatbots and virtual personal assistants (VPAs) such as Alexa
or Google Home, is prioritized among innovative insurance CIOs to
connect with consumers in new and innovative ways (see “Four Use
Cases for Chatbots in the Enterprise Now”
ref=grbody&refval=3900964) and “Architecture of Conversational
Platforms” (https://www.gartner.com/document/code/371397?
ref=grbody&refval=3900964) ). For example, CIOs have begun to use
chatbot technology to enable interactive websites as well as support
inbound interactions in the contact center. Also, life insurers have begun
to leverage roboadvisors that can support financial advisory services —
both direct to consumer or via an advisor (see “Innovation Insight for Life
Insurance Roboadvisors”
These types of technologies will help transform the customer experience

using a combination of technologies. AI, for instance, can help insurers
support real-time, learning-based analysis such as advanced customer
segmentation. It does so using preferences, interaction history and
predictive models such as next-best action, sentiment and factors such
as financial status/portfolio analysis. In contrast, a variety of
technologies aim to support back-office processes such as transaction
processing, internal decision support and information discovery. They
include, but are not limited to, technologies such as ML, NLP and deep
learning These can be used alone or in combination with customer-
facing technologies such as chatbots, depending on the use case. One
such example is the combination of robotic process automation (RPA)
with AI for intelligent processing, which is a new emerging trend.
Adoption of RPA has been increasing in the industry, especially for high-
volume back-office tasks such as data entry. These technologies lacked
data insight and as a result did not learn as they processed. With the
combination of RPA and AI, the results are amplified and outcomes
improved. Also, one use case in marketing and sales is the deployment
of these technologies to support customer analytics, including large-
volume customer data analysis (such as structured/transactional data),
high-volume data (such as IoT data) and nonstructured data (such as
social analytics). Also, they have been used for core processes such as
claims processing to handle highly data-intensive tasks that require
more analytical capabilities than humans can support and that often
require real-time response. When using these technologies, back-office
administrative staff are incrementally being replaced with AI for a variety
of processing tasks, but not on a large scale (most staffing
replacements are fewer than 50 people per use case). These include
reviewing incoming documents (such as medical statements) or, with
automation of billing, supporting no-touch claims processing in
combination with chatbot technology. Analyzing large, complex
contracts in product lines such as reinsurance or commercial/specialty
P&C insurance is another administrative staff task that AI can take over.
Be aware of these emerging areas in AI:
■ Use of RPA is accelerating in the industry; however, these rule-based

systems lack any learning capabilities and, therefore, are not AI. The
vendors in this market are advancing these solutions to become
smarter and embedding AI for greater ROI. This merger of technology
will provide more process automation and allow for more complex
decisions to be made by the robots than are possible today (see “Real-
World Use Cases Are Key to Successful RPA Implementations in
Insurance” (https://www.gartner.com/document/code/368472?
■ Advancements are taking place in areas such as autonomous or

intelligent things (see “Top 10 Strategic Technology Trends for 2017:
Intelligent Things”
ref=grbody&refval=3900964) ). Many of these objects such as autos,
homes and drones (that are insured) are being embedded with
advanced technologies such as AI. This creates a new opportunity for
insurers because they can leverage these things to connect with
insureds, obtain new data and implement new business models. But, it
also introduces new risks to the industry such as cybersecurity risk
from hacking these devices or rising replacement costs due to the
cost of sensors and data analysis platforms that will reside on the
things. Insurance CIOs need to understand these emerging areas to
help drive business discussions on the future of AI throughout the
enterprise, and to manage the shifting risks/opportunities that the
blending of AI with “things” offers to their business model (see
“Operational Efficiency Drives Life Insurers’ Adoption of RPA and
Process Automation”
These solutions come from a variety vendors and service providers

including:
■ Large system integrators
■ Specialized vendors for chatbots or other technology categories like

NLP see “Market Guide for Conversational Platforms”
ref=grbody&refval=3900964)
■ Insurance core system vendors that are augmenting their solutions

through the incorporation of AI
■ Platform vendors such as those offering customer engagement
solutions and adding AI (see “Top Use Cases to Deliver a CRM-
Integrated Chatbot”
ref=grbody&refval=3900964) )
■ RPA vendors that are enhancing their solutions to add more AI
■ Emerging insurtechs that offer niche solutions aimed at specific

insurance industry processes (e.g., mobile chatbots or fraud analytics)
The market is highly complex, overlapping and confusing due to the

variety of terminology used in the market. Insurance CIOs need to
carefully map out their business needs and compare them against the
use cases and technical capabilities of the various vendor markets to
ensure the proper fit against business objectives. They also need to
balance the risk of company failure inherent with smaller insurtechs
against the high cost of large system integrator-backed solutions (see
“Why Most Insurtechs Will Fail and How Insurance CIOs Can Take
Advantage of That” (https://www.gartner.com/document/code/327952?
Benefits and Uses

