New AI tool helps insurers navigate complex policies

The recent trend of increasingly sophisticated and costly claims amid a “talent cliff” in the American insurance industry has led one Chicago-based startup to launch an AI tool that will help insurance professionals navigate complex policies.

Qumis, founded in 2022, delivers AI solutions that help insurance professionals understand complex policy language while saving time and improving efficiency.

“Our vision is anytime someone is doing something involving reading a policy — whether that’s claims or brokers or account managers — we want to have a solution for them that’s really targeted specifically to their workflow, that’s really accurate. We want to be the most accurate AI for insurance,” Dan Schuleman, founder and CEO, Qumis, said.

As a former practicing insurance coverage attorney, Schuleman said he realized that many insurance professionals have similar workflows and skill sets to lawyers but inadequate support tools.

“A lot of folks are spending good chunks of their days scrolling through 200-page PDFs and making very important decisions on what they find, and it’s just a very manual process,” he said.

In his view, this presented a perfect opportunity for AI to help accelerate and expedite that process, unearthing additional insights and leveraging institutional knowledge in new ways.

“We really think that if the entire insurance industry could hire lawyers to review everything for them all the time, they would, but that’s not possible because of money and time. But we can kind of get there with AI now, with the right tool, the right platform and built by the right people to provide insights like that,” Schuleman noted.

Is it time for an ‘AI partner’?

One of the major reasons why Schuleman felt it was the right time for Qumis is because American insurers are facing increasingly complex claims, such as novel cyber claims the industry has never seen before and “crazy” social inflation that traditional methods fail to effectively address.

“I think an aspect that goes under-discussed in the conversation about social inflation is the literal complexity of the claims themselves. The claimants are only going to get more sophisticated, the claim types are only going to get more complex, and so the carriers are going to need tools that radically help with that in order to combat the very unsustainable trends happening,” Schuleman said.

At the same time, he noted that a “giant generational talent cliff looming over the industry right now” adds to the difficulty with navigating these complexities.

“Usually, when you’re doing these more complex things, there’s usually seasoned professionals at your firm who have the answers and you can pick up the phone and call them. But what happens when they’re gone?” he said.

Schuleman believes AI tools like Qumis can help both with maintaining and preserving the knowledge of seasoned professionals and training new staff.

He acknowledged that some insurance professionals feel uneasy when it comes to AI. However, he said the Qumis platform was designed with this in mind and built to be a user-friendly assistant that augments human expertise.

“We view our role not as just a vendor, but as a real AI partner that helps with not just training our platform, but prompting and how to use AI and what it's actually doing… We want to package up the AI so it’s almost magical and there’s not the intimidation of needing to figure out a new tool that’s complicated,” Schuleman said.

He noted that while the platform aims for over 90% accuracy, it’s not 100% and human expertise remains a critical part of the equation.

“We’re not here to replace people. We’re not here to replace their skill sets or judgments. We’re here to get all the information for them where they can look through it and see if there might be something wrong, with a lot of verification mechanisms for that,” he said.

Complex policies and claim processing

Qumis can primarily be used for comparing or analyzing different documents and as a strong claims tool.

For example, Schuleman said, it could be used for marketing where different quotes are being compared for a broker to make a recommendation. Or, if a broker wants to compare a renewal from last year to this year.

“We have pre-built outputs to do that for you automatically, where if you get those three quotes, you can drag and drop them right into Qumis and then we’ll analyze and prepare and provide that information in a format that you want to see it in,” he said.

Similarly, users could upload different documents as part of a claim file and the AI tool would provide detailed law firm-caliber reporting on coverage issues within that claim. A user could then interact with that report to understand what the next best steps are and how to navigate through the process.

“We see a lot of cyber professional liability, D&O, things like that go through the platform because that’s where it takes a day to go through that kind of stuff right now. In Qumis, you could probably do a complex placement in half an hour,” Schuleman said.

Qumis was founded in Chicago, IL, in 2022. It is an attorney-trained AI platform designed to support insurance professionals with complex policies and documents. The company has relationships with five of the 15 largest U.S. insurance brokers, including NFP and Brown & Brown. It was developed as a top-down solution, first primarily serving large companies but gradually expanding to provide solutions for medium and smaller firms as well.

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Rayne Morgan is a journalist, copywriter, and editor with over 10 years' combined experience in digital content and print media. You can reach her at [email protected].