Abstract

The increase in claim sophistication in both the insurance and legal domains is a result of an increase in stokes and heterogeneity of data needed to assess the claim validity. Originally, this task was performed by some sort of subjectivity assessments and graphical rule sets, which is very slow and may be inherently erroneous due to its purely manual nature. Hence, with progressivity in multimodal learning, specifically in AI, there is now a unique chance of solving these challenges through the use of text data, which may include policies, reports and images, which may include accident images, evidence images, videos such as surveillance, cam videos among others. However, existing AI-based solutions usually address only one of the modalities, which makes it difficult to evaluate an integrated situation. This has led to the need for systems that will integrate information from all these modalities and come up with an accurate, efficient, and transparent processing system. Indeed, this paper seeks to discuss the use of Multimodal generative AI to address this need as one of the most recent approaches that rely on high-performing models that can process and integrate text, image, and video data. The proposed system combines these modalities to ensure that the system captures relevant data from each data type and combines all in a way that provides more comprehensive and enriched decision support. An initial system was designed and empirically tested against current claim adjudication techniques and was found to yield substantial enhancements in all utilization rates, throughput and main rationale for the claim decisions. The findings shown in the study stress the capability of multimodal generative AI for revolutionizing the present approaches of claims analysis and developing more efficient, accurate, and capable responses to various real-life conditions. This integration of technologies is an unprecedented advance towards advancing functional processes in the insurance and legal industries.