Insurance Claims Automation
AI that processes insurance claims from first notice through payout. These systems ingest documents, validate coverage, detect fraud, and auto-decide straightforward claims—learning from adjusters' decisions. The result: faster settlements, lower costs per claim, and adjusters focused on complex cases.
The Problem
“Claims ops is drowning in documents and exceptions—costs climb while cycle times slip”
Organizations face these key challenges:
Adjusters spend hours re-keying data from PDFs, emails, medical records, and photos into multiple systems
Cycle times spike during CAT events or seasonal peaks, creating backlogs and poor customer NPS
Inconsistent decisions and payout amounts across adjusters due to complex policy language and variable documentation quality
Fraud signals are missed or escalated too late because triage is manual and SIU capacity is limited