Celent says claims system buying now hinges on AI and cloud
Claims buying is moving past feature checklists. Celent says the real decision now is whether AI and cloud can improve the hard files without surrendering control.
The average time to complete a repair was 29.6 days, and customers waited 40.7 days for final payment in J.D. Power’s 2026 U.S. Property Claims Satisfaction Study. Claims buying is no longer just a system swap. Celent’s June 28 buyer’s guide treats the claims platform as the operational hub where insurer and policyholder meet, making the purchase as much a governance decision as a technology one. The right answer has to balance flexibility with the rigidity needed for corporate controls, regulatory expectations, and the realities of complex loss handling.
Claims systems now sit at the center of the operating model
Claims is where carriers feel the cost of slow work first. Extended claim cycle times create real pressure on loss control and customer experience, so modernization is not just about shaving labor from the back office. It is about shortening the path from notice of loss to resolution without weakening oversight on reserve setting, documentation, or exception handling.
Claims replacement is a program, not a one-off purchase. The June 28 guide works alongside Celent’s 2026 claims vendor reports because the best fit depends on how tightly claims must connect to policy, billing, intake, and downstream finance. Some carriers need a full core replacement; others can get faster value by layering specialist intake or AI tooling onto an existing platform.
AI is moving from demo material to claims workflow
AI is reshaping what buyers should expect from a claims platform. The discussion goes well beyond classic machine learning. Vendors and insurers are piloting conversational interfaces, AI workflows, and natural language processing, with the strongest use cases in document processing and document management.
Claims files are still document-heavy and exception-heavy, especially in complex property, casualty, and specialty lines. The next wave of value sits in the rough fifteen percent of claims that are complex, multi-party, document-heavy, or litigation-prone, where AI can cut adjuster overhead in ways straight-through automation never could.
The buyer’s trap is easy to spot: do not judge AI by how flashy the chatbot looks in a demo. Judge it by whether it reduces manual review in the ugly files, whether it can extract data from attachments without creating cleanup work, and whether it fits the carrier’s control framework.
Cloud matters because it lowers the friction of change
Cloud-based systems are now the dominant direction of travel, with only a minority of insurers still on-premise. That is not just a hosting preference. Cloud-based claims systems can integrate AI capabilities with less disruption, which lets insurers adopt new models and tools as those capabilities mature.
AI in claims is still moving fast. A carrier that locks itself into a brittle on-premise stack may get trapped waiting for upgrades or custom integration work every time it wants to test a new model, workflow engine, or document classification layer. Cloud changes the economics of adoption: it does not automatically make claims better, but it makes the platform easier to evolve.
The practical question for buyers is whether cloud becomes a release valve or another form of lock-in. The carriers that handle this best keep operational control over core claims rules, audit trails, and exception paths, while using cloud architecture to accelerate access to new functions.
The market is broad, crowded, and still fragmented
Celent’s North America claims systems report, published June 29, shows insurers still face a wide spectrum of systems and vendors. That breadth reflects how much the market has been pulled in different directions by supply-chain shock, consumer digitalization, remote-work expectations, and increasingly brutal catastrophe events. Those forces have undone gains in claims automation from the first fifth of the century.
Celent’s 2024 North America claims systems report profiled 33 core claims solutions. Buyers are not choosing among a handful of obvious platforms. They are sorting through a dense market where implementation model, line-of-business depth, support model, and technology architecture can matter more than headline functionality.
Celent evaluates vendors in North America across three dimensions: Advanced Technology, Breadth of Functionality, and Customer Base and Support. A platform can look sophisticated on AI and still miss on specialty-line fit, or look broad on paper and still struggle with service and implementation discipline.
Modernization should start with the hardest files, not the easiest ones
Celent’s Q2 2026 claims modernization note focuses on the most difficult slice of the portfolio. The next value is in the claims that are complex, multi-party, document-heavy, or litigation-prone. That is where AI can actually move the needle on adjuster workload and file handling discipline.
Many claims programs stall there. Straightforward auto glass or low-severity property losses are easy to automate in a pilot, but those files do not tell you much about the durability of a replacement strategy. The better test is whether the new platform can reduce friction on the claims that usually require multiple handoffs, extensive documentation, and repeated judgment calls.
Operating leaders should build the business case around the claims that create queue pressure, not the ones that already process cleanly.
Customer experience is now part of the system-selection math
J.D. Power’s 2026 U.S. Property Claims Satisfaction Study, released March 27, put overall satisfaction at 702 out of 1,000, up 20 points, helped by faster repair and payment cycle times and better digital capabilities.
It also found that 41 percent of customers used direct repair programs.
J.D. Power noted that a decline in large-scale weather events, a relatively calm hurricane season, and lower non-catastrophic claims volumes helped stabilize the experience.
The buy decision is now architecture, not just functionality
AI, cloud, governance, and operating resilience are converging as the major carrier IT themes. Claims software buying now asks whether a platform can support new AI models, preserve control over regulated work, and adapt without a fresh replacement cycle every few years.
For carriers, the right shortlist starts with three questions: how much control the operating model demands, how much AI value is available in the messy files, and whether the deployment architecture can absorb change without locking the business into another rigid stack.
This article was produced by Prism’s automated news system from verified source data, official records, and press releases, then run through automated quality and moderation checks before publishing. The system is built and supervised by the people who set the standards it runs under. Read our full AI policy.
Did this article answer your question?
