Claims Automation
Claims automation that keeps the decision accountable
First notice of loss, document intake, coverage checks, and status updates run continuously — while every recommendation carries a reasoning trace an adjuster and an auditor can both read.
Cycle time on low-complexity claims
Cost per claim handled
Reasoning trace on every action
The constraints this work removes
Intake is manual and uneven
FNOL arrives by phone, email, portal, and PDF. Re-keying it into the claims system consumes adjuster hours before any judgment happens.
Cycle time is set by queues, not complexity
Simple claims wait behind complex ones. Severity is discovered late, so reserves and routing lag the actual exposure.
Status chasing eats the day
A large share of inbound volume is claimants asking where things stand — work that produces no decision and no coverage outcome.
Capabilities
Automated FNOL intake
Voice, email, and document channels normalized into structured claim records in your policy admin or claims platform.
Document and evidence extraction
Estimates, police reports, medical bills, and photos parsed into the fields adjudication actually uses, with confidence scores.
Severity triage and routing
Claims scored and routed at intake so complex files reach senior adjusters immediately and straightforward ones move.
Proactive status communication
Claimants receive milestone updates automatically, removing the inbound status volume from the queue.
Adjudication support with a trace
Coverage checks and recommendations presented with the evidence behind them — the agent proposes, the adjuster decides.
Fraud-aware review flags
Pattern signals surfaced to SIU at intake instead of after payment.
See it against your own numbers
We start with a diagnostic on your current workflow, then run a parallel-control pilot so the lift is measured, not asserted.
Book a call