Financial Services agent
Insurance claims handling
Triage severity at intake, complete the mechanical lifecycle work, and settle simple claims the day they arrive.
What it does
The agent triages severity at first notice of loss, validates the estimate against coverage limits, completes the mechanical lifecycle work, and settles the simplest claims straight through. An adjuster decides everything else.
Without it: Simple claims wait behind complex ones, and the overpayments nobody had capacity to review are reviewed by nobody at all.
- Fraud indicators at first notice route the file to special investigations, never to settlement.
- Chases the missing police report or repair invoice instead of parking the file
- Photos and third-party attachments are opened in a disposable environment per claim
- The reserve and the coverage check are posted before an adjuster opens it
Illustrative example
FNOL-88231 comes in through the broker portal: a windscreen replacement on policy MTR-4419-06, estimate $610, comprehensive cover with a $250 excess. The agent triages it as simple, checks the estimate against the limit, requests the one missing repair invoice from the shop, and settles the $360 net on a sanctioned payment path. No adjuster opens the file, and the triage path, the coverage check, and the payment sit on the claim record.
Claims platform
Open claims, reserves
Policy admin
Cover, limits, excess
Payment rails
Sanctioned payment paths
Document intake
Photos, repair invoices
Insurance claims handling
ExecuteStarts when
A first notice of loss arrives by phone, portal, or broker
How far it goes
it acts inside set limits, and every call is logged
Never
DENIAL: enforced below the model, not asked of it
FNOL
Triaged by severity
Estimate
Checked against limits
Simple claims
Settled same day
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Case studies
View all
Insurance · Solution blueprintClaims Processing Automation, FNOL to SettlementSimple claims settle in under a day, so adjusters reach the complex ones.Read case study →
Insurance · Solution blueprintThe Bad-Faith Exposure Hiding in Inconsistent DenialsEvery decision is logged as it happens, so the reasoning survives the file.Read case study →
Insurance · Solution blueprintA Million Unvetted Files Reach a System That PaysEach file opens in a disposable VM with no path to the payment rails.Read case study →
Insurance · Solution blueprintRecovering What Was Overpaid and Never ReviewedA carrier paying $500M a year across 250,000 claims cannot check them all.Read case study →
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