<Elementary> Lesson No.15
AI査定ツールの試験導入 / Implementing AI Claims Assessment Tools
0.Greetings & Ice-break (2min.)|挨拶と導入
0-1 Greetings
Let’s practice a short small talk that you can use to greet a business partner and start building a good relationship.
講師との挨拶を兼ねて、ビジネスパートナーと信頼関係を築くための短いスモールトークを練習してみましょう。
[Tips / 会話のヒント]
・Can you hear me clearly?
私の声はクリアに聞こえますか?
・How's your day going so far?
今日はどんな一日でしたか?
・Talk about one small topic (Work, Weather, News, Hometown, Sports event, etc.)
軽い話題について話しましょう(仕事、天気、ニュース、地元、スポーツイベントなど)
0-2 Introduction
In today’s lesson, we’ll learn about the following situation. Have you ever experienced something similar?
本日のレッスンでは以下のようなシチュエーションについて学びます。同様のシチュエーションを経験したことがありますか?
- If you have experience, please tell us what it was like, what was difficult, or what you learned.
経験があれば、どんな内容だったか、難しかったことや学んだことなどを教えて下さい。
- If you don’t have experience, try to imagine yourself handling that situation in English.
What do you think would be challenging?
経験がなければ、英語でその状況に対応しているところを想像してみましょう。どんなことが難しそうですか?
Situation / シチュエーション
Persuading local staff to adopt AI technology in claims processing.
テクノロジー導入に抵抗する現地のベテラン層を説得し、業務変革を推進する場面です。
1. Read (2 min)|型を学ぶ
Let's read the following key sentences aloud!
下記の文章や単語を順番に音読しましょう!
1-1 Basic phrases
1.Let me explain the purpose of...(...の目的を説明させてください)
2.The AI is designed to support...(AIは...をサポートするために設計されている)
3.That is exactly why we need...(それこそが私たちが...を必要とする理由です)
4.You will have full authority to...(あなたは...する完全な権限を持ちます)
5.We tested the AI on...(私たちは...でAIをテストしました)
6.We will set up a review period where...(...できる審査期間を設けます)
7.I appreciate your willingness to...(...していただける意思に感謝します)
1-2 Essential words
1.concern(懸念)
2.explain(説明する)
3.support(サポートする)
4.expertise(専門知識)
5.handle(扱う)
6.approve(承認する)
7.reject(却下する)
8.improve(改善する)
9.review(審査)
10.effective(効果的な)
2. Try (3 min)|ロールプレイ練習
Let’s practice the role-play.
ロールプレイの練習をしましょう!
Situation / シチュエーション(Reference again)
Persuading local staff to adopt AI technology in claims processing.
テクノロジー導入に抵抗する現地のベテラン層を説得し、業務変革を推進する場面です。
👨💼【Teacher / Senior Claims Assessor】:
Thank you for meeting with me today. I heard that the company is planning to introduce an AI tool for automatic payment decisions. I need to understand how this will affect our work and accuracy.
(本日はお時間をいただきありがとうございます。会社がAIによる自動支払い判断ツールの導入を計画していると聞きました。これが私たちの業務と正確性にどう影響するのか理解する必要があります。)
🧑🎓【Student / AI Implementation Manager】:
I appreciate your concern. Let me explain the purpose of this tool. The AI is designed to support your decisions, not replace your expertise. It will handle routine cases and allow you to focus on complex claims that require your experience.
(ご懸念ありがとうございます。このツールの目的を説明させてください。AIはあなたの判断を置き換えるのではなく、サポートするために設計されています。定型的なケースを処理し、あなたの経験を必要とする複雑な請求に集中できるようにします。)
👨💼【Teacher / Senior Claims Assessor】:
I understand the intention, but I have reviewed thousands of claims over 15 years. My judgment is based on details that a machine cannot capture. How can the AI handle cases with special circumstances or unusual medical conditions?
(意図は理解しますが、私は15年間で何千もの請求を審査してきました。私の判断は機械が捉えられない詳細に基づいています。AIは特別な状況や通常とは異なる医療状態のケースをどう扱えるのですか?)
