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This is a summary of an episode of Pioneers, an educational podcast on AI led by our founder. Join 3,000+ business leaders and AI enthusiasts and be the first to know when new episodes go live. Subscribe to our newsletter here.
TL;DR:
- Carriers face rising claim complexity, aging workforces, and tech-savvy plaintiffs, but most still rely on outdated claims processes.
- Institutional knowledge lives in adjusters’ heads; AI offers a path to democratize that expertise for younger and less experienced staff.
- Claims have long been underinvested compared to underwriting. Mocklow argues they’re now key to competitive advantage and customer retention.
- TPAs may adopt modern tech faster than carriers, fueling an outsourcing trend unless insurers invest intentionally in internal modernization.
- If they want to lead long-term, Mocklow urges carriers to invest in better tech and training now, not during the next market upswing.
Before we dive into the key takeaways from this episode, be sure to catch the full episode here:
Meet David - Office of the CUO at MSIG USA
David Mocklow, Office of the CUO at MSIG USA, brings a global perspective and decades of financial and insurance experience to his role.
He led transformation efforts across operating models, claims infrastructure, and delegated business channels, helping MSIG USA move from legacy practices toward future-ready capabilities.
David’s career has spanned investment banking and capital markets, giving him a sharp lens on risk, capital efficiency, and the real-world impact of claims handling.
Now at MSIG USA, he’s helping modernize core systems and rethink claims as a differentiator, not just a cost center.
A vocal advocate for bridging institutional knowledge gaps and preparing for plaintiff-side innovation, David believes the carriers that invest in modern claims now will outperform in the long run, both financially and in customer loyalty.
“Modern claims need better tooling, better data, and better judgment.” — Ankur Patel
Why Claims Are the Insurance Industry’s Sleeping Giant
David explains that for years, the insurance industry has prioritized distribution and underwriting innovation, while claims remained underinvested. However, claims are the most direct and frequent touchpoint with policyholders.
Customers do not judge a carrier based on how easy it is to bind a policy. They judge based on how well the claim is handled. David sees claims as the ultimate moment of truth in insurance, where trust is earned or lost. He believes that modernizing claims is no longer optional.
It is now a source of competitive differentiation.
With mounting external pressures and changing customer expectations, carriers that treat claims as a strategic function rather than a cost center will be the ones that maintain loyalty and drive long-term performance.
The Staffing Crisis in Claims: A Risk Few Are Solving
David shares a clear concern about the changing demographics within claims organizations.
Many experienced adjusters are retiring, and newer employees often lack the same depth of expertise.
In many cases, the knowledge required to handle complex claims lives in the heads of senior staff and is not documented or structured in a transferable way. This puts carriers at risk as institutional knowledge walks out the door.
Additionally, carriers are not investing enough in developing or supporting junior staff to step into those roles. David warns that this is a long-term risk that will compound if left unaddressed.
Building systems that can scale knowledge, offer guidance, and create consistency is essential to prevent the quality of claims handling from deteriorating over time.
AI and Claims: Can We Capture What’s in Experts’ Heads?
David raises a critical question.
“How can carriers ensure that the judgment and decision-making of their best adjusters does not disappear as staff turns over?”
He believes there is an opportunity to use AI to help capture and distribute expert-level knowledge. AI systems can support adjusters in real time by offering suggestions, flagging patterns, and learning from historical claims behavior.
Rather than replacing humans, AI should serve as a supportive layer that helps newer staff make better decisions.
David emphasizes that this is not just about automation. It is about capturing how a seasoned expert thinks and applying that framework across the organization. With the right structure and use of data, AI can help carriers close the growing expertise gap in claims.
Why Underinvesting in Claims Will Cost You in the Long Run
David highlights that many carriers still allocate the majority of technology spend to underwriting and distribution while leaving claims behind. He argues that this is a mistake that will cost carriers in the long run. Claims drive both loss ratios and customer experience.
“Underwriting gets the investment, but claims drive the customer experience.” — David Mocklow
Neglecting the operational infrastructure and tooling of the claims team leads to slower service, inconsistent decisions, and declining satisfaction.
It also affects retention and brand reputation. David stresses that modernizing claims systems is not something that should be put off until market conditions improve. By the time volumes spike or competitive pressure rises, it may be too late to catch up.
The investment in claims must happen proactively in order to protect the company’s long-term health.
How TPAs and MGAs Are Accelerating Claims Innovation
Third-party administrators and managing general agents are moving faster than many carriers when it comes to modernizing claims.
David explains that these organizations often operate with more flexibility and fewer legacy systems. As a result, they are more willing to experiment with new technologies and data models. In some cases, they are even setting the benchmark for claims performance. David points out that this dynamic could push more carriers to outsource claims to TPAs if they cannot keep up internally.
This outsourcing might deliver short-term efficiencies, but it risks eroding control over customer experience and data quality.
Carriers need to recognize that TPAs and MGAs are not just vendors. They are competitors in the race to build the claims organization of the future.
Real vs. Social Inflation: The New Math Behind Claims Risk
David discusses the growing concern around social inflation, where rising jury awards and plaintiff-side sophistication drive up claim costs. He acknowledges that it is difficult to untangle how much of the inflation is truly structural and how much is a temporary response to unique market conditions.
However, he believes carriers should still prepare for a world where claims costs continue to rise. That means improving how data is collected and analyzed.
Claims organizations need to spot early signals of emerging risk and understand the drivers behind claim inflation. Without better tools and models, carriers will remain reactive instead of proactive. David’s message is clear.
Inflation is not just an underwriting issue. It is a claims challenge that must be addressed through better intelligence and faster response.
What the Financial Markets Can Teach Us About Claims Signals
Drawing on his capital markets background, David explains how claims organizations can take inspiration from financial trading desks.
In capital markets, firms invest heavily in signal processing, real-time feedback, and system-wide learning. David sees a similar opportunity in claims.
By identifying key signals early in a claim’s lifecycle, such as tone, language, or frequency of touchpoints, carriers can make better triage decisions and apply resources more efficiently.
This could mean routing a complex claim to a senior adjuster sooner or identifying fraud patterns before they escalate. David believes claims departments need to think like data-driven risk managers, not just processors.
Bringing in that financial lens allows the organization to respond faster and smarter to emerging risks and outliers.
Building for Resilience: Why Now Is the Time to Modernize Claims
David warns against waiting for a hard market or economic upswing to begin claims modernization. He explains that resilience is not built during a crisis. It is built in advance.
“The carriers that modernize claims now will be the ones that lead later.” — David Mocklow
The claims function is central to the customer experience and also has a direct impact on capital. Delaying investments in technology, process redesign, and training puts the entire business at risk.
David encourages carriers to act now, while they still have the time and space to think strategically.
The cost of modernization is small compared to the cost of delay. He believes that the winners in the next five years will be those who did the work before they had to and built claims functions that can adapt to whatever comes next.
