Solving specialty
claims challenges

24 September 2025

Claims automation is no longer just for personal lines

With growing pressure to improve efficiency and reduce costs, insurers are increasingly turning to claims automation – even in complex specialty lines. Historically, high-value, low-frequency claims and case-by-case complexity made automation challenging for specialty insurers.

But modern platforms are changing that by supporting expert decision-making, enhancing data usage, boosting consistency, and reducing friction throughout the claims lifecycle.

What does claims automation mean for specialty insurers?

At its core, claims automation combines rule-based logic, straight-through processing (STP), and AI-powered decision support to streamline the entire claims lifecycle – from first notification of loss (FNOL) to settlement.

Unlike personal lines automation, which often fully automates routine claims, specialty claims automation focuses on supporting expert judgment by automating repetitive tasks while reserving complex decisions for skilled claims handlers.

Driving value beyond claims handling

Automation can also generate structured data that underwriters can use to:

• Improve risk assessment

• Enhance pricing accuracy

• Strengthen collaboration between claims and underwriting teams

This deeper integration unlocks new opportunities for specialty insurers to make smarter, faster decisions across the business.

What’s driving adoption in Lloyd’s and the London Market?

Pressure to improve efficiency without losing control

Specialist claims often involve high value, complexity, and multiple stakeholders. While full automation isn’t always appropriate, intelligent automation can streamline routine steps, surface key insights, and support expert decision-making, freeing up time for the work that matters.

Expectations for responsiveness and transparency

Even in complex claims, clients and brokers expect regular updates, clear documentation, and fewer delays. Automation helps create more consistent, traceable processes and supports faster communication.

Smarter data, better decisions

The structured insights generated through automated claims processes aren’t just valuable to handlers. Underwriters can use this data to understand emerging risks, inform pricing decisions, and improve future product design – closing the loop between underwriting and claims in a way that’s long been talked about, but rarely achieved in practice.

_{Explore how AI is reshaping claims across the market – read our related article: From Efficiency to Trust: What AI-Powered Claim Solutions Mean for MGAs}

How is claims automation being applied in specialty insurance?

At recent industry events, specialty insurers have shown strong interest in applying automation to tasks such as:

• Pre-checking policy coverage

• Automating document gathering

• Accelerating third-party data requests

• AI-driven triage and case allocation

• Straight-through settlement in lower-value, high-volume scenarios

By defining configurable decision trees and leveraging data-rich insights, specialty lines are beginning to overcome past limitations. RDT’s ACE platform, for example, enables rules-based and AI-guided journeys – even when data sits across multiple systems or external providers.

Making the investment case

In specialty markets, the strongest case for automation ties to measurable outcomes that enhance expertise and improve decision-making. These include:

• Faster, more consistent claims resolution by streamlining routine steps, allowing specialists to focus on complex judgment calls

• Relieving strain on expert teams by reducing manual effort and enabling better use of scarce talent

• Reducing claims leakage through data-driven prompts and oversight for triage, reserving, and settlement

• Improving broker and client experience by ensuring timely updates, clearer audit trails, and fewer delays – even in complex cases

• Empowering underwriters with better data that feeds structured claims insights back into underwriting to refine pricing, spot emerging risks, and close the loop

 

_{Hear from SBL and HIBRiD, who joined RDT on the Instech panel “Claims Automation Platforms Dispelling the Myths” to share real-world experiences of building and scaling claims automation in personal lines and specialty}

When SBL partnered with RDT, they saw immediate value in automating personal lines claims with our flexible decision engine. Their results show what’s possible when process and technology align.

Our new client HIBRiD is taking that further with a greenfield platform designed from day one to be digital-first. As a TPA serving complex schemes, they trust RDT to build a scalable, automation-led environment that puts them ahead of the curve.

Lessons from motor and property automation

While specialty insurance has unique challenges, there are valuable lessons from personal lines, especially motor and home, where automation has delivered proven ROI at scale.

Start small, think strategically

You don’t need to automate entire journeys. Begin with high-friction, low-risk areas like document ingestion, MI generation, or status notifications to demonstrate quick wins and build momentum.

Earn trust through transparency

Automation works best when people understand and trust it. Use clear rules, explainable AI (if applicable), audit logs, and always offer human override – especially for decisions with high financial or reputational risk.

Invest in data foundations

Automation is only as good as the data it runs on. Focus on cleaning, structuring, and connecting data sources – especially across legacy and third-party systems.

Align automation with business priorities

Success comes from addressing real pain points, like reducing cycle time or improving regulatory compliance. Specialty insurers should focus on areas like reducing expert report delays or improving bordereaux turnaround.

Design for exception handling

Specialty claims often include edge cases. The best systems flag anomalies, route exceptions effectively, and equip experts with the right tools for action.

Treat automation as a change programme, not just tech

Automation requires cross-functional collaboration, updated workflows, training, and sometimes cultural shifts. This holds true for specialty markets, where people and processes are deeply embedded.

Measure, learn, iterate

Top insurers treat automation as a living process. Measure impact, gather feedback from claims handlers and underwriters, and refine continuously.

How ACE helps

RDT’s ACE platform lets specialty insurers define automation journeys that are:

• Transparent and auditable

• Easily adjusted without coding

• Agile in delivery with controlled governance

• Designed to deliver measurable outcomes from day one

ACE includes advanced AI and Intelligent Document Processing to support decision-making:

AI supports claims automation by:

• Summarising documents and emails

• Extracting data from free text

• Suggesting next best actions for handlers

• Identifying potential fraud or escalation points

Importantly, ACE doesn’t use AI to make decisions in isolation. Instead, AI works alongside claims experts – offering intelligent support while leaving final judgment in human hands. This hybrid approach is essential in specialty markets, where nuance and experience remain critical.

Building trust in claims technology

At RDT, our track record speaks for itself. We’re trusted by forward-thinking insurers and TPAs to build platforms that don’t just automate for automation’s sake but deliver real operational and customer impact.

With proven results in personal lines and growing success in specialty, we help insurers cut through the hype to deliver intelligent, scalable claims automation.

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Ready to explore what’s possible for your business?

Contact us to learn more about ACE, claims automation, and how we’re supporting digital-first insurers, MGA and TPAs.

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