🧑🎓【Student / AI Implementation Manager】:
That is exactly why we need your expertise. The AI will flag complex cases and send them to you for final review. You will have full authority to approve or reject any decision. The system learns from your feedback, so your experience will improve the tool over time.
(それこそがあなたの専門知識を必要とする理由です。AIは複雑なケースにフラグを立て、最終審査のためにあなたに送ります。あなたはすべての決定を承認または却下する完全な権限を持ちます。システムはあなたのフィードバックから学習するため、あなたの経験が時間とともにツールを改善します。)
👨💼【Teacher / Senior Claims Assessor】:
What about the accuracy rate? I am concerned that the AI might make errors that could damage our reputation with customers. We cannot afford mistakes in this business.
(正確性の割合はどうですか?AIが顧客との評判を損なうような誤りを犯すのではないかと心配しています。このビジネスでは間違いは許されません。)
🧑🎓【Student / AI Implementation Manager】:
I completely agree. We tested the AI on 10000 past claims, and it achieved 95 percent accuracy on routine cases. For the remaining 5 percent, the system automatically sends the case to a human assessor. This ensures that no payment decision is made without proper review when needed.
(完全に同意します。私たちは過去の10000件の請求でAIをテストし、定型的なケースで95パーセントの正確性を達成しました。残りの5パーセントについては、システムが自動的にケースを人間の査定員に送ります。これにより、必要な場合には適切な審査なしに支払い決定が行われないことを保証します。)
👨💼【Teacher / Senior Claims Assessor】:
I see the benefits for routine work, but I still worry about losing control over the process. Will I be able to check the AI decisions before they are finalized?
(定型業務の利点は分かりますが、プロセスの管理を失うことをまだ心配しています。決定が確定する前にAIの判断を確認できますか?)
🧑🎓【Student / AI Implementation Manager】:
Yes, absolutely. We will set up a review period where you can monitor all AI decisions for the first 3 months. You can override any decision at any time. We will also provide training sessions to help you understand how the system works and how to use it effectively.
(はい、もちろんです。最初の3か月間、すべてのAI決定を監視できる審査期間を設けます。いつでも決定を覆すことができます。また、システムがどのように機能し、効果的に使用する方法を理解していただくためのトレーニングセッションも提供します。)
👨💼【Teacher / Senior Claims Assessor】:
That sounds more reasonable. If I can keep my authority and the AI only handles simple cases, I am willing to try this approach. However, I want regular meetings to discuss any issues that come up.
(それはより合理的に聞こえます。私が権限を保持でき、AIが単純なケースのみを扱うのであれば、このアプローチを試してみる意思があります。ただし、発生する問題について話し合うための定期的な会議を希望します。)
🧑🎓【Student / AI Implementation Manager】:
I appreciate your willingness to work with us. We will schedule monthly review meetings to discuss the system performance and address any concerns. Your feedback will be essential for making this tool work effectively for everyone.
(私たちと協力していただける意思に感謝します。システムのパフォーマンスについて話し合い、懸念事項に対処するために月次の審査会議を予定します。このツールをすべての人にとって効果的に機能させるために、あなたのフィードバックが不可欠です。)
👨💼【Teacher / Senior Claims Assessor】:
Thank you for listening to my concerns and offering these safeguards. I feel more confident about moving forward with this change. Let me know when the training sessions will begin.
(私の懸念を聞いていただき、これらの保護措置を提供していただきありがとうございます。この変更を進めることについてより自信が持てます。トレーニングセッションがいつ始まるか教えてください。)
3. Use (4 min)|ロールプレイ & 実践(空欄補完)
Let's perform the role-play and fill in the blanks by translating the Japanese into English!
空欄の日本語を英語に訳しながら、ロールプレイを実践してみましょう!
Situation / シチュエーション(Reference again)
Persuading local staff to adopt AI technology in claims processing.
テクノロジー導入に抵抗する現地のベテラン層を説得し、業務変革を推進する場面です。
👨💼【Teacher / Senior Claims Assessor】:
Thank you for meeting with me today. I heard that the company is planning to introduce an AI tool for automatic payment decisions. I need to understand how this will affect our work and accuracy.
