The future of claims automation

The outdated back and forth of manually settling an insurance claim often leads to a waiting game that can strain healthcare providers, increase administrative costs for payers and frustrate members. For example, in a manual system, a healthcare provider might submit a claim for a patient’s treatment, only to have it sit in a queue for days, or weeks, awaiting review. Errors in coding or incomplete documentation could lead to denials or resubmissions, delaying reimbursement and impacting cash flow. Automation reduces these delays by flagging errors instantly and routing clean claims for immediate processing.

Luckily, claims processing has come a long way from slow, manual workflows to the fast-paced, digitally powered systems we see emerging today. As insurers face mounting pressures from rising claim volumes and increased customer expectations, claims automation is proving essential to staying competitive and compliant. Powered by AI and intelligent technologies, automation is transforming the claims journey from end-to-end.

What is claims automation?

Claims automation is the use of digital technologies to manage and process insurance claims with minimal human intervention. Unlike traditional paper-based or manual systems, which can be time-consuming and error-prone, automated claims processing leverages intelligent tools to streamline the entire workflow. The result can mean a near instant and more personalized level of care for members that is easy to scale. 

From automatically extracting information from claim forms to routing tasks and making real-time decisions, automated claims processing improves accuracy, scalability and efficiency. It enables insurers to handle large claim volumes while reducing administrative errors and improving communication with policyholders.

Why insurance carriers are investing in claims automation

The global population is only increasing –– reaching 8.2 billion as of July, 2025.  As claims volumes surge due to aging populations and chronic health conditions, automation offers a critical path forward. By reducing manual touchpoints, insurance claims automation eliminates bottlenecks, accelerates turnaround times and enhances accuracy. It also ensures regulatory compliance through standardized workflows and consistent rule application.

Consider this scenario, where a global third-party administrator (TPA) supercharged claims processing and accelerated growth by implementing automated document management. The result was cutting the lifecycle of a claim by 50% with $1.3M in savings. 

Automated systems eliminate many of the operational bottlenecks that slow down manual claims processing. They streamline repetitive tasks, reduce human error and ensure consistent application of business rules. This not only speeds up resolution times but also enhances accuracy and compliance — critical in a highly regulated industry.

Moreover, intelligent claims management platforms help insurers deliver more personalized and customer-centric outcomes. By integrating automation with analytics and customer data, insurers can provide faster, fairer and more transparent decisions, improving policyholder satisfaction and retention.

Key technologies powering automated claims

Several cutting-edge technologies are driving the evolution of automated insurance claims systems:

• Artificial intelligence (AI) and machine learning (ML): These tools help analyze vast amounts of structured and unstructured data, assist in decision-making and detect fraud patterns.
• Natural language processing (NLP): NLP enables systems to read and extract relevant information from emails, forms and customer interactions — improving both speed and accuracy.
• Predictive analytics: This helps insurers anticipate claim outcomes, detect anomalies early, and optimize claims workflows for better efficiency.

Emerging trends in claims processing

The insurance industry is evolving rapidly — and so are the tools supporting claims automation. Here are some of the most influential trends shaping its future:

• Hyper automation: The goal is to automate every step of the claims lifecycle — from intake to resolution — using a combination of advanced technologies.
• Internet of Things (IoT) and telematics: Devices and sensors provide real-time data that enhances the accuracy of claims assessments and speeds up investigations.
• Customer self-service portals and chatbots: These tools empower policyholders to initiate and track claims independently, improving convenience and satisfaction.
• Ethical AI and explainability: With increasing focus on fairness and transparency, insurers must ensure AI-driven decisions are explainable and auditable.
• Low-code/no-code platforms: These platforms enable insurers to rapidly build and deploy customized automation solutions without heavy IT involvement.

For decades, slow and error-prone manual workflows have overburdened healthcare providers, patients and payers. And those delays, inefficiencies and errors create real-world consequences. 

But today, AI-powered automation is unlocking a smarter, faster and more transparent approach to claims management. From faster processing and reduced costs to improved customer experiences and regulatory compliance, the benefits of claims automation are clear and measurable. 

Automation is not just about reducing costs — it’s about improving lives through faster access to care, accurate payments and a smoother member experience. As emerging technologies continue to mature, insurers who embrace intelligent claims automation will be better equipped to thrive in a dynamic and competitive market. Explore how Conduent’s Claims Processing Services can help modernize your claims operation and deliver better outcomes for everyone involved.