Overall, CIOs need to enable a new platform to help their business
partners achieve the speed and lower cost structure required to stay
competitive and meet customer engagement needs. AI will become an
important element in fulfilling emerging business requirements,
providing great benefit to both P&C and life insurance CIOs (see Table 1).
Table 1: Benefits of AI in Insurance

Front-Office/Customer-Facing Back-Office/Transactional
Benefits Benefits
Customer satisfaction and retention Efficiency
Interaction improvement Lower cost of operations
Sales/service completion Faster and in real time
Lower cost of servicing/sales Improved accuracy
Improved customer intelligence Anomaly detection
Contextualization and personalization Decision support

of content
Information discovery

2
According to the 2018 Gartner Financial Services Technology study, AI
is being employed for a variety of use cases, ranging from product
support to customer-facing service (see Figure 2).
Figure 2. Use Cases for AI Among P&C and Life Insurers

User and Customer-Facing Use Cases

Many use cases for AI support customer-facing tasks, and some
customers are already receptive to the idea of interacting with a machine
during a sales/customer service engagement. Studies show that up to
69% of consumers believe it’s acceptable to communicate with a
chatbot about basic information such as corporate information or
brand. 3 Many consumers are using these technologies at work as well.
Adoption has lingered in insurance, but has picked up during the last
years as some Tier 1 insurers launched customer service initiatives
leveraging chatbots. As a result, Gartner predicted that by year-end 2019,
30% of online insurance sales and service will be supported by AI and
cognitive computing (see “Predicts 2017: Insurance CIOs Must Balance
Emerging Technology Opportunities and Risks to Drive Innovation”
ref=grbody&refval=3900964) ). Various use cases for implementing AI to
increase and improve customer engagement include:
■ Enablement of chat via the web or a mobile site to support interactive

sales support or customer servicing
■ Support of the contact center to answer inbound calls for users

wanting self-service
■ Support of inbound agent email or calls for administrative and help

desk
■ Enablement of more accurate financial analysis, which can be offered

direct to consumer or via a financial advisor
■ Analysis of social media to identify life stage and life event

information for marketing and sales
■ Support of FAQ and basic insurance information (e.g., billing status,

find an agent/office, coverage details or IoT data feedback) using
voice in the home or via the customer’s mobile
■ Enablement of a platform to build new mobile applications to allow

consumers to manage their insurance policies or find the best policy
suited for them
■ Integration with IoT such as telematics, smart home or wearables to

provide real-time feedback to users
Back-Office Use Cases
CIOs should explore all the opportunities that AI can offer to transform
back-office transactions and processes through learning-based
methods. In the back office, AI has the promise to help drive efficiency
through process automation using advanced analytics and algorithms.
This will result in faster, less expensive and more accurate decision
making than derived today through disconnected, human-based and
slow decision-making processes. AI can help skilled workers make more
accurate assessments or decisions in areas such as complex
underwriting, where a lot of data has to be analyzed to determine risk or
price.
Back-office use cases include:
■ Billing review and payment, including review of statements of services
■ No-touch claims processing to assess claims risks and fraud, and

initiate immediate payment for claims
■ Advanced fraud detection using ML to review fraud rings and identify

new, complex fraud patterns that are not detected through human
review
■ Large contract review (e.g., commercial P&C and reinsurance

contracts) and coverage assessments to quickly assess and predict
next steps and recommendations
■ Advanced customer analytics and modeling for large, complex

multiline product companies that want to do advanced customer
segmentation based on new variables or support marketing through
customer analytics for next-best action and personalization
■ Automated underwriting for complex risks such as commercial
property or specialty products
■ Underwriting assistants to support underwriters in decision making

for life insurance or commercial P&C through large-volume data
analysis and decision support
■ Review of IoT data to reproduce accident details for claims
■ Review of wearables data to provide real-time feedback on healthy

living to program participants
■ Review and assessment of images for claims verification
■ Verification and analysis of drone images and videos for catastrophe