🧑🎓【Student / AI Implementation Manager】:
I appreciate your [懸念]. Let me [説明する] the purpose of this tool. The AI is designed to [サポートする] your decisions, not replace your [専門知識]. It will [扱う] routine cases and allow you to focus on complex claims that require your experience.
👨💼【Teacher / Senior Claims Assessor】:
I understand the intention, but I have reviewed thousands of claims over 15 years. My judgment is based on details that a machine cannot capture. How can the AI handle cases with special circumstances or unusual medical conditions?
🧑🎓【Student / AI Implementation Manager】:
That is exactly why we need your [専門知識]. The AI will flag complex cases and send them to you for final [審査]. You will have full authority to [承認する] or [却下する] any decision. The system learns from your feedback, so your experience will [改善する] the tool over time.
👨💼【Teacher / Senior Claims Assessor】:
What about the accuracy rate? I am concerned that the AI might make errors that could damage our reputation with customers. We cannot afford mistakes in this business.
🧑🎓【Student / AI Implementation Manager】:
I completely agree. We tested the AI on 10000 past claims, and it achieved 95 percent accuracy on routine cases. For the remaining 5 percent, the system automatically sends the case to a human assessor. This ensures that no payment decision is made without proper [審査] when needed.
👨💼【Teacher / Senior Claims Assessor】:
I see the benefits for routine work, but I still worry about losing control over the process. Will I be able to check the AI decisions before they are finalized?
🧑🎓【Student / AI Implementation Manager】:
Yes, absolutely. We will set up a [審査] period where you can monitor all AI decisions for the first 3 months. You can override any decision at any time. We will also provide training sessions to help you understand how the system works and how to use it [効果的な]ly.
👨💼【Teacher / Senior Claims Assessor】:
That sounds more reasonable. If I can keep my authority and the AI only handles simple cases, I am willing to try this approach. However, I want regular meetings to discuss any issues that come up.
🧑🎓【Student / AI Implementation Manager】:
I appreciate your willingness to work with us. We will schedule monthly [審査] meetings to discuss the system performance and address any concerns. Your feedback will be essential for making this tool work [効果的な]ly for everyone.
👨💼【Teacher / Senior Claims Assessor】:
Thank you for listening to my concerns and offering these safeguards. I feel more confident about moving forward with this change. Let me know when the training sessions will begin.
4. Challenge (7 min)|応用実践
Let's perform the role-play and fill in the blanks by translating the Japanese into English!
空欄の日本語を英語に訳しながら、ロールプレイを実践してみましょう!
*Let's practice this part repeatedly until we can speak it smoothly.
このパートはスムーズにスピーキングできるようになるまで繰り返し練習しましょう。
Situation / シチュエーション(Reference again)
Persuading local staff to adopt AI technology in claims processing.
テクノロジー導入に抵抗する現地のベテラン層を説得し、業務変革を推進する場面です。
👨💼【Teacher / Senior Claims Assessor】:
Thank you for meeting with me today. I heard that the company is planning to introduce an AI tool for automatic payment decisions. I need to understand how this will affect our work and accuracy.
🧑🎓【Student / AI Implementation Manager】:
I appreciate your concern. [このツールの目的を説明させてください。] [AIはあなたの判断を置き換えるのではなく、サポートするために設計されています。] It will handle routine cases and allow you to focus on complex claims that require your experience.
👨💼【Teacher / Senior Claims Assessor】:
I understand the intention, but I have reviewed thousands of claims over 15 years. My judgment is based on details that a machine cannot capture. How can the AI handle cases with special circumstances or unusual medical conditions?
🧑🎓【Student / AI Implementation Manager】:
[それこそがあなたの専門知識を必要とする理由です。] The AI will flag complex cases and send them to you for final review. [あなたはすべての決定を承認または却下する完全な権限を持ちます。] The system learns from your feedback, so your experience will improve the tool over time.
👨💼【Teacher / Senior Claims Assessor】:
What about the accuracy rate? I am concerned that the AI might make errors that could damage our reputation with customers. We cannot afford mistakes in this business.
🧑🎓【Student / AI Implementation Manager】:
I completely agree. We tested the AI on 10000 past claims, and it achieved 95 percent accuracy on routine cases. For the remaining 5 percent, the system automatically sends the case to a human assessor. This ensures that no payment decision is made without proper review when needed.
