AI-powered decision-making in facilitating insurance claim dispute resolution
研究利用AI技术加速道路交通事故保险理赔争议解决，基于88个真实案例发现最终司法成本与最重伤情持续时间存在渐近关系，并展示了正则表达式和自然语言处理等AI工具在信息提取和结果预测中的有效性。
Abstract Leveraging Artificial Intelligence (AI) techniques to empower decision-making can promote social welfare by generating significant cost savings and promoting efficient utilization of public resources, besides revolutionizing commercial operations. This study investigates how AI can expedite dispute resolution in road traffic accident (RTA) insurance claims, benefiting all parties involved. Specifically, we devise and implement a disciplined AI-driven approach to derive the cost estimates and inform negotiation decision-making, compared to conventional practices that draw upon official guidance and lawyer experience. We build the investigation on 88 real-life RTA cases and detect an asymptotic relationship between the final judicial cost and the duration of the most severe injury, marked by a notable predicted $${R}^{2}$$ <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"> <mml:msup> <mml:mrow> <mml:mi>R</mml:mi> </mml:mrow> <mml:mn>2</mml:mn> </mml:msup> </mml:math> value of 0.527. Further, we illustrate how various AI-powered toolkits can facilitate information processing and outcome prediction: (1) how regular expression (RegEx) collates precise injury information for subsequent predictive analysis; (2) how alternative natural language processing (NLP) techniques construct predictions directly from narratives. Our proposed RegEx framework enables automated information extraction that accommodates diverse report formats; different NLP methods deliver comparable plausible performance. This research unleashes AI’s untapped potential for social good to reinvent legal-related decision-making processes, support litigation efforts, and aid in the optimization of legal resource consumption.