IDEAS home Printed from https://ideas.repec.org/p/ehl/lserod/120649.html
   My bibliography  Save this paper

AI-powered decision-making in facilitating insurance claim dispute resolution

Author

Listed:
  • Zhang, Wen
  • Shi, Jingwen
  • Wang, Xiaojun
  • Wynn, Henry

Abstract

Leveraging Artificial Intelligence (AI) techniques to empower decision-making can promote social welfare by generating significant cost savings and promoting efficient utilization of public resources, besides revolutionizing commercial operations. This study investigates how AI can expedite dispute resolution in road traffic accident (RTA) insurance claims, benefiting all parties involved. Specifically, we devise and implement a disciplined AI-driven approach to derive the cost estimates and inform negotiation decision-making, compared to conventional practices that draw upon official guidance and lawyer experience. We build the investigation on 88 real-life RTA cases and detect an asymptotic relationship between the final judicial cost and the duration of the most severe injury, marked by a notable predicted R2 value of 0.527. Further, we illustrate how various AI-powered toolkits can facilitate information processing and outcome prediction: (1) how regular expression (RegEx) collates precise injury information for subsequent predictive analysis; (2) how alternative natural language processing (NLP) techniques construct predictions directly from narratives. Our proposed RegEx framework enables automated information extraction that accommodates diverse report formats; different NLP methods deliver comparable plausible performance. This research unleashes AI’s untapped potential for social good to reinvent legal-related decision-making processes, support litigation efforts, and aid in the optimization of legal resource consumption.

Suggested Citation

  • Zhang, Wen & Shi, Jingwen & Wang, Xiaojun & Wynn, Henry, 2023. "AI-powered decision-making in facilitating insurance claim dispute resolution," LSE Research Online Documents on Economics 120649, London School of Economics and Political Science, LSE Library.
  • Handle: RePEc:ehl:lserod:120649
    as