👨💼【Teacher / Senior Claims Assessor】:
I see the benefits for routine work, but I still worry about losing control over the process. Will I be able to check the AI decisions before they are finalized?
🧑🎓【Student / AI Implementation Manager】:
Yes, absolutely. [最初の3か月間、すべてのAI決定を監視できる審査期間を設けます。] You can override any decision at any time. We will also provide training sessions to help you understand how the system works and how to use it effectively.
👨💼【Teacher / Senior Claims Assessor】:
That sounds more reasonable. If I can keep my authority and the AI only handles simple cases, I am willing to try this approach. However, I want regular meetings to discuss any issues that come up.
🧑🎓【Student / AI Implementation Manager】:
[私たちと協力していただける意思に感謝します。] We will schedule monthly review meetings to discuss the system performance and address any concerns. Your feedback will be essential for making this tool work effectively for everyone.
👨💼【Teacher / Senior Claims Assessor】:
Thank you for listening to my concerns and offering these safeguards. I feel more confident about moving forward with this change. Let me know when the training sessions will begin.
\ If you have some extra capacity, give it a try(余力があればやってみましょう)/
5. Real-world application (5 min)|実務応用
Let's speak freely with the phrases and flow we learned today. If you can, imagine your real job—it makes practice more effective.
本日学習した単語やフレーズ、会話の流れを思い出しながら、自由に話してみましょう。可能であれば、自身の実務を想像しながら話すと効果的です。
Situation / シチュエーション
Your company is introducing an AI tool for automatic payment decisions in claims assessment.
A senior assessor is concerned about accuracy and losing control over the decision process.
あなたの会社は請求査定において自動支払い判断のためのAIツールを導入しています。
ベテラン査定員が正確性と決定プロセスの管理を失うことを懸念しています。
👨💼【Teacher / Senior Claims Assessor】:
I am worried that this AI tool will reduce the quality of our work. Can you explain how it will support us without replacing our judgment?
(このAIツールが私たちの業務の質を低下させるのではないかと心配しています。私たちの判断を置き換えることなく、どのようにサポートするのか説明していただけますか?)
🧑🎓【Student / Your Role】:
(Free Speaking based on today's lesson)
Hints / ヒント
1.Explain the support role of AI(AIのサポート役割を説明する)
2.Describe the authority structure(権限構造を述べる)
3.Present the testing results(テスト結果を提示する)
4.Offer a review period(審査期間を提示する)
※This is not a role-play. Please speak until you finish your thoughts.
このパートはロールプレイ形式ではありません。最後まで通して話してみましょう。
6. Wrap-up (2 min) |レッスンの振り返り
Let's review today's lesson with your teacher!
今日のレッスンについて講師と振り返ってみましょう!
6-1 Comments from student
・Good points / 良かったところ・上手くできたところ
・Things to work on / 今後強化したいところ
6-2 Feedback from teacher
・Good points / 良かった点
・Things to work on / 今後の強化ポイント
・What to review / 復習ポイント
*6-3 Questions from student (if any)
Japanese translation(日本語訳)
1. Read (2min)(型を学ぶ)|基本フレーズ
2. Try (4min)(ロールプレイ練習)|型を使った練習
Let’s practice the role-play.
ロールプレイの練習をしましょう!
3. Use (7min)|応用
Let’s perform the role-play and filling in the missing English!
英語を補完しながら、ロールプレイを実践してみましょう!
4. Challenge (7min)|実践
Let’s perform the role-play and filling in the missing English!
英語を補完しながら、ロールプレイを実践してみましょう!
5. Wrap-up (3min) – レッスンの振り返り
"Let’s review today’s lesson with your teacher!”
「今日のレッスンについて講師と振り返ってみましょう!」
5-1. Comments from Student
- Good points / 良かったところ・上手くできたところ
- Things to work on / 今後強化したいところ
5-2. Feedback from Teacher
- Good points / 良かった点
- Things to work on / 今後の強化ポイント
- What to review / 復習ポイント
5-3. Question from Students (If any)
