Taiyo Life Insurance to Full-Scale Implement Generative AI in Claims Processing

Taiyo Life Insurance to Full-Scale Implement Generative AI in Claims Processing

Taiyo Life Insurance (Taiyo Life), part of the T&D Insurance Group, has announced a joint project with IBM Japan to develop a claims assessment system utilizing generative AI and other advanced technologies. Operations will begin sequentially from January 2027. By leveraging IBM’s cutting-edge technologies, Taiyo Life expects significant efficiency gains across its 500,000 annual claims assessment tasks.

### 1. Background Taiyo Life handles approximately 500,000 claims annually, which have traditionally been verified by multiple staff members to ensure accuracy. The introduction of generative AI aims to further automate and enhance these processes.

### 2. Overview of the Initiative Frontline assessment staff led the project by identifying and analyzing approximately 720 assessment rules. The system employs a hybrid approach: - Rule Engine (IBM Operational Decision Manager): Automates routine tasks such as checking for incomplete documents and standardized assessment judgments. - Generative AI (IBM watsonx): Supports non-routine tasks, such as understanding free-form descriptions in medical certificates and checking for consistency between documents.

### 3. Expected Benefits - Approximately 40% reduction in work hours for 60 claims assessment staff. - Creation of an environment where staff can focus on high-value tasks, such as customer engagement. - Enhanced reliability and speed in claims payments.