Claims Agent
From notification to payment, on its own.
Not a chatbot, an insurance specialist. Runs simple, high-volume claims end-to-end, first notice through payment, and hands the edge cases to an adjuster with the assessment ready. The code is yours.
- Reference masters
- Documents & forms
- Historical data
- Drafted communications
- Audit-ready evidence
- Exception flags
Why this work breaks at scale.
It burns senior time on low-judgment steps and leaves no clean trail of why each call was made.
What the Claims Agent does for your team.
Deterministic where it matters
Regulated or high-stakes steps follow fixed, testable workflows, generative help is reserved for drafting and ideation.
Reads what you already have
Ingests documents, records, and messages in the formats your insurance stack produces, no clean-room data prep required.
Writes a complete audit trail
Every step is timestamped and reversible, giving you 100% coverage for internal review and external audit.
Human-in-the-loop by design
Routine cases run end-to-end; anything above your confidence or value threshold is routed to a person with the full context attached.
Quote, bind, and pay, without the swivel-chair.
Listen
Watches the queue, inbox, or event stream for new work to pick up.
Analyse
Cross-references each item against policy, history, and live context.
Recommend
Surfaces a scored recommendation with the evidence behind it.
Hand off
Acts autonomously below threshold; routes to a person above it.
- Reference masters
- Documents & forms
- Historical data
- Email & chat
- Drafted communications
- Audit-ready evidence
- Exception flags
- Posted transactions
Deployed into the systems you already run.
No rip-and-replace. The Claims Agent connects to your existing insurance tooling and writes back to your system of record.
Deployed for High-volume claims teams — lower cost to settle.
The practical details.
Every action is logged, reversible, and traceable to source, giving you 100% audit coverage. The platform is SOC 2 compliant and deployable in your private cloud or on-prem.
A first version typically runs against your own data within weeks, the first agent can be live in as little as 48 hours, with full deployment in two to eight weeks.
Yes. You own 100% of the IP, code, and documentation. There is no platform lock-in and the full system transfers to your team.
No. It removes the low-judgment, repetitive work and routes anything consequential to a person with the context attached, so your team spends time where judgment actually pays off.
Policy Agent
Plain-language answers on the hardest clauses.
Submission Agent
Broker submissions, triaged in minutes.
Claims Document Intelligence
Reads the bills, estimates, and reports.
Risk & Guideline Validation
Every applicant, checked before you bind.