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Agentic AI: Automated Claims Processing Multi-Agent System

Publisher IDC
Published Mar 31, 2025
Length 13 Pages
SKU # IDC19899479

Description

This IDC Perspective explores the transformative potential of agentic AI in the insurance industry, particularly in automated claims processing. Agentic AI stands out for its ability to operate autonomously across complex, fragmented systems, making it uniquely suited to handle intricate processes such as claims management. Unlike traditional AI, which focuses on well-defined tasks, agentic AI coordinates across various architectures, applications, and technologies, enabling seamless integration and improved operational efficiency.The true value of agentic AI lies in its capacity to manage the complexity of claims workflows by involving multiple stakeholders and diverse systems. By leveraging a multi-agent framework, it streamlines operations, enhances decision-making, and reduces operational silos. This capability improves claims processing and creates new opportunities for insurers to deliver faster, more accurate, and personalized services, driving growth and competitive advantage."In a landscape often defined by complexity and fragmentation, agentic AI paves the way for a smarter, more seamless future where collaboration across systems and stakeholders drives innovation and excellence. By enabling multi-agent systems to autonomously manage claims, insurers can transform the way they engage with policyholders, mitigate risks, and foster growth. This is not just about automating tasks — it is about redefining how the entire claims process functions with unparalleled efficiency and precision, enabling the industry to uphold its promise of delivering personalized, transparent care to policyholders," said Davide Palanza, research manager, IDC Financial Insights.

Table of Contents

13 Pages

Executive Snapshot

Situation Overview

What AI Agents Are, and What They're Not

AI Agent Use Case: Automated Claims Processing with Multi-Agent Systems

Claims Initiation (FNOL Detection)

Data Collection

Claims Triage and Severity Assessment

Parallel Processing by Specialized Sub-Agents

Claims Decisioning

Final Claims Outcome Communication

Agentic AI Design Patterns in Automated Claims Processing

The Benefits of Automated Claims Processing Multi-Agent System

Challenges of Automated Claims Processing Multi-Agent System

Advice for the Technology Buyer

Learn More

Related Research

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