Agentic AI in Insurance: Automating Claims, Underwriting & Beyond

Insurance companies are deploying artificial intelligence (AI) systems capable of orchestrating complex workflows across claims, underwriting, and policy servicing, a shift that extends beyond simple automation, according to industry observers.

These “agentic AI” systems differ from previous automation efforts, such as robotic process automation, by their ability to ingest unstructured data – emails, PDFs, and intake forms – extract relevant information, apply policy rules, and route exceptions to human adjusters. In some instances, these systems are autonomously triggering actions like payments and customer notifications.

The most immediate impact of this technology is being felt in claims operations, particularly in first notice of loss intake and triage. Microsoft reported on February 9 that collaborations with insurers are focused on embedding AI agents throughout the claims process, rather than adding tools to existing steps. These systems interpret loss reports, classify severity, verify coverage, and dynamically assign cases, aiming to reduce manual review.

Sedgwick, a global claims management provider, announced in April 2024 the optimization of claim workflows through its AI application, Sidekick, integrated with Microsoft technologies. The company stated that Sidekick supports claims professionals by surfacing policy information and automating routine interactions, with the goal of accelerating cycle times although maintaining compliance.

Major carriers are also experimenting with catastrophe response. Allianz described in November 2024 using AI to manage post-storm claims surges, with systems designed to analyze damage documentation and prioritize cases to expedite claim processing after extreme weather events.

Underwriting, traditionally reliant on human judgment, is also undergoing transformation. Insurers are testing AI agents that can parse broker submissions, extract risk attributes from attachments, cross-reference external data sources, and flag anomalies or missing information for human underwriters. Swiss Re has highlighted the potential for AI to support more granular risk assessment, including improved modeling of complex risks.

The Boston Consulting Group argued in a January 2025 article that agentic AI represents a new phase in insurance modernization, moving beyond chatbots and dashboards toward systems that actively coordinate processes across policy administration, billing, and claims platforms. The firm suggests that AI agents can operate across existing silos, integrating fragmented workflows while longer-term modernization programs proceed.

Although, the increasing orchestration of tasks by AI is drawing regulatory scrutiny. The insurance industry operates under strict model risk management frameworks, and autonomous decision-making raises oversight concerns. The Insurance Information Institute noted on February 10 that agentic AI necessitates a reevaluation of model risk management, as systems triggering actions across multiple functions may not fit existing validation categories.

Audit trails, explainability, and human-in-the-loop controls are becoming critical. Insurers must demonstrate not only the accuracy of their models but also the documentation and contestability of decision pathways. Regulators will expect clarity on how AI systems arrive at outcomes such as claim routing, payment recommendations, or fraud alerts.