From manual claims reviews to AI-supported claims intelligence and analytics
AI-powered solutions for smarter claims management
Reinvent claims handling with PwC and DGTAL. AI in Claims combines intelligent document processing with a claims copilot engine to streamline simple cases and augment complex ones. Routine claims are processed straight-through in seconds, while high-severity cases are flagged, analysed, and supported with AI-driven insights. The result: faster processing, sharper risk detection, improved customer experience, and trusted, built-in compliance.
Transform the insurance claims process with data, AI, and clarity.
In insurance, claims are the single largest driver of cost – accounting for 40–80% of the underwriting result. Yet for many insurers, the claims process remains fragmented, manual, and resource-intensive. Teams are buried in paperwork, validation checks are inconsistent, and critical high-severity cases can be overlooked. The result is rising operational pressure, growing compliance risk, and customer frustration at slow or opaque outcomes.
Expectations, however, are shifting. Policyholders demand speed, transparency, and fairness; regulators expect control and auditability; executives want measurable efficiency gains. To meet all three, the industry needs a step change in how claims are managed.
PwC and DGTAL deliver that change. With Grabber, our AI-powered document processing engine, simple cases are handled straight-through in seconds. With Driller, our claims copilot, complex situations are flagged, analysed, and supported with AI-driven insights. Together, they free up capacity, sharpen decision-making, and make the overall process faster, fairer, and more reliable – for insurers, regulators, and customers alike.
Introducing PwC and DGTAL’s AI in Claims
Our joint offering brings together insurance expertise and cutting-edge AI to cover the full spectrum of claims handling – from routine automation to complex case support.
- Grabber automates straight-through processing for low-value, out-of-hospital claims. With AI-powered document validation and data extraction, claims below CHF 500 can be processed instantly.
- Driller supports teams with medium and complex claims. It applies severity markers, performs policy and reserve checks, and provides an AI copilot for deep dives into litigation, death, or disability cases.
- Guardrails-first approach: All solutions are built for responsible AI deployment, ensuring fairness, compliance, and transparency.
Together, Grabber and Driller give insurers the ability to handle claims faster, more accurately, and with greater confidence – enhancing customer experience while ensuring compliance and control.
“Our partnership with DGTAL ensures that policyholders experience seamless, transparent, and efficient claims handling, transforming their moments of need into moments of reassurance – enabling insurers to achieve faster claims processing, reduce leakage and fraud, and make data-driven decisions, ultimately leading to a more competitive and sustainable business model."
Juliane WelzDirector Insurance Consulting, PwC SwitzerlandOur services
PwC and DGTAL’s AI in Claims offering covers the end-to-end claims lifecycle – from assessment and design through to automation, augmentation, and compliance. Each component is designed to remove friction, strengthen accuracy, and deliver measurable outcomes.
Claims assessment and strategy
We begin with a structured review of your claims processes, data quality, and governance. This allows us to identify automation opportunities and define a target operating model for AI-enabled claims handling.
Grabber: straight-through claims
Our intelligent document processing tool validates completeness, flags exclusions, and processes simple, out-of-hospital claims below CHF 500 instantly – eliminating manual effort and accelerating settlement.
Driller: claims copilot
For mid- and high-severity cases, Driller acts as an AI copilot. It applies severity markers, performs policy coverage and reserve plausibility checks, and enables deep dives through AI-driven search – improving detection of high-risk cases and supporting better decisions.
Integration and compliance
All solutions integrate seamlessly with core claims systems. Built-in governance ensures auditability, transparency, and regulatory compliance – making AI deployment responsible, scalable, and trusted.
Adoption and change management
Successful AI implementation depends largely on organisational change management, training, leadership commitment, and user adoption, with up to 70% of AI success attributed to these human factors rather than technology alone. There are no results without adoption. Successful implementation of AI-driven claims management systems requires comprehensive change management strategies addressing both technical and human factors. User adoption represents the primary determinant of implementation success delivering 3-4 times greater business value than those with lower adoption rates.
Together, these services provide a modular yet comprehensive pathway to claims transformation – enabling insurers to achieve faster processing, sharper risk management, and a superior customer experience.
Bernhard SchneiderPartner Insurance Consulting, PwC SwitzerlandHow AI in Claims drives value for your business
AI in Claims is not just about automation – it delivers measurable improvements across efficiency, risk, and customer outcomes.
- Efficiency gains – reduce processing time by up to 60% with automation
- Better risk detection – flag over 90% of high-severity cases at first pass
- Improved customer experience – faster, fairer claim outcomes
- Cost savings – lower operational costs through automation
- Compliance and trust – guardrails-first AI, aligned with regulation
- Improved Decision-Making – through advanced analytics platforms, predictive analytics capabilities
- Scalability and Flexibility – unified, AI-ready data layers that can be queried, analyzed, and actioned in real-time
In practice, this means claims are processed in a fraction of the time, risks are spotted earlier, customers receive faster and more transparent outcomes, and insurers gain the confidence of knowing their operations are efficient, compliant, and trusted.
Talk to an expert
Why PwC and DGTAL for AI in Claims?
PwC and DGTAL combine complementary strengths to transform claims. PwC brings deep insurance expertise, regulatory assurance, and transformation know-how, while DGTAL contributes cutting-edge AI technology purpose-built for the insurance sector.
Together, we provide not an experiment but a proven, production-grade solution delivering measurable results for insurers. What sets our partnership apart is the ability to unite industry insight, tested technology, and regulatory trust in one offering. By rethinking claims processes end-to-end, we ensure that AI augments human expertise, scales across operations, and creates lasting business value.
Ready to transform your claims process?
Contact us to explore how PwC and DGTAL can help you streamline claims, improve risk detection, and deliver a faster, fairer experience to your customers.