A task performed by Customer Service Representatives
Review insurance policy terms to determine whether a particular loss is covered by insurance.
Technically, much of it, experts rate AI capability 5/5, but workers don't want it automated (desire 2.86/5). It's an Automation Red Light: proceed with care.
Do you want this task automated?
How much the people who do this task want AI to take it over (avg of 7 workers).
How capable experts rate current AI at this task (avg of 2 experts).
How much human involvement should stay?
The Human Agency Scale (H1–H5) captures how much human direction workers think this task should keep.
Why workers feel the way they do
- It's repetitive57%
- Frees up time for higher-value work43%
- It's stressful43%
- It's difficult29%
- Helps handle larger scale29%
- Reduces human error14%
How to automate this
Doable with technology, but keep a person clearly in charge.
Judgment, review & checks
Automate the checks, keep the decision with a person.
- 1Write down the rules and checklists you follow to review insurance policy terms to determine whether a particular loss is covered by insurance, then encode them so routine cases are flagged automatically.
- 2Add validation rules to catch errors before they reach you.
- 3Let AI pre-screen and surface the exceptions, you decide the hard ones.
Tools that can help
Know a better way, or spot an error?
Share how you automate this in real life, or correct the data. Reviewed before publishing.
This is 1 of 11 tasks studied for Customer Service Representatives, where workers want 27% of tasks automated.
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