Sprout.ai Reveals Growing Acceptance of AI in Health Claims

A widening gap between customer expectations and experiences in health insurance claims processing is creating opportunities for AI-driven solutions, according to new research by Sprout.ai, a claims automation technology provider for the insurance industry.

The study, which surveyed 2,012 consumers across the UK and US in February 2025, reveals a marked shift in attitudes towards artificial intelligence in health insurance claims processing, with the majority of consumers now open to AI solutions that promise efficiency and accuracy.

The expectation-reality gap

Health insurance claims processing faces unique challenges due to the complex nature of medical documentation. Claims often contain hundreds of pages in varied formats, including receipts, invoices, medical reports, prescriptions, and doctors' notes.

This complexity creates bottlenecks in manual processing systems.

The research highlights the consequences of these inefficiencies. In the UK, 56% of respondents have experienced wait times exceeding a month for their insurance claims, while 59% have waited over six months.

This contrasts sharply with customer expectations, as 43% of UK consumers believe an insurance claim should be processed within a week, and 37% expect it to take just a day.

These delays are driving customer dissatisfaction, with 46% of UK respondents indicating they would switch insurers due to long wait times. Additionally, 24% report having sleepless nights worrying about health insurance claims.

Roi Amir, CEO of Sprout.ai, says: "The health insurance industry is at a turning point. Consumers today expect fast, fair, and transparent claims processing. These standards are shaped by the digital-first world they navigate daily. Yet, as our research reveals, the reality often falls short."

Evolving consumer attitudes

The study indicates a significant shift in consumer attitudes towards AI in insurance since 2023. Two years ago, only 9% of customers expressed a preference for insurers that leverage AI, with 36% actively preferring insurers that don't use AI.

By 2025, this has dramatically shifted, with 59% of UK respondents willing to accept fully AI-driven claims approval if it delivers accuracy and speed.

This shift is particularly pronounced among younger demographics. The research shows 73% of 18-34-year-olds are now comfortable with AI processing their health claims, suggesting a rapid generational shift in acceptance.

Concerns about bias and privacy, often cited as barriers to AI adoption, appear to be less prominent than previously thought.

The study reveals 59% of respondents believe AI processing isn't affected by personal bias, while 33% appreciate that an AI system "won't judge" them.

However, privacy remains a consideration, with 38% of respondents indicating they would embrace AI-driven systems, but only if strict privacy rules were followed.

Operational challenges

The research identifies several operational challenges specific to health insurance claims processing.

Claims handlers typically spend 70% of their time manually reviewing documentation rather than engaging with customers or making decisions. This contributes to job dissatisfaction and skills shortages in the industry.

Health claims also contain sensitive personal and medical information, requiring strict compliance with data protection regulations like HIPAA (Health Insurance Portability and Accountability Act) in the US and GDPR (General Data Protection Regulation) in Europe.

The financial stakes are high. In the US alone, health GWP (Gross Written Premium) is expected to reach approximately 1.76 trillion dollars in 2025. A 1% reduction in indemnity costs could amount to over 11 billion dollars saved.

Sprout.ai's intelligent claims automation platform addresses these challenges by processing claims in as little as 20 seconds with accuracy rates reaching 99%.

The system can recognise over 450 document types, enabling it to rapidly extract and validate critical information from medical documentation.

One Sprout.ai customer reported a 19% increase in CSAT (Customer Satisfaction) score, a 23% reduction in claim turnaround time, and a 12% increase in NPS (Net Promoter Score) over 24 months.

"The future of health insurance claims is intelligent, responsive, and patient-centric," says Roi.

"The question is no longer if insurers should embrace AI, but how quickly they can implement it to meet the evolving needs of their customers. For insurers failing to evolve, falling behind isn't a possibility, it's a certainty."

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