Journal of Modern Business Administration

The service quality and sustainable development of the insurance industry largely depend on the operational efficiency of the core link of claims scope review. With the deep integration of digital technology into various fields of social economy, the transformation of insurance operation mode has become an inevitable trend, and claims scope review has also undergone profound changes. This article focuses on the trend of digital transformation in insurance operations, and explores in detail the application of technologies such as big data and artificial intelligence in optimizing claims review processes and strengthening risk management. It explores the construction of a new claims review model that fits the digital age, providing a feasible path for the insurance industry to improve service efficiency and enhance risk prevention and control capabilities, and helping the industry achieve high-quality development.

Insurance operation; Digitization; Review of claims scope; Change