May 14, 2025
At Riskworld 2025, industry leaders gathered for an engaging session, Risk Unscripted: 360° Conversations – Tackling Claims Handling Challenges. The conversation, led by Kimberly George, Global Chief Brand Officer at Sedgwick, and Mark Walls, Vice President of Communications and Strategic Analysis at Safety National, provided a deep dive into some of the most pressing issues in claims management today.
Adjuster Turnover and TPA Management Trends
The discussion kicked off with a focus on third-party administrator (TPA) management and the ongoing challenge of adjuster turnover. Many participants noted the frustration of losing an adjuster just as they were getting comfortable with their handling style.
A key theme emerged: retention strategies matter. Relationship-building with adjusters plays a significant role in keeping talent engaged. Some companies emphasized the importance of making adjusters feel connected to the clients they serve, fostering a “we’re in it together” culture.
With adjuster shortages on the rise, organizations that successfully minimize turnover often prioritize:
- Providing regular training and hands-on experience, such as mediation sessions.
- Ensuring adjusters feel recognized and valued for their efforts.
- Encouraging social engagement and team bonding to create a cohesive work environment.
- Developing formal training programs to support new adjusters, nurturing their skills and professional growth.
Another vital component is recognizing generational differences in workplace expectations. Many younger professionals prefer remote or hybrid work models, but these require careful trust-building and structured training programs to maintain effectiveness. Companies adopting hybrid work strategies find success by using office days for collaboration and at-home days for focused work.
The Rise of AI in Claims Management
The conversation then shifted to artificial intelligence (AI) and its evolving role in claims handling. In industries like commercial real estate, professionals are exploring ways to leverage AI to enhance general liability (GL) claims processing.
At Sedgwick, AI tools have already transformed medical summarizations, helping adjusters review critical case information faster. The GL sector is now looking for similar enhancements, particularly AI-driven demand packet models to streamline processes.
Additionally, AI can score defense and plaintiff attorneys, predicting probable case outcomes and helping adjusters refine their decision-making. By analyzing median settlement spends, AI can generate prompts and recommendations, guiding claims professionals toward cost-effective resolutions.
These innovations are designed to support adjusters rather than replace them—a critical distinction as AI integration continues to evolve.
Balancing Automation and Human Expertise
A key concern among claims professionals is AI’s impact on jobs. Many adjusters worry that automation could replace their roles, but industry experts argue that AI is best used as a support system rather than a substitute.
AI-driven tools can improve communication workflows, helping adjusters respond to multiple stakeholders more efficiently. For example, claims technology can handle administrative updates, allowing professionals to focus on the complexities of claims resolution instead of constantly fielding status inquiries.
That said, AI adoption must be responsible and refined. Some organizations reported early missteps in implementing AI for contract reviews, with accuracy being a major concern. AI models require continuous learning, and adjusters must remain actively involved to ensure fair and effective usage.
For high-frequency, low-value claims, AI has significant potential to improve efficiency. However, organizations must avoid over-promising AI capabilities before models are truly ready for real-world applications.
The Path Forward
The session emphasized that the future of claims handling will rely on a balanced approach—leveraging technology to enhance processes while maintaining the critical human expertise needed for complex claims resolution.
With ongoing advancements in AI and strategic talent retention, organizations can strengthen their claims handling operations while ensuring adjusters feel valued, supported, and empowered to deliver exceptional service.
This collaborative, peer-driven discussion at Riskworld 2025 reinforced the importance of staying ahead of industry challenges, embracing continuous innovation, and building lasting relationships in claims management.
As the claims landscape evolves, the key to success will be adapting strategies that align with both technological progress and the human elements essential to exceptional claims resolution.
