The Claim Industry’s New Reality: AI as the Policyholder’s Adviser 

June 25, 2026

The relationship between insurers and their policyholders is changing rapidly and artificial intelligence is accelerating that shift.  

Only a few years ago, most policyholders relied heavily on the expertise of insurers, loss adjusters and restoration professionals to guide them through a claim. Today, before an industry professional has even attended site, customers are armed with screenshots, AI-generated summaries, and Google’s Overviews which are not necessarily from a trusted source. They are researching terminology, challenging methodologies and questioning decisions in ways that were once rare outside of commercial or legally represented claims. 

In many ways, this is understandable and even positive. Policyholders should absolutely feel entitled to ask difficult questions about works taking place in their homes or businesses. They should expect clear explanations, technical reassurance and transparency around health, safety and scope of works decisions. The industry cannot dismiss scrutiny simply because it is inconvenient. 

However, the growing influence of AI-generated information is creating a new, increasingly difficult environment for claims professionals to operate in, and we must mitigate it.  

AI summaries are now deeply embedded into search engines and use of AI products such as Claude, ChatGPT etc are an everyday customer behaviour. Google’s AI-generated responses, will pull information from most websites that are getting good traffic and good SEO scores, or even forums such as Reddit, which doesn’t always mean they are factually correct or contextualised. A recent example of this would be ‘toxic black mould’, which is something we discuss in our mould training. The AI overview produced is presented with confidence and authority regardless of whether the conclusions are contextualised or even entirely accurate, which they often are not. 

The result is that claims are becoming adversarial far earlier in the process, and not just on mould jobs. 

Instead of a conversation beginning from a position of trust, many now begin from a position of scepticism: “AI says this should happen, why are you saying something different?” 

Post-pandemic, health concerns and liability awareness have increased significantly across society. Customers are more alert to potential long-term impacts, more aware of legal accountability and far more likely to challenge decisions they perceive as insufficient or dismissive. For restoration and claims professionals, this creates several operational and reputational risks. 

Figure 1: ChatGPT response regarding health risk after a lithium-ion battery fire at a commercial property. 

 So what does that mean for our industry?  

Firstly, claims are taking longer. When speculative concerns are raised, they require investigation, explanation and documentation. Professionals increasingly find themselves having to prove a negative e.g. demonstrating why there is NOT hidden contamination, why additional strip-out is unnecessary, or why certain risks are low probability. Every additional rebuttal, query or reassurance extends claim lifecycle times and increases costs through additional accommodation, business interruption exposure and secondary damage risks.  

Secondly, the justification of scopes of work have become significantly more important. Even technically correct decisions can appear questionable when a customer has an AI advisor suggesting otherwise. A straightforward drying strategy or limited strip-out recommendation can quickly become challenged by AI-generated “best practice” advice that lacks context, property-specific understanding or technical accuracy. 

Thirdly, there is growing liability exposure around health-related concerns. Whether discussing mould, fire-related contamination or indoor air quality, the industry is increasingly operating within a heightened culture of perceived risk. If concerns are raised, regardless of how speculative they may initially be, organisations must now demonstrate robust reasoning, documentation and validation behind their decisions. 

The reality is that this trend is not going away. Policyholders will continue using Google and AI tools as part of the claims process, and the industry must adapt accordingly.  

The solution? Be better prepared for scrutiny. 

That starts with validation. 

Upfront assessment and cause investigation is vital. Early inspection and detailed evidence gathering help establish factual baselines before assumptions. The more robust the early-stage diagnosis, the easier it becomes to justify decisions later, and it puts parentheses around the size of the claim.  

Detailed planning and methodology are also critical. Customers increasingly expect transparency around what will happen, why it will happen and how risks are being controlled. ‘Trust us, we know what we are doing’ is no longer sufficient. Clear scopes, documented methodologies and visible project management all help build confidence and reduce friction. 

End-of-project validation testing is becoming increasingly important, particularly where health concerns are involved. Independent verification provides reassurance not only to insurers and contractors, but also to customers who may otherwise remain unconvinced by verbal assurances alone. 

But perhaps the most overlooked element is communication itself. 

The right point of contact, someone who can reassure, explain and guide calmly through the process, is becoming just as important as the technical delivery itself. In this new environment, customers are not simply comparing your response against other insurers; they are comparing it against the internet and an AI instructed set of expectations. 

Figure 2: ChatGPT response regarding expectations of a claim timeline and actions following an EOW event in a residential property. 

Independence plays a major role here too. Customers are far more likely to trust a process when they feel the advice, testing and conclusions are objective, evidence-led and transparent. In a world increasingly shaped by AI-generated doubt and online misinformation, trusted independent expertise becomes a powerful tool for restoring confidence. 

If the industry wants to maintain trust, reduce friction and protect both operational performance and reputation, it must be ready to meet that challenge head-on.