The AI terms shaping claims in 2026

Claims operations aren’t just a back-office task anymore. They sit at the center of customer experience, efficiency, and loss ratio performance.

AI is speeding up that shift. Across the industry, claims teams are moving from manual, fragmented workflows to automation, and smarter decision-making. The conversation has changed from “can we automate?” to “how do we build a claims workflow that are fast, reliable, and trustworthy from FNOL to settlement?”

At the same time, a new set of terms is popping up everywhere. STP, OCR, LLMs, predictive analytics – these aren’t just buzzwords. They’re the tools and capabilities that define what modern claims can actually do.

Here’s a practical handbook to the AI and automation vocabulary shaping modern pet insurance claims:

Straight-Through Processing (STP)
The express lane for claims: instant processing and approval for simple cases – no human touch required.

Optical Character Recognition (OCR)
Scans handwritten bills or PDFs and turns them into digital text in seconds, so nothing gets lost in translation.

Natural Language Processing (NLP)
Algorithms that read and interpret text to pull out key info from vet notes and claims, even when the handwriting is messy.

Large Language Models (LLMs)
AI trained on huge amounts of text that can summarise, infer, and generate language. Unlike standard NLP, LLMs can fill in gaps, and help make faster, more consistent claims decisions.

Small Language Models (SLMs)
‍Lightweight AI models for targeted tasks, like summarizing specific vet notes or pre-screening claims, offering speed with lower resource needs.

EMR – Electronic Medical Record
Digital veterinary records containing treatment history, diagnoses, and procedures – a key source of unstructured data for AI-powered claims processing.

AI-Powered Data Extraction
Automatically grabs pet names, treatment dates, costs, and more from forms and documents – saving hours of typing and double-checking.

Automated Policy & Coverage Validation
Checks if treatments are covered, deductibles met, and limits applied – all in real time, so no one has to chase paperwork.

Predictive Analytics
Estimates claim complexity and cost, helping you know what needs human attention first.

Intelligent Automation
‍The combination of AI, ML, and workflow orchestration to streamline claims, reduce errors, and ensure consistency across every stage.

Machine Learning (ML) Models
The system gets smarter with every claim processed, improving accuracy and efficiency over time.

Real-Time Fraud Detection
Our watchful eye spots unusual patterns instantly and flags them for review – catching red flags before they snowball.

AI Hallucination
When AI guesses instead of relying on real data. And a Human-in-the-Loop ensures that decisions stay accurate and trustworthy.

PMS – Patient Management System
Software used by vet clinics to manage patients, appointments, and treatments. Integrating claims with PMS data reduces friction and errors.

FWA – Fraud, Waste, and Abuse
A framework for spotting suspicious patterns and anomalies in claims to prevent fraud, unnecessary costs, and inefficiencies.

Digital Workflow Automation
The backbone that keeps everything moving smoothly from submission to payout, orchestrating AI, ML, and human oversight seamlessly.

And of course:
‍WEC – Wisentic Enabled Customer
‍The kind of customer who’s basically supercharged by our platform – making claims look easy.

Claims aren’t just about automation anymore – they need to work for everyone involved, from vets to pets to your team. It’s about making the whole process easier for all.

The insurers making real progress aren’t chasing every new tool. They’re asking the questions that actually matter and make a difference. Like where does good data come from, what should we really automate, and where do humans still need to step in?

When you get those right everything changes – faster payouts, fewer mistakes, happier vets and clients, and better long-term results.