Talk to us
  1. Home
  2. AI use cases
  3. Insurance

AI use cases

AI use cases in insurance

32 AI agents that insurance companies run today, grouped by the team they work for. For each one: the process, what the AI does, where people step in and the result the company reported.

Customer service

In production · reported 2026

60% calls resolved without rep

Inbound calls on case status and policy values

US life insurance and annuity company

What the AI does
Authenticates callers, identifies intent, checks case status or retrieves policy values and answers in conversation, while AI QA scores every call.
Where people step in
Complex needs go to service reps; the agent handles only the requests it was designed for.
Systems
Phone · Contact center · CRM

In production · reported 2023

-85% processing time

Customer email and attachment data extraction

Fortune 500 US insurer

What the AI does
Extracts data from 200+ document types in customer emails and attachments, including handwritten and mobile-captured documents.
Where people step in
People review low-confidence items; contact center agents are supported, not replaced.
Systems
Email · Contact center

In production

~75-80% automation rate

Insurance contact center automation

Major Latin American insurer

What the AI does
Automates 40+ frequent tasks such as claims inquiries, coverage checks, scheduling and provider coordination, and assists human agents.
Where people step in
Live agents handle the rest with real-time guidance and summaries.
Systems
Web chat · Email · WhatsApp · Phone

In production · reported 2023

25% of calls fully resolved

Consumer line FAQs and vulnerable caller routing

UK health insurer

What the AI does
Answers FAQs or points callers to online resources, and identifies vulnerable callers and transfers them to the right department.
Where people step in
Vulnerable callers go straight to humans; paper claim form requests go to an agent.
Systems
Phone · SMS

In production · reported 2025

100+ hours saved weekly

Member plan FAQs and case status

UK health plan provider, 2.5M members

What the AI does
Answers plan FAQs and case status questions from a rep-built knowledge base and drafts emails for reps.
Where people step in
Inquiries needing human support, especially from vulnerable members, go to a live rep.
Systems
CRM · Contact center · WhatsApp · Knowledge base

Sales

In production

30-40% productivity gain (target)

Sales rep meeting prep and CRM updates

US title insurer

What the AI does
Prepares reps each morning with account history and relationship maps, handles post-meeting follow-up and proposes CRM record updates, following the sales playbook.
Where people step in
Reps review and approve proposed record updates before anything changes.
Systems
CRM · Data platform · BI

In production

10x faster eligibility checks

Point-of-sale credit life insurance underwriting

EMEA bancassurance credit life insurer

What the AI does
Combines customer, loan and policy data for advisors, runs eligibility checks and premium calculations, scores risk, validates compliance and generates policy correspondence.
Where people step in
Underwriters handle exceptions only.
Systems
Legacy policy systems

In production · reported 2025

100+ hours saved weekly

Member plan FAQs and case status

UK health plan provider, 2.5M members

What the AI does
Answers plan FAQs and case status questions from a rep-built knowledge base and drafts emails for reps.
Where people step in
Inquiries needing human support, especially from vulnerable members, go to a live rep.
Systems
CRM · Contact center · WhatsApp · Knowledge base

In production

7% increase in revenue in nine months

Real-time broker sales coaching

Fortune 500 US insurance company

What the AI does
Gives brokers real-time insights and surfaces coaching opportunities during peak insurance season.
Where people step in
Supervisors coach the human brokers.

In production · reported 2025

96% routing accuracy

Hotline call routing to experts

German insurance and pension provider

What the AI does
Understands callers' concerns by phone and routes them to the right expert.
Where people step in
Experts take the routed calls.
Systems
Phone

Operations

In production

Up to 80% of ACORD forms straight-through

New-business submission intake and entry

Top-20 US P&C insurer

What the AI does
Reviews submission emails, extracts ACORD form data, enters it and uploads attachments into the application system, and completes the submission to trigger quoting.
Where people step in
Submissions with incorrect agency, policy or line-of-business data go to a person for review.
Systems
Email · Submission system