support
■ Internal help desk support
■ Email review and response
■ Pricing model evaluation and actuarial analysis
Adoption Rate
Adoption of AI among P&C and life insurers continues to grow steadily.
Many insurers report high use of ML, especially in the actuarial
department, with far less experience in other business units such as
underwriting, marketing or claims. Although Gartner reported in early
2018 that rates were in the single digits, it has now grown. According to
the 2018 Gartner Financial Services Technology Survey, approximately
11% of insurers have installed and are using AI, and an additional 25%
were in the process of installing or developing.
Adoption remains low for a number of reasons, including lack of:
■ Budget for innovation among many insurers
■ Adoption of cloud models, which prohibits testing for more

conservative companies
■ Business vision on where to apply AI throughout the value chain
■ Continued focus on more tactical projects that are more foundational

in nature
Many insurers doing proofs of concept and pilots also have trouble
getting AI into production due to lack of business support or metrics
showing the value of the use case (see “How to Scale RPA in Insurance
as the Foundation of Your Automation Strategy”
Risks
Many of the risks associated with the use of AI in insurance are related
to implementation, organizational readiness and execution. Today, the
technology is being used by other industries at a far faster pace than in
the P&C and life insurance sectors. Early implementations show that IT
leaders in insurance often struggle with a variety of problems, which
leads to long implementation cycles and rising deployment costs, such
as:
■ Having IT lead AI projects without proper business sponsorship in
developing the use cases or project plans.
■ Lacking IT staff knowledgeable in implementing and managing AI.
■ Lacking the adequate and quality data needed to support the

decisions the chatbot or machine will be making.
■ Validating decisions made via AI to determine if they are correct and

ethical.
■ Lacking the insight on how to implement a hybrid model, where

certain tasks are handled by the AI engine, and setting the threshold
for what tasks are to be routed to be handled by humans.
■ Managing variations in speech and terminology associated with

insurance products.
■ Finding the right resources to train the machine, especially when

processes are not documented and vary based on traditional staff.
Gartner predicts that, starting in 2020, AI will create 2.3 million new
jobs while eliminating 1.8 million jobs. 4 CIOs will need to understand
this talent transition and work with HR to effectively fill these
positions to support their AI initiatives.
■ Trying to use AI for initiatives that do not require learning-based

technologies. Today, AI is the cool technology, and it is being applied
for some tasks that do not demand its power or cost. This results in
greater-than-needed complexity and cost.
■ Experiencing confusion over the vendor landscape, which is quickly

becoming a crowded and fragmented market with a variety of vendor
types offering a range of technologies and solutions.
Insurance CIOs need to raise awareness of AI within their companies by

educating their business peers on the needs and requirements for AI
implementation success. This will facilitate its use. They also need to
aggressively face staffing issues by working with HR to develop or hire
the technical resources trained in AI, and to guide and support the data
scientists and analytics team to ensure clean, accessible and valid data
is used in the AI engine. CIOs should engage with data scientists to
perfect the algorithms the machines will need to execute, and then build
a practice around algorithm maintenance because these are adapted
based on changes in consumers or markets.
As AI matures, CIOs should watch regulatory changes such as the

General Data Protection Regulation (GDPR) in Europe. These changes
impact the use of machines or autonomous things throughout the
insurance value chain, as well as the types of data that can be used for
decision making (e.g., credit scoring and social media). CIOs also need
to monitor licensing requirements because in most countries anyone
offering product advice has to be licensed to sell insurance. Laws will
require that sales discussions reside with agents and licensed
professionals. This will further require an effective hybrid model that
automates handoffs and machine-to-human-based transactions in a
fast, effective manner. These steps will be key to optimizing AI
outcomes and ensuring success with AI initiatives.
Recommendations
Insurance CIOs driving financial services digital business strategy and
innovation:
■ Avoid falling victim to the AI hype. Assess the technical needs for
each use case to determine what needs AI and what can be done
through technologies such as RPA and advanced analytics.
■ Ensure business leadership and development of use cases takes

place for project success, adoption and optimal ROI through execution
of leadership and strategy meetings and joint use-case development.
■ Develop the foundations for AI, if you are not yet ready to implement
AI in 2019, by assessing accessibility and completeness of data
sources. Ensure you have an internal culture to support AI use,
develop innovation labs and train staff for maintenance/support of
machine-based technologies.
■ Create a prototype of small and less complex technologies by

