Step 04 · Future State
Designing the future operating model
The same claims journey, re-shaped so claims handlers spend their time on judgement rather than retrieval.
Today
Current process
- Customer submits claim
- Claims handler triage
- Document review
- Approval
- Payment
With AI
AI-enabled future process
- Claim documents received
- AI extracts and structures the information
- AI prepares a summary and recommendation
- Claims handlers review the recommendation
- Decision completed and recorded
-0%
Processing time
-0%
Manual effort
+0%
Decision quality
+0%
Customer experience
Effort distribution, future state
Work shifts to AI, while every outcome still passes through a human.
- Automated by AI42%
- Human review35%
- Human decision23%
42%AI assisted
0%Implementation readiness
- Strong business case
- High process standardisation
- Data ownership and quality to be confirmed
- Stakeholder engagement required
- Integration path is straightforward