The $170 Billion Problem - How Agentic AI Ends Insurance's 70% Claims Denial Fiasco

04/10/2025 14 min Episodio 2
The $170 Billion Problem - How Agentic AI Ends Insurance's 70% Claims Denial Fiasco

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Episode Synopsis


What's in this episode: The $170 billion claims processing crisis - 20-30 minute FNOL calls, business hours only, 15-30 day settlement waits. How four autonomous agents (FNOL Automation, 24/7 Claims Support, Validation, Fraud Detection) deliver round-the-clock service and 3-5 day settlements. Real deployments hitting 80% FNOL automation, 95% fraud detection accuracy, 90% error reduction, 40% cost savings. What breaks with emotionally charged customer interactions and regulatory compliance. When to escalate to humans versus autonomous handling. SimplAI research across property & casualty, health, and auto insurance showing why 24/7 availability is now table stakes.