In production · reported 2023

-85% processing time

Customer email and attachment data extraction

Fortune 500 US insurer

What the AI does
Extracts data from 200+ document types in customer emails and attachments, including handwritten and mobile-captured documents.
Where people step in
People review low-confidence items; contact center agents are supported, not replaced.
Systems
Email · Contact center

In production

200k+ cases/month with accelerated approval

Prior authorization decisioning

Fortune 20 US health insurer

What the AI does
Reviews prior authorization requests and medical records against clinical policies, then approves or escalates with step-by-step reasoning and source citations.
Where people step in
Escalated cases go to human review; clinical experts refine the AI's logic in plain language.
Systems
Medical record databases

In production

Policy update cycle 12 → <3 months

Reimbursement policy research and drafting

Fortune 20 US health insurer

What the AI does
Builds research grids from competitor data and regulations, writes alignment summaries and drafts first policy updates with inline suggestions, learning from analyst feedback.
Where people step in
Analysts accept or reject suggestions; peer reviews and committee approvals remain at every review gate.

In production

80%+ claims handled by AI

Medical claim form extraction and entry

US insurance claims clearing house

What the AI does
Reads often-handwritten CMS-1500 forms, extracts the data and enters it into the claims system.
Where people step in
Staff process the claims the agent does not handle, under 20%.
Systems
Claims system

Finance

In production

97% no-touch rate

Claims vendor invoice processing

US regional property insurer

What the AI does
Receives emailed invoices, extracts key data, keys values into the claims system, creates reserves and executes payments.
Where people step in
People handle exceptions only; simple single-invoice claims run with no touch.
Systems
Email · Claims system

In production

90%+ no-touch

Legal bill review, status checks and appeals

US national third-party claims administrator

What the AI does
Retrieves invoice decisions across legal billing platforms, detects reductions and deductions, files appeals when criteria are met and logs full transaction history.
Where people step in
Only complex exceptions go to staff for review.
Systems
Legal billing platforms

In production · reported 2025

$100,000+/day prepayment savings identified

Prepayment claims editing for payment integrity

Large US national health plan

What the AI does
Ingests claims data, applies targeted edits and returns reason codes with explainable context before payment.
Where people step in
The plan decides how it responds to each edit.
Systems
Claims system

In production

10x ROI in won disputes

Payment dispute resolution

US renters insurance provider

What the AI does
Validates addresses across the dispute process and updates user records automatically to reduce how often disputes occur.
Where people step in
A service team submits evidence such as documents and communications when required.

In production

Projected redeployment of 200 FTEs

Invoice creation and payment reconciliation

Global insurer

What the AI does
Creates invoices centrally, distributes them, connects with banks and reconciles incoming payments across currencies and tax rules.
Systems
Banking systems · Partner systems

Procurement

In production

$16M annual savings

Provider contract term extraction and decisioning

US Fortune 20 health insurer

What the AI does
Extracts rate terms, reimbursement methods, renewal and termination clauses and amendments from provider contracts into searchable data and ranks providers by actionability.
Where people step in
Subject-matter experts own contract term definitions and extraction logic.

IT

In production

45% reduction in MTTR

IT incident correlation and root-cause analysis

North American insurer

What the AI does
Connects monitoring, ticketing and logging data, correlates and deduplicates alerts, enriches tickets and answers root-cause questions with sources shown.
Systems
Monitoring · Ticketing · Logging · Documentation

Claims

In production

40% reduction in loss adjustment expenses

Claims intake and adjudication from FNOL

Global multi-line insurer

What the AI does
Digitizes and validates submissions such as invoices and medical records, updates systems of record, runs fraud and compliance checks and adjudicates routine claims.
Where people step in
Exceptions are flagged and escalated for adjuster review.
Systems
Claims system

In production

91% eligible claims automated

Motor claims decisioning

Dutch insurer

What the AI does
Applies adjuster decision criteria to eligible motor claims, approving straightforward claims and denying those without coverage.
Where people step in
Claims adjusters review complex or uncertain cases.
Systems
Claims system

In production

70%+ claims handled straight through

Property FNOL claim setup from email

Global insurance conglomerate

What the AI does
Receives FNOL emails, extracts claim details from PDFs and scans and enters them into the claims system 24/7 across time zones.
Where people step in
Incomplete claims are flagged for human review using confidence scores.
Systems
Email · Claims system

