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AI Claims Intake & Triage

Automate Claims Intake. Triage Instantly.

Your AI Claims Intake & Triage Teammate receives first notice of loss across every channel, classifies severity in real time, routes claims to the right adjuster, and populates claim files — automatically. No manual data entry. No delays. No dropped claims.

SOC 2 Compliant HIPAA Ready Fully Auditable
What This Teammate Does

End-to-End Claims Intake & Triage — Fully Automated

From the moment a claim is reported to the second it reaches the right adjuster, your AI teammate handles every step with speed and precision.

Omnichannel FNOL Capture

Receives first notice of loss from phone, email, web portal, mobile app, and agent submissions — consolidating every claim into a single, structured record automatically.

Real-Time Severity Classification

Analyzes claim details, loss descriptions, and supporting documents to classify severity instantly — flagging high-priority and catastrophe claims for immediate attention.

Intelligent Adjuster Routing

Routes each claim to the optimal adjuster based on expertise, workload, jurisdiction, and line of business — eliminating bottlenecks and ensuring balanced distribution.

Automated Claim File Population

Extracts data from submitted documents, emails, and forms to populate claim files with policy details, coverage information, and loss data — zero manual entry required.

Duplicate & Fraud Detection

Cross-references incoming claims against existing records and known fraud patterns, flagging duplicates and suspicious submissions before they enter the pipeline.

Policyholder Communication

Sends instant acknowledgments, provides claim reference numbers, and delivers status updates to policyholders — keeping everyone informed without adjuster intervention.

Who It's For

Built for Insurance Leaders Who Need Speed & Scale

Designed for the executives and operations leaders responsible for claims performance, cost management, and customer experience.

Claims Operations Leaders

VP of Claims, Claims Directors, and Heads of Claims Operations who need to reduce cycle times, improve accuracy, and handle surge volume without adding headcount.

  • Reduce first-contact resolution time
  • Eliminate manual intake bottlenecks
  • Improve claims accuracy at scale

COOs & CFOs

C-suite executives accountable for operational efficiency, cost per claim, and BPO spend — looking for measurable ROI without multi-year transformation programs.

  • Cut cost per claim by 40–60%
  • Replace or reduce BPO dependency
  • Demonstrate ROI within 30 days

Heads of Shared Services

Leaders managing centralized claims operations across multiple lines of business who need consistent, scalable intake processes that don't break under volume.

  • Standardize intake across LOBs
  • Handle CAT surge without temp staff
  • Centralized audit & compliance
What It Replaces

Replace Manual Intake with Intelligent Automation

AI Claims Intake & Triage directly displaces costly, error-prone manual processes — without disrupting your existing workflows.

Traditional Model
AI Teammate
Manual FNOL data entry teams
Automated omnichannel capture
Outsourced TPA intake processing
In-house AI with full audit trail
Manual severity assessment & routing
Real-time AI triage & routing
Spreadsheet-based claim tracking
Structured claim file auto-population
Temp staff during CAT events
Elastic AI capacity on demand
Measurable Impact

KPIs That Move the Business

Every AI Claims Intake deployment is benchmarked against the metrics that matter most to insurance operations leaders.

60%Faster Cycle Time

First-contact resolution time drops from hours to minutes with automated intake, classification, and routing.

40–60%Lower Cost Per Claim

Eliminate manual data entry labor, reduce BPO dependency, and cut overhead on every claim processed.

↓35%Reduced Leakage

Accurate severity classification and fraud detection minimize overpayments, missed subrogation, and reserve miscalculations.

90%+Auto-Classification Rate

Over 90% of incoming claims are classified and routed without human intervention — freeing adjusters for complex cases.

0Temp Staff Needed for CAT

Handle catastrophe-level claim surges without hiring temporary staff — AI scales elastically to meet demand.

99.9%Data Capture Accuracy

Automated extraction from documents, emails, and forms ensures near-perfect data fidelity from first touch.

Seamless Integration

Connects to Your Existing Claims Systems

Your AI teammate integrates with the policy admin, claims management, and document systems you already use — no rip-and-replace required.

Guidewire ClaimCenter

Native integration with Guidewire ClaimCenter for claim creation, status updates, and adjuster assignment workflows.

Duck Creek Claims

Bi-directional sync with Duck Creek for policy verification, claim file population, and automated workflow triggers.

Email & Portal Systems

Monitors shared inboxes, web portals, and mobile submissions — extracting claim data from unstructured communications automatically.

Document Management

Integrates with OnBase, ImageRight, and other ECM platforms for automated document classification and indexing.

Majesco & Custom PAS

Connects to Majesco, custom policy admin systems, and legacy platforms via secure APIs and RPA bridges.

API & Webhook Support

RESTful APIs and configurable webhooks for any system not covered by out-of-the-box connectors — fully extensible.

Deployment Timeline

Live in Weeks — Not Quarters

A structured, phased deployment that delivers measurable results from the first sprint. No multi-year transformation required.

Week 1–2

Discovery & Configuration

  • Map existing intake workflows and claim types
  • Configure system integrations (ClaimCenter, Duck Creek, etc.)
  • Define severity classification rules and routing logic
  • Set up governance controls and audit logging
Week 3–4

Pilot Launch & Validation

  • Deploy AI teammate on a selected claim type or LOB
  • Human-in-the-loop validation of classification accuracy
  • Benchmark KPIs: cycle time, accuracy, cost per claim
  • Iterate on routing rules based on real claim data
Week 5+

Scale & Optimize

  • Expand to additional claim types and lines of business
  • Continuous model improvement from adjuster feedback
  • Onboard additional teams and adjust routing rules
  • Quarterly business reviews with ROI benchmarking
Governance & Trust

Enterprise-Grade Security for Claims Operations

Every decision is auditable. Every action is governed. Built from the ground up for regulated insurance environments.

Human-in-the-Loop by Default

Every high-severity claim and edge case routes to a human reviewer. AI handles the volume — adjusters retain decision authority.

SOC 2 Type II & Audit-Ready

Full decision audit trails, role-based access control, and compliance logging designed for DOI examinations.

Data Residency & Encryption

Data residency controls, AES-256 encryption at rest and in transit, and configurable retention policies for every jurisdiction.

Works With Legacy Core Systems

Connects to Guidewire, Duck Creek, Majesco, and custom policy admin systems via secure APIs and RPA bridges.

Get Started in 30 Days

Launch Your AI Claims Intake Pilot

See measurable results — reduced cycle times, lower cost per claim, and higher accuracy — within your first month. No multi-year commitment. No rip-and-replace. Just results.

Live in 2–4 Weeks SOC 2 Type II Human-in-the-Loop No Data Lock-in