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Insurance / Claims operations

Moveclaimsintakefromdocumentqueuetogovernedcaseworkflow.

Turn claim intake signals into structured situations, triage recommendations, human approvals, and governed case actions — with evidence at every step.

Run a workflow assessmentReview Governance & Trust
Claims handler reviewing intake queue and damage photos with triage recommendations

ClaimsIntake&Triage

First-notice-of-loss arrives as mixed documents and media. Handlers repeatedly classify, re-key, and chase missing information before coverage or triage review can begin.

Improve

Intake completeness

Reduce

Time to triage

Reduce

Rework rate

Track

Handler throughput

Currentworkflow

  1. 01Receive FNOL
  2. 02Read and classify attachments
  3. 03Re-key claim fields
  4. 04Request missing evidence
  5. 05Triage and assign

Targetworkflow

  1. 1

    Intake

    Ingest documents and media inside the tenant boundary.

  2. 2

    Structure

    Create claim, claimant, policy, and evidence objects with confidence.

  3. 3

    Check

    Identify missing information, coverage cues, and review signals.

  4. 4

    Review

    Present a cited triage proposal to the claims handler.

  5. 5

    Assign

    Create approved tasks and preserve a complete decision trail.

Required data

  • FNOL forms and email
  • Policy administration
  • Claims core system
  • Photographs and reports
  • Document management

Business objects

ClaimPolicyClaimantEvidence itemCoverage cueTaskDecision

Human approval gates

  • Triage disposition
  • Coverage interpretation
  • Fraud escalation
  • Financial recommendation

Governance profile

  • Matter-scoped access
  • No autonomous payout decision
  • Cited extraction and confidence
  • Mandatory handler approval

AIco-workers

Intake co-worker

Classifies submissions and proposes structured claim fields.

Triage co-worker

Summarizes evidence, missing data, and routing options.

QA reviewer

Checks completeness, citations, and policy-gate compliance.

Evidenceoutput

Claims Intake & Triage

  • Original submission lineage
  • Field-level confidence
  • Policy references
  • Handler approvals
  • Case audit trail
Deployment boundary

Tenant-isolated workspace integrated with existing claims and document systems.

Scope this workflow

Relateduse-casepatterns

Pilot

Claims Intake Copilot

Extract structured data from FNOL documents, photos, and correspondence — then route cases through policy-gated triage with full audit trail before adjuster assignment.

View pattern Reference

Underwriting Review Agent

Assist underwriters with governed retrieval over submission documents, rating manuals, and exclusion rules — every recommendation requires human sign-off before quote generation.

View pattern Reference

Policy Document Intelligence

Brokers and internal teams query policy wordings, endorsements, and exclusions — answers cite source clauses and respect data access boundaries.

View pattern

Bring us one operational problem.

You do not need a finished brief. Bring the problem — we will work out the next step together.

Or book a call with the team