In production · reported 2025

-60% email handling time

Claims email triage and claim matching

UK commercial auto insurer

What the AI does
Reads and logs incoming claim emails, identifies original senders, matches each email to the right claim and summarizes, classifies and files attachments.
Where people step in
Adjusters still handle general queue items and focus on servicing policyholders.
Systems
Claims system · Email

In production · reported 2023

90% estimates without human appraisers

Photo-based motor claims estimates

Spanish motor insurer

What the AI does
Assesses vehicle damage from customer photos and builds the estimate and offer automatically, end to end.
Where people step in
Estimates are ready for review; about 10% still need human appraisers.
Systems
Portal

Underwriting & risk

In production · reported 2025

>75% automation; -70% effort

Commercial insurance submission intake

UK commercial insurer

What the AI does
Classifies and extracts data from broker submission emails, spreadsheets and documents to prepare submissions for underwriting.
Where people step in
Submissions that are not automated are handled manually.
Systems
Email · Spreadsheets

In production

15,000 applications analyzed in first month

Submission research and risk appetite matching

Global specialty insurer

What the AI does
Researches each submission, surfaces relevant risk characteristics, matches cases to risk appetite and applies industry codes.
Where people step in
Underwriters make the decision using the AI-prepared analysis.
Systems
Underwriting system

In production

-50% turnaround times

Cyber insurance submission analysis

Italian global insurance group

What the AI does
Structures all submission risk information into an underwriter dashboard for rating and speeds up cyber risk engineering reports.
Where people step in
Underwriters review the structured analysis, which is required input for every quote.
Systems
Cyber data sources · Rating system

In production

Up to 80% of ACORD forms straight-through

New-business submission intake and entry

Top-20 US P&C insurer

What the AI does
Reviews submission emails, extracts ACORD form data, enters it and uploads attachments into the application system, and completes the submission to trigger quoting.
Where people step in
Submissions with incorrect agency, policy or line-of-business data go to a person for review.
Systems
Email · Submission system

In production

Agent completed 25% of audit team's work

Premium audit pre-assessment

Fortune 500 US P&C insurer

What the AI does
Reviews financial reports, validates employee and vehicle classifications, analyzes payroll, redacts PII and prepares pre-audit assessments.
Where people step in
The audit team takes the pre-audit and completes the full assessment.
Systems
Unstructured data sources

Anonymised summaries of public case studies published from 2023 to 2026. Company and vendor names are withheld. Figures are as the companies reported them; they are not Retexa results.

Questions

AI in insurance

What are the most common AI use cases in insurance?

In the 32 public cases we collected, AI agents in insurance work mostly in customer service, sales and operations. Examples: inbound calls on case status and policy values; customer email and attachment data extraction; insurance contact center automation.

Where do people stay in the loop?

Each card says where people step in. In this industry, for example: complex needs go to service reps; the agent handles only the requests it was designed for; people review low-confidence items; contact center agents are supported, not replaced.

Are these Retexa results?

No. These are anonymised summaries of public case studies from 2023 to 2026, with company and vendor names withheld. Figures are as the companies reported them. Retexa builds the same kind of agents on top of the systems you already run.

Other industries

More AI use cases

See every industry and team on one map

AI use cases in logistics and freight31 examplesAI use cases in banking and finance33 examplesAI use cases in telecom13 examplesAI use cases in retail and e-commerce30 examplesAI use cases in healthcare37 examplesAI use cases in manufacturing33 examplesAI use cases in energy and utilities17 examplesAI use cases in travel and hospitality20 examplesAI use cases in real estate15 examplesAI use cases in government17 examplesAI use cases in software and SaaS35 examplesAI use cases in media and entertainment19 examplesAI use cases in automotive15 examplesAI use cases in consumer services21 examplesAI use cases in professional services26 examplesAI use cases in education9 examples

One of these looks like your desk?

Bring us the process. We build the agent on top of the systems you already run, and you pay per accepted result.

Talk to an engineer