Human-in-the-Loop in Claims: When AI Knows to Escalate

The future of insurance claims isn’t fully automated—it’s collaborative.

Human-in-the-loop (HITL) AI systems combine the speed of automation with the judgment of experienced professionals.

When AI Handles the Load

AI agents manage:

• Data collection

• Status communication

• Routine claim updates

• Document verification

When Humans Step In

AI escalation triggers include:

• High-value claims

• Fraud indicators

• Emotional distress

• Regulatory complexity

Benefits of HITL Claims Models

• Faster average resolution time

• Lower adjuster burnout

• Higher customer trust

• Improved compliance

AI ensures humans focus where they matter most.