Claims processing automation that takes the paperwork off adjusters

AI agents read, check, and route each claim, and your claims team approves

Book a process reviewHow we automate claims processing with your team
Claim 25-1142, kitchen water damageIllustrated
Received
Email, 3 photos, a plumber's invoice
Checked
Policy in force, $1,000 deductible
Missing
Date of loss proof, asked for
Waiting on
Your claims handler's approval

Automated claims processing for the steps your team repeats

From the first email to the settlement letter, on the claims system you run

Take in claims from every channel

Email, web forms, and portals feed one queue, and each claim is read, sorted, and opened.

Check each claim against the policy

Coverage, dates, limits, and missing details are checked before the claim reaches a person.

Pull the facts out of documents

Scanned forms, invoices, and reports are read, and their figures land on the claim record.

Show where every claim stands

Your team and your policyholders see each claim's status, so the follow-up calls stop.

How we automate claims processing with your team

Four steps, from a five-day review to automation your team runs every day

  1. Days 1 to 5

    Map one claim type

    We follow real claims from intake to payment, list every task, and time every wait.

  2. Weeks 2 to 6

    Build in weekly rounds

    Agents take intake, checks, and document reading, inside your tenant and on your core.

  3. Before launch

    Run beside your team

    Agents draft while your handlers work as usual, until the drafts match their decisions.

  4. After launch

    Add the next claim type

    We operate it against the KPIs we agreed, then extend it to the next line or step.

When claims processing automation is the right fit

And when another kind of help would serve you better

A good fit when
  • Your handlers spend more time keying claims than deciding them
  • Policyholders call to ask where their claim stands
  • A storm season doubles your queue and the backlog takes weeks to clear
Look elsewhere when
  • You want to replace your claims core in one cutover
  • Your claims arrive in one clean format and none of them wait
  • You need extra adjusters on the ground, not software

Insurance claims automation in detail

What each part covers, from first notice of loss to the settlement

Why manual claims processing slows settlements

Most claims still move by hand. Someone reads the first notice of loss, chases the documents, checks the policy, keys the details into the claims system, and passes the file to an adjuster.

Each of those five handoffs adds a wait. Your adjusters spend their day on clerical work, and your policyholders wait for an update nobody has time to send.

Automated claims intake

Claims reach you by email, web form, portal, and phone. An agent reads each one, finds the policy, sorts the claim by type, and opens it in your claims system with every attachment in place.

A claim that arrives at 11 pm is ready for review at 8 am. Nobody re-keys a form, and nothing sits unread in a shared inbox.

Intelligent validation and claim routing

Every claim is checked against the policy and your rules before a person sees it: coverage, dates, limits, deductibles, and the documents still missing. The agent asks the claimant for what's missing, so the file is complete when it reaches your team.

Then the claim goes to the right desk. Simple claims go to a fast lane, and claims with injuries, large reserves, or signs of fraud go to a senior adjuster or your special investigations unit.

  • Coverage and limit checks on every claim
  • Missing documents requested automatically
  • Routing rules your managers can read and change

Smart document handling

A single claim can carry a police report, repair invoices, medical bills, and photos. Agents read scanned and digital files, pull out the amounts, dates, and names, and attach them to the claim record.

Your adjuster opens one file with the facts already laid out, and each figure links back to the page it came from.

Real-time claim status tracking

Managers see every open claim on one screen: where it is, who has it, and how long it has waited. Bottlenecks show up in the first week, not at the month-end report.

Policyholders get updates by email or text at each step, written from the claim record. Fewer calls reach your team, and the ones that do are about decisions, not status.

Straight-through processing, with a person on every payment

For simple, low-value claims, automation can take a claim from intake to an approval screen in minutes. Your handler reviews the complete file and approves it in one look, inside the authority limits you set.

Every step an agent takes is on the record, with the rule it applied and the person who approved it. That gives auditors and regulators a clear trail, and it lets you absorb a catastrophe week without hiring temporary staff.

Questions about claims processing automation

What claims leaders ask us before they start

Why do I need claims processing automation?

Manual claims processing is slow and error-prone, because every claim is read, checked, and keyed by hand. Automation takes those routine steps, so your adjusters spend their time on the claims that need judgment. You handle more claims with the same team, and policyholders hear back sooner.

Can claims automation work for different types of insurance?

Yes. We automate claims for auto, property, life, health, and specialty lines, with rules set for each product. A homeowners water claim and a life claim follow different steps, and each gets its own checks.

Can it connect with the claims system we already use?

Yes. We build on the core you run through its APIs, whether that's Guidewire, Duck Creek, Majesco, Sapiens, a homegrown system, or InsureEdge. Your claims system stays the record, and the agents work on top of it.

Will claims processing automation scale as we grow?

Yes. Agents don't tire in a catastrophe week, and adding a new line or region means adding its rules, not rebuilding the system. We start with one claim type and extend it once the first one pays off.

Do AI agents approve or deny claims on their own?

No. Agents draft, check, and route, and every payment, denial, and reserve change waits for a person. Each agent signs in as a user with its own permissions, so it can't do more than you allow.

How do I get pricing for claims processing automation?

Pricing depends on the claim types, the volume, and the systems we connect. We start with a five-day process review of one claim type, then quote the build and the monthly cost to operate it.