AI Agents 4 Claims: Smart insights. Confident decisions. Qorus-NTT DATA Innovation in Insurance Awards 2026

The traditional handling of family claims requires intensive manual effort. Claim handlers must search through incident reports, emails, letter and third party communication to gather relevant details and judge whether a file is complete and ready-to-decide. This often causes a heavy administrative burden and long lead times. The AI agent directly addresses these issues by processing all external information immediately upon file creation, structuring and interpreting that information and by presenting a clear and actionable summary to the claim handler.

The AI Agent is designed to prepare new claim files end-to-end, ensuring they are decision-ready before they reach the claim handlers. The agent will extract all crucial data from incoming documents and will identify any missing information that is relevant for the handler to decide on cover and liability. In case crucial information is missing, the AI Agent will generate the communication needed to request it from relevant stakeholders. Finally, the AI Agent will produce a Summary report that is automatically stored in the case file and provided the handlers with immediate insights into the case. Our core objective is simple: we aim to reduce the handler’s workload to what truly matters – making the actual decisions on coverage, liability and damages.

Within KBC Insurance, this is a first-of-its-kind initiative: an AI system that not only reads and summarizes documents but prepares complete files autonomously. Externally, solutions usually cover partial automation. This is, however, only an initial step. Over the course of 2026, this AI model for claims handling will be further expanded to new capabilities and new products, with the objective of reducing the number of human touchpoints throughout the lifecycle of a claim. Importantly, the design is human-in-the-loop by default: the AI model supports the handler with transparent outputs and traceability, while the final decision remains a human responsibility.