AI Claims Automation
AI that reads the FNOL, gathers the evidence, and moves clean claims to settlement while adjusters focus on the ones that need judgment.
Most claims are slow not because they are complicated but because someone has to read the notice of loss, chase the documents, check coverage, and type the same facts into three systems. We build AI claims automation that does that work: it extracts the loss details from forms, photos, and emails, verifies coverage against the actual policy, estimates severity, and routes each claim down the right path. Straightforward claims move toward fast settlement with every step logged, while injuries, coverage disputes, and suspected fraud go straight to an adjuster with the file already assembled. The system runs in your environment, follows your claims handling guidelines, and leaves a complete audit trail for regulators and reinsurers.
Ingest FNOL forms, photos, estimates, and correspondence, then extract structured loss facts with citations back to each source.
Verify coverage against the bound policy and endorsements, and score the claim for severity, complexity, and fraud indicators.
Route clean claims toward fast-track settlement and send complex, injury, or flagged claims to an adjuster with the evidence organized.
Log every extraction, decision, and adjuster override so the process is auditable and the models keep improving on your book.
What it does
FNOL intake extraction
Reads loss notices, photos, and unstructured emails into structured claim facts, with each field traceable to its source document.
Coverage verification
Checks the reported loss against the actual policy wording and endorsements, flagging gaps and exclusions before money moves.
Severity and fraud triage
Scores each claim for expected severity and fraud indicators so fast-track, standard, and investigation queues fill themselves.
Adjuster in the loop
Complex and flagged claims route to a human adjuster with the file pre-assembled. Settlement authority stays with your people.
One carrier moved 43 percent of auto claims to same-week settlement and cut average cycle time from 18 days to 6.
Questions, answered
Only within the bands you define. Clean, low-severity claims can auto-advance through steps you approve, while anything involving injury, coverage doubt, or fraud indicators always routes to an adjuster.
The intake models are built for real claim files: phone photos, scanned estimates, and rambling emails. Every extracted fact carries a citation so an adjuster can verify it in seconds.
Yes. We integrate with your core claims platform rather than replacing it, so the AI reads from and writes to the systems your adjusters already use.
Every decision, data source, and override is logged, and routing follows your written claims handling guidelines, so you can show regulators exactly how each claim was processed.
Bring ai claims automation to your team
Book a free consultation and we'll map the fastest path to production.