partnering with insurtechs and other technology firms that have
developed point solutions.
Evidence
1
2019 Gartner CIO Survey: The 2019 Gartner CIO Survey was
conducted online between 17 April and 22 June 2018. The respondents,
who included Gartner Executive Programs members and other CIOs,
were all the most senior IT leaders for their overall organizations or a
part of their organizations (for example, a business unit or region). The
total sample was 3,102, with representation from all geographies and
industry sectors (public and private), including 151 in the insurance
industry. The survey was developed collaboratively by a team of Gartner
analysts, and was reviewed, tested and administered by Gartner’s
Research Data and Analytics team.
2
2018 Financial Services Technology Survey: The 2018 Financial
Services Technology Survey was conducted online between December
2017 and February 2018. Gartner reached out to more than 2,500
technology experts and executives, and surveyed them across five
different business lines and 121 technology areas to learn about the life
cycle, value, and outlook for key technologies. The total sample was
2,719 across the financial services industry sectors, including 479
executives from the Insurance industry. The survey was developed
collaboratively by a team of Gartner analysts, and was reviewed, tested
and administered by Gartner’s Research Data and Analytics team.
3
“69% of Consumers Prefer Chatbots for Quick Communication With
Brands.” (https://www.salesforce.com/blog/2018/01/why-consumers-
prefer-chatbots.html) Salesforce blog.
4
“The Secret to Digital Success: Talent.”
(https://blogs.gartner.com/smarterwithgartner/the-secret-to-digital-
success-talent/) Smarter With Gartner. 2 October 2017.
Document Revision History

Innovation Insight for Artificial Intelligence in Life and P&C Insurance - 19
October 2017 (https://www.gartner.com/document/code/341942?
ref=ddrec)
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This research note is restricted to the personal use of Vivek Jasuja

Innovation Insight for Artiﬁcial

By Analysts Kimberly Harris-Ferrante

Adoption and maturity of AI are increasing among insurance early

■ Some of the hottest use cases in insurance include no-touch claims

■ No single AI technology will meet all of a CIO’s business objectives. To

■ Create a use case library that identiﬁes short- and long-term

■ Plan a roadmap to develop the technical foundation for insurers not

Strategic Planning Assumption(s)

■ Automation of insurance processes (back-end and customer-facing)

■ Decision support (such as an underwriting assistant)

■ Decision automation (such as exception processing or no-touch

■ Real-time decisioning (such as fraud detection)

Figure 1. Range of AI Technologies

Today’s focus on front-ofﬁce technologies generates more attention in

These types of technologies will help transform the customer experience

Be aware of these emerging areas in AI:

■ Use of RPA is accelerating in the industry; however, these rule-based

■ Advancements are taking place in areas such as autonomous or

These solutions come from a variety vendors and service providers

■ Large system integrators

■ Specialized vendors for chatbots or other technology categories like

■ Insurance core system vendors that are augmenting their solutions

■ RPA vendors that are enhancing their solutions to add more AI

■ Emerging insurtechs that offer niche solutions aimed at speciﬁc

The market is highly complex, overlapping and confusing due to the

Beneﬁts and Uses

Table 1: Benefits of AI in Insurance

Customer satisfaction and retention Efﬁciency

Interaction improvement Lower cost of operations

Sales/service completion Faster and in real time

Lower cost of servicing/sales Improved accuracy

Improved customer intelligence Anomaly detection

Contextualization and personalization Decision support

Source: Gartner (February 2019)

Figure 2. Use Cases for AI Among P&C and Life Insurers

User and Customer-Facing Use Cases

■ Enablement of chat via the web or a mobile site to support interactive

■ Support of the contact center to answer inbound calls for users

■ Support of inbound agent email or calls for administrative and help

■ Enablement of more accurate ﬁnancial analysis, which can be offered

■ Analysis of social media to identify life stage and life event

■ Support of FAQ and basic insurance information (e.g., billing status,

■ Enablement of a platform to build new mobile applications to allow

■ Integration with IoT such as telematics, smart home or wearables to

Back-ofﬁce use cases include:

■ Billing review and payment, including review of statements of services

■ No-touch claims processing to assess claims risks and fraud, and

■ Advanced fraud detection using ML to review fraud rings and identify

■ Large contract review (e.g., commercial P&C and reinsurance

■ Advanced customer analytics and modeling for large, complex

■ Underwriting assistants to support underwriters in decision making

■ Review of IoT data to reproduce accident details for claims

■ Review of wearables data to provide real-time feedback on healthy

■ Review and assessment of images for claims veriﬁcation

■ Veriﬁcation and analysis of drone images and videos for catastrophe

■ Internal help desk support

■ Email review and response

■ Pricing model evaluation and actuarial analysis

Adoption remains low for a number of reasons, including lack of:

■ Budget for innovation among many insurers

■ Adoption of cloud models, which prohibits testing for more