Balancing Empathy and Vigilance: Supporting Vulnerable Customers in the Claims Process

The challenge of identifying and appropriately important and growing challenge for our industry. The challenge of identifying and appropriately supporting vulnerable customers during insurance claims is becoming more complex—and more urgent. With over half (51%) of UK financial services customers now classified as vulnerable, up from 44% in 2023i, insurers and their claims partners face growing pressure to navigate the fine line between care and caution. Vulnerability must remain a central theme in how we manage claims.

As I reflected during the session, claims professionals must balance two responsibilities: empathy towards vulnerable customers and vigilance against fraud. Striking this balance requires not only technical skill but also compassion, flexibility, and collaboration across the sector.

Lived Experiences: Why Empathy Matters

We were fortunate to be joined by Martyn Griffiths, Sales Director UK&I at FRISS, and Kelly Harland, Account Manager at Woodgate & Clark. Both told personal stories that revealed the real-world impact of vulnerability.

Martyn shared how he was diagnosed with ADHD at the age of 52, and the ways neurodiversity has shaped his family life. Kelly shared her experience supporting her daughter, who has autism and ADHD, and her godmother, who is living with dementia. Kelly and Martyn’s accounts helped to show how vulnerabilities are lived experiences that directly influence how people engage with insurers, especially during the claims process.

Case Study: Dementia and Claims Handling

I shared a recent case where an elderly policyholder, showing signs of dementia, was convinced that her property was being deliberately damaged. Her distress and aggression during the investigation highlighted the complexities of balancing care with fraud detection. Ultimately, there was no claim to be made and certainly no fraud – but the case illustrated how undisclosed vulnerabilities can emerge during the claims process, raising questions over our duty of care to the individual.

Kelly pointed out that to help manage such cases, repeating questions throughout the claims journey can help surface hidden vulnerabilities. Martyn agreed, noting that using examples rather than blunt questions can make conversations less intimidating. Both stressed the importance of empathetic questioning, using terminology like “neurodivergent” appropriately, and ensuring claimants feel respected.

Tailored methods of communication

A recurring theme in the discussion was communication. We heard examples of customers with ADHD preferring bullet-point communications over long paragraphs. The message was clear: plain English, minimal jargon, and flexibility in format can make a huge difference. Just as important as the style of communication is the delivery and we all agreed that customers should be given the option

to choose which way they want to receive updates – whether email, phone, or another format. Again, this can help with clarity and shows respect for individual needs.

A Human in the mix

Technology can also play a role in supporting vulnerable customers. Martyn highlighted how AI could be used to simplify written communications, so that they are more digestible for customers with ADHD or similar conditions. Technology could also be explored to help detect signs of vulnerability in claims – much in the same way it used in fraud detection. This is with the caveat of a human in the loop. Empathy is a human skill that cannot be automated, and vulnerable customers benefit from reassurance that their circumstances are understood by a person, not a bot.

Regular check-ins, supported by well-trained claims professionals, remain essential to spotting changes in a customer’s condition and ensuring their needs are met.

Collaboration and Next Steps

The conversation highlighted a number of actions for our sector:

• Examine undisclosed vulnerabilities – such as dementia – and define clear duty-of-care protocols.
• Validate disclosed vulnerabilities in a supportive way during broader investigations.
• Share best practices across insurers to balance care, caution, and compliance.
• Use examples when asking about vulnerability, not just yes/no questions.
• Explore technology and AI tools to simplify communications while keeping empathy central.

In our next CII webinar in December, we will examine these next steps with a claims professional from one of the UK’s largest insurers.

Fairness, Trust, and Integrity

As disclosures of mental health conditions rise, it is vital that as an industry we continue to listen, adapt, and collaborate to support vulnerable customers, understanding that what may be interpreted as flags for fraud could in fact be behaviours linked to neurodiverse conditions. By using the right mix of technology and humanity, vigilance and empathy, consistency and flexibility, we can help to ensure vulnerable customers are correctly identified in the way they prefer and offered the protection, care, and dignity they deserve.

i. https://www.huntswood.com/wp-content/uploads/2025/04/vulnerability-in-2025.pdf