    Download full text from publisher

    File URL: http://eprints.lse.ac.uk/120649/
    File Function: Open access version.
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Emmanouil Avgerinos & Bilal Gokpinar, 2018. "Task Variety in Professional Service Work: When It Helps and When It Hurts," Production and Operations Management, Production and Operations Management Society, vol. 27(7), pages 1368-1389, July.
    2. Subodha Kumar & Vijay Mookerjee & Abhinav Shubham, 2018. "Research in Operations Management and Information Systems Interface," Production and Operations Management, Production and Operations Management Society, vol. 27(11), pages 1893-1905, November.
    3. Alan S. Abrahams & Weiguo Fan & G. Alan Wang & Zhongju (John) Zhang & Jian Jiao, 2015. "An Integrated Text Analytic Framework for Product Defect Discovery," Production and Operations Management, Production and Operations Management Society, vol. 24(6), pages 975-990, June.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Rong Liu & Jujun Huang & Zhongju Zhang, 2023. "Tracking disclosure change trajectories for financial fraud detection," Production and Operations Management, Production and Operations Management Society, vol. 32(2), pages 584-602, February.
    2. Yi Yang & Kunpeng Zhang & Yangyang Fan, 2023. "sDTM: A Supervised Bayesian Deep Topic Model for Text Analytics," Information Systems Research, INFORMS, vol. 34(1), pages 137-156, March.
    3. Maximilian Klöckner & Christoph G. Schmidt & Stephan M. Wagner, 2022. "When Blockchain Creates Shareholder Value: Empirical Evidence from International Firm Announcements," Production and Operations Management, Production and Operations Management Society, vol. 31(1), pages 46-64, January.
    4. Chaklader, Barnali & Gupta, Brij B. & Panigrahi, Prabin Kumar, 2023. "Analyzing the progress of FINTECH-companies and their integration with new technologies for innovation and entrepreneurship," Journal of Business Research, Elsevier, vol. 161(C).
    5. Wei Zhao & Qianqian Ben Liu & Xitong Guo & Tianshi Wu & Subodha Kumar, 2022. "Quid pro quo in online medical consultation? Investigating the effects of small monetary gifts from patients," Production and Operations Management, Production and Operations Management Society, vol. 31(4), pages 1698-1718, April.
    6. Zhijun Yan & Lini Kuang & Liangfei Qiu, 2022. "Prosocial behaviors and economic performance: Evidence from an online mental healthcare platform," Production and Operations Management, Production and Operations Management Society, vol. 31(10), pages 3859-3876, October.
    7. Lingli Wang & Ni Huang & Yili Hong & Luning Liu & Xunhua Guo & Guoqing Chen, 2023. "Voice‐based AI in call center customer service: A natural field experiment," Production and Operations Management, Production and Operations Management Society, vol. 32(4), pages 1002-1018, April.
    8. Chang, Jasmine (Aichih) & Katehakis, Michael N. & Shi, Jim (Junmin) & Yan, Zhipeng, 2021. "Blockchain-empowered Newsvendor optimization," International Journal of Production Economics, Elsevier, vol. 238(C).
    9. Dominik Gutt & Jürgen Neumann & Wael Jabr & Dennis Kundisch, 2020. "The Fate of the App: Economic Implications of Updating under Reputation Resetting," Working Papers Dissertations 76, Paderborn University, Faculty of Business Administration and Economics.
    10. Alekh Gour & Shikha Aggarwal & Subodha Kumar, 2022. "Lending ears to unheard voices: An empirical analysis of user‐generated content on social media," Production and Operations Management, Production and Operations Management Society, vol. 31(6), pages 2457-2476, June.
    11. David M. Goldberg & Nohel Zaman & Arin Brahma & Mariano Aloiso, 2022. "Are mortgage loan closing delay risks predictable? A predictive analysis using text mining on discussion threads," Journal of the Association for Information Science & Technology, Association for Information Science & Technology, vol. 73(3), pages 419-437, March.
    12. Zhan, Yuanzhu & Tan, Kim Hua, 2020. "An analytic infrastructure for harvesting big data to enhance supply chain performance," European Journal of Operational Research, Elsevier, vol. 281(3), pages 559-574.
    13. ManMohan S. Sodhi & Zahra Seyedghorban & Hossein Tahernejad & Danny Samson, 2022. "Why emerging supply chain technologies initially disappoint: Blockchain, IoT, and AI," Production and Operations Management, Production and Operations Management Society, vol. 31(6), pages 2517-2537, June.
    14. Xunyi Wang & Meiling Jiang & Wencui Han & Liangfei Qiu, 2022. "Do Emotions Sell? The Impact of Emotional Expressions on Sales in the Space‐Sharing Economy," Production and Operations Management, Production and Operations Management Society, vol. 31(1), pages 65-82, January.
    15. Ahmed Abbasi & Jingjing Li & Donald Adjeroh & Marie Abate & Wanhong Zheng, 2019. "Don’t Mention It? Analyzing User-Generated Content Signals for Early Adverse Event Warnings," Information Systems Research, INFORMS, vol. 30(3), pages 1007-1028, September.
    16. Gopesh Anand & Eric C. Larson & Joseph T. Mahoney, 2020. "Thomas Kuhn on Paradigms," Production and Operations Management, Production and Operations Management Society, vol. 29(7), pages 1650-1657, July.
    17. K Thirumaran & Haejin Jang & Zahra Pourabedin & Jacob Wood, 2021. "The Role of Social Media in the Luxury Tourism Business: A Research Review and Trajectory Assessment," Sustainability, MDPI, vol. 13(3), pages 1-13, January.
    18. Subodha Kumar & Rakesh R. Mallipeddi, 2022. "Impact of cybersecurity on operations and supply chain management: Emerging trends and future research directions," Production and Operations Management, Production and Operations Management Society, vol. 31(12), pages 4488-4500, December.
    19. Tiwari, Sunil & Sharma, Pankaj & Choi, Tsan-Ming & Lim, Andrew, 2023. "Blockchain and third-party logistics for global supply chain operations: Stakeholders’ perspectives and decision roadmap," Transportation Research Part E: Logistics and Transportation Review, Elsevier, vol. 170(C).
    20. Liu, Zhenyuan & Geng, Ruoqi & Tse, Ying Kei (Mike) & Han, Shuihua, 2023. "Mapping the relationship between social media usage and organizational performance: A meta-analysis," Technological Forecasting and Social Change, Elsevier, vol. 187(C).

    More about this item

    Keywords

    professional service operation; insurance claim; civil litigation; AI; natural language processing;
    All these keywords.

    JEL classification:

    • C1 - Mathematical and Quantitative Methods - - Econometric and Statistical Methods and Methodology: General

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:ehl:lserod:120649. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: LSERO Manager (email available below). General contact details of provider: https://edirc.repec.org/data/lsepsuk.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.