Long delays in health insurance claims processing are not only frustrating but also impacting Americans’ wellbeing, with 28% losing sleep and nearly 30% avoiding medical care due to claim issues, according to a new Sprout.ai survey.
The research, which surveyed more than 2000 US consumers, highlights the claims processing challenges and the respondents’ attitudes toward AI intervention. The survey was conducted for leading insurtech platform Sprout.ai in February 2025.
Key findings
- Health insurance delays cause stress: More than a quarter (28%) of Americans have waited more than a month for a claim to be processed, with 11% waiting over six months. Concerns over claims have caused 28% to lose sleep, with that number increasing to 44% among 18-24-year-olds.
- Patients are skipping care: Nearly 30% of respondents have delayed or avoided medical treatment due to claim issues, rising to 41% among young adults aged 18-24.
- AI-powered claims processing gains acceptance: A majority (61%) of Americans would accept AI-driven claims approvals for faster processing, increasing to 68% among 18-24-year-olds.
- Out-of-pocket costs are the biggest frustration: Some 24% of Americans cite paying medical expenses upfront before reimbursement as their biggest frustration, followed by unexpected denials (21%).
- Expectations for speed are high: Forty-one percent of Americans expect their “dream insurer” to process claims in under a week, with 36% expecting approval within a day. Notably, over a quarter (26%) of 25-34-year-olds want claim approval in under an hour.
Roi Amir, CEO of Sprout.ai, said, “Insurance claim delays aren’t just frustrating – they can have serious consequences for people’s wellbeing. This research shows a clear demand for faster claims processing, with many consumers open to AI-driven solutions that deliver speed and accuracy. Insurers must find ways to speed up their processes and improve customer experiences.”
While insurers have traditionally relied on manual processes, consumer sentiment suggests that automation could be the key to improving the claims experience. A majority of Americans are open to AI-driven claims processing, with 61% saying they would accept a fully AI-powered approval process for faster claim resolution. However, trust in AI varies-54% of respondents said they would trust an AI-driven system to handle their health claim for faster processing, as long as it followed strict privacy rules.
Amir added, “As demand for efficiency and transparency grows, insurers have an opportunity to leverage AI-powered claims processing to improve customer satisfaction and retention. By embracing automation, insurers can gain a competitive edge while delivering the speed and accuracy consumers expect.”
To access the full Sprout.ai report, which also includes research findings from both the US and UK survey respondents, visit this link. The research was conducted by Perspectus Global for Sprout.ai in February 2025 and surveyed 2,000 people from across the US and 2,000 and 2,000 in the UK.
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