"AI Takes Over Medical Reviews and Fault Ratio Assessments"... Insurance Industry Accelerates Innovation

KB Insurance Introduces Car Accident Fault Ratio AI Agent
Samsung Fire & Marine Launches "AI Medical Review" Service
Hanwha and Kyobo Life Advance Innovative Financial AI Services

The insurance industry is moving forward with the full-scale adoption of artificial intelligence (AI). From document reviews traditionally handled by medical professionals to determining fault ratios in car accidents, the scope of AI utilization is expanding across the entire range of services.

According to the financial sector on September 19, KB Insurance introduced its "Car Accident Fault Ratio AI Agent" powered by generative AI the previous day. This service analyzes reported accident details using AI and automatically calculates the expected fault ratio according to standard guidelines. Previously, employees had to search and determine the fault ratio themselves, but going forward, the AI will recommend fault ratios by type, enabling faster processing of work. A KB Insurance representative stated, "By the end of the year, we plan to expand the application of the AI agent to various work areas, including complaint management, call center consultation support, underwriting, and advertising review."

Last month, Samsung Fire & Marine Insurance launched its "AI Medical Review" service. This system automatically analyzes documents such as medical certificates, test results, and surgical records based on vast amounts of medical data. By combining optical character recognition (OCR) technology with generative AI, the process of manually reviewing documents that can span dozens of pages has been significantly reduced. As a result, the proportion of manual reviews for cancer claim assessments has decreased by 55%.

In August, NH NongHyup Property & Casualty Insurance initiated a project to build an "AI Contact Center (AICC)" to enhance its customer consultation service capabilities. The project aims to improve consultation quality by analyzing and supporting up to 3 million annual customer consultations using AI technology. The company plans to introduce a generative AI-based consultation assistant, as well as chatbot and voicebot services. NH NongHyup Property & Casualty Insurance aims to reduce the average consultation time from 4 minutes to 3 minutes and increase the customer self-service rate to over 15%.

DB Insurance also signed a business agreement last month with T3Q, an AI big data integration platform provider, to develop AI-powered claims automation. Earlier this month, Meritz Fire & Marine Insurance received designation from the Financial Services Commission for its AI-based personalized consultation assistant and AI work support service for employees as innovative financial services.

The life insurance sector is also accelerating the advancement of AI services. On September 18, Hanwha Life announced that its "AI Translation" and "Enrollment Planning AI Agent" services were newly designated as innovative financial services. The AI translation service was developed to eliminate language barriers between agents and customers. The AI agent was created to provide fast and accurate personalized insurance planning results by integrating AI into the insurance planning process. Hanwha Life plans to utilize both services across all work areas.

Earlier this month, Kyobo Life launched three generative AI services: the Coverage Analysis AI Supporter, the AI Assistant for Financial Planners (FPs), and the AI Desk for employees. The Coverage Analysis AI Supporter assists Kyobo Life planners in analyzing customer coverage and proposing optimal coverage plans. The FP AI Assistant supports key tasks of FP managers, including recruitment, training, and team performance management. The AI Desk is Kyobo Life's internal generative AI integrated service developed to enhance employee work productivity.

Last month, AIA Life introduced a large language model (LLM)-based AI optical character recognition (OCR) solution to its insurance claim service. Through the AIA Life application, customers can automatically extract and input key information from both structured documents, such as medical certificates or hospitalization/discharge certificates, and unstructured documents, such as medical opinions. As a result, the proportion of same-day payments for hospitalization, surgery, and fracture insurance claims improved from an average of 64.9% last year to 83% last month.

Earlier this month, Mirae Asset Life also began offering customer guidance services using an AI voicebot. Information related to premium payments and policy cancellations is now provided through the AI voicebot. Mirae Asset Life plans to expand the scope of its AI voicebot services to include guidance for maturity claim submissions and annuity commencement applications in the future.

The Insurance Development Institute, which presents growth strategies for the insurance industry, held the "2025 Insurance Future Forum" on September 12 under the theme of AI and insurance convergence. At the event, Insurance Development Institute President Heo Chang-eon emphasized, "To achieve true AI innovation, it is essential to first address challenges such as data ethics, personal information protection, algorithm reliability, and accountability. We hope that the insurance industry, which is built on public trust, will establish a transparent and responsible innovation model suitable for the AI era."

This content was produced with the assistance of